Reports of Societies

1912 BMJ (Clinical Research Edition)  
Medical Officer.) J. B., aged 19, unmarried, and pregnant for the second time, was admitted from the workhouse to the lying-in ward on September 4th, 1912, at 4.30 a.m., when she first complained. of pains. At 4.45 a.m. she was delivered of a female child weighing 7 lb. 10 oz. The labour was easy and normal and the loss moderate. She appeared perfectly well until 5.10 p.m. (twelve and a half hours after delivery), when she suddenly became blind; she was unable to distinguish light from
more » ... light from darkness, and complained of severe headache. A catheter specimen of urine withdrawn at 5.20 p.m. contained a thick cloud of albumen, but no casts and no deposit. An enema was given, but returned clear. At 7.10 p.m. she vomited. At 7.30 she had a typical eclamptic convulsion, which was treated by chloroform inhalation. At 8.7 p.m. she had a second convulsion, more severe than the first, the face becoming eyanosed. At 9 p.m. the stomach was washed ouit by means of a rubber tube and glass funnel, a solution of sodium bicarbonate, one drachm to the ounce, being used; some greenish fluid was withdrawn; six drachms of magnesium sulphate dissolved in one ounce of water were left in the stomach. At 9.10 p.m. the patient had a convulsion; blankets and hot bottles were packed round her. 9.55 p.m. A convulsion; 1 pint of normal saline solution was infused under the left breast. 11 p.m. She vomited greenish fluid; pulse 102. Convulsions followed at 11.45 p.m., and on September 5th at 12.35 a.m., 1.15 a.m., 1.45 a.m., 2.30 a.m., and 3.5 a.m. At 4 a.m., the bowels not having acted, a drop of croton oil was placed on the back of the tongue. At 4.10 a.m. a hypodermic injection of morphine sulphate i-grain was given. At 4.20 a.m., the patient being restless, chloroform inhalation was repeated and one pint of normal saline solution was infused under the right breast. At 5.50 a.m. she had another convulsion, and again at 9.55 a.m. Temperature 980 F., pulse 88. 10.5 a.m. Hypodermic injection of morphine sulphate & graiin. Still no action of bowels, so croton oil repeated. 11 a.m. Continuous rectal infusion of normal saline solution begun and continued until .12.25 p.m., but not well retained. At 11.3 a.m. convulsion; vomited greenish fluid. 11.20 a.m. Convulsion; very eyanosed. 12.30 p.m. Convulsion; chloroform given continuously. At 1.40 p.m. the patient was removed on a stretcher to a ward of the South Inifirmary, being kept under chloroform during the transfer; on arrival there a vapour bath at 1200 F. was given for half an hour; the skin reacted well. Up to this point she had had fifteen convulsions in six hours, and had remained unconscious during the whole time. At 2.45 p.m., convulsion; chloroform inhalation recommenced; vomited about 4 ounces of greenish fluid. 3 p.m. Hypodermic
doi:10.1136/bmj.2.2709.1548-a fatcat:dk534ggnznewzabp66e7hsmuuu