Successful Case of Caesarean Operation: Mother and Child Saved
Authors: J. Hawkins
Journal: BMJ (1858)

particular from other siimilar cases can lhardly be considered a very strong argiument either way.In a case which we reported last year (pp. 125, 252,vol.for 1857), the presence of a fatty tumoour )ressing onI the cord had occasioned convulsive move- ients; but in the present case there seemed to have been no prlessure, and there was no historv of convulsions.Wlhether, if the tumour had been left to growv, tllese symptoms might not have followed, it is not easy to say,; but it seems probable that theywould.The secon(d case is also interesting, from the length of tilue wlhich the symptoms lasted; and further, as showing the reguilarity with wlhich union progressed, anid the success with wlhiclh the fracture was treated, in a subject agitated wvith constant tetanic spasms.CASE I. Henry D., aged 31, was admitted March 14th, 1858, under the care of Mr. Johnson, with a scald from hot water, received half an hour before.He was quiet and sensible on admission.The upper and inner part of both thighs, genitals, nates, and lower part of the body, were scalded.March 15th.He had slept well; the pulse was quiet duriing the day; the appetite good.In the afternoon, when about to be dressed, the boy was lving on his back; he gave a sudden start, and all the muscles of the body became con- vulsed; the face was livid; the eyes fixed and staring.He was insensible.A short time afterwards, spasms came on like general tetanus, chiefly about the mouth; there was trismus to a certain extent; the pulse was rapid; the bowels were not open. 1 Pulv.ipecac.comp.gr.iij; hydrargyri chloridi gr.iij.Ml.Fiat pulvis statim sumendus.] Syrupi papaveris 3 ss; haustuLs salin.hiss.M. Fiat haustus 4tis horis sumendus.Tlhroughout the day the spasms continued at intervals, chiefly about the face; lie was restless; the eyes were fixed; he ap- peared to be in no pain, but took no notice of his frienlds.The pulse varied remarkably even in two minutes; the spasms were never more than momentary.March l3th.The bowels were not open.Soap and water injection was given effectually.He was pretty quiet and in- sensible during the niglht; the spasms were few and slight.The pupils wvere much contracted.The face was flushed; the skirn cool; pulse 120, weak.The poppy s'yrup was omitted; and he was ordered to have port wvine and beef-tea.He did not take nmuch food.March lth.He was quiet, and stared about, apparently seeing n-othing; pulse feebler, but stronger during the day.He became quite sensible, and put out his tongue when asked; he was very restless in bed, and refused beef-tea, but took mill.No spasms occurred.In the evening, lie was quiet again, and lay as if awake; but took no notice of his friends.Pulse weaker.The scalded surface was looking unhealthy.Mlarch 18tlh.He was improved, and was more sensible; he nioticed his friends, and took a little food.The bowels weore open; and he passed urine.Marchl19th.The burn was sloughing.The boy was often found dosing, with the head always thrown hack.No spasms occurred.He refused food, but took wine.March 20th.The pupils were verv dilated; pulse weak and quiet.The head was thriown back; but there were ino spasms.T're burns were very unhealth; bowels not open; tongue coated.March 21st.He was in the same state, always restless when touched.He took nothing but wine.He passed urine.He was decidedly opisthotonic.Sordes were present about the miouth.March 22'nd.He was less strong, more comatose.The eyes were little sensible to light and touch; the pupils dilated.He. was very restless; took milk and wine; put out his tongue when asked.Duling the evening, he screamied out repeatedly, and was verv restless, rolling on the face and back.He was semi-comatose; the eyes were fixed; he noticed nothing; tongue dry and brown; bowels open.The head was thrown back, so that it nearlv touched the scapulae.March 23rd.He died at a quarter to 8 A.M.