ELECTRICITY IN DYSTOCIA.

BY HANNAH TYLER WILCOX, M.D., CHICAGO, ILL.

THE worthy chairman of this bureau, at a late hour, asked me to write upon the use of electricity in dystocia, and as time to prepare my thoughts has been so limited, I beg your lenient criticism.

Electricity as a therapeutic agent has but recently received attention from the medical world. I do not know that our early fathers in medicine understood it, even so late as our beloved Hahnemann. As the great motor agent in the mechanical and economic world, we have just begun to understand it; as a great therapeutic agent, no one who observes can doubt its future merit.

I remember at the meeting of this Institute, some eight years ago, at Saratoga, the words of my worthy colleague, Dr. Comstock. He said, "I believe that electricity will, in the near future, become the great therapeutic agent," and as time advances, I am convinced of this fact. Is is a similia when the tired nerves are crying for more food; it is this life-force that can supply the little capillaries so speedily. But that we have learned to potentize it, according to our nomenclature, is not even thought of. An Edison or a Tesla may, with their genius, accomplish this.

What is electricity? We all would like to know. No satisfactory definition has ever yet been given, though the greatest scientists, in this research, define it now as 66 waves of ether in motion, more than 757 billions of times in a second." For we know that this number of waves between 400 billions and 757 billions produces light and heat, and we all know that it far exceeds light and heat in power, though it comprises both. Who can comprehend 757 billions of waves of motion in a second? None but the Infinite mind.

That it has dynamic force more minutely potentized than the chiefest Hahnemannian could conceive of, that it has oxytocic power, we cannot deny. In gynecology it is taking high rank by such men as Apostoli, and supplanting many remedies. I have found

that it has saved me the use of forceps sometimes, and in dystocia it stimulates the exhausted nerves not only of the uterus, but the whole nervous system. It excites true pains. Severe pain often suspends uterine action. The sensory nerves, when quieted, will aid the motor nerves to their full energy. It may take the place of Ipecac, Ergot and other oxytoxics. The rigidity of cervix is often occasioned by debility, and this is a stimulus. The muscular fibres have no such responsive stimulus as electricity.

I have found great service if mechanical obstruction be not present. It may take the place of Ipecac, Sabina or Ergot as a prophylactic in post-partum hæmorrhage. It is a great hæmostatic. It gives courage to the patient in feeling that something is being done to relieve her suffering. This may be psychological, but any agent is acceptable, and I believe the frequent use of the forceps, with its accompanying tears and ruptures, will be in the future superseded by electricity; for it will excite all uterine nerves and contractions that neither unaided nature or the indicated remedy can do. Subinvolution is frequently removed by it.

THE VALUE OF PREPARATORY TREATMENT IN PARTURITION.

BY J. W. MEANS, M.D., TROY, OHIO.

THE management of labor is a trite subject, one that has been fully discussed by the medical profession in and out of season. The position of the woman, stages of labor, presentation, drugs, sepsis-all have been so ably handled that it would seem like sacrilege to impose further discussion upon an already thoroughly equipped practitioner. But theory alone does not impart the necessary information. The young practitioner is as completely at sea in his first labor case as a blind man in a canebrake. Practical experience alone educates the touch, the ear and that faculty known in common parlance as "common sense." Hence it is of no practical value to enter into a long dissertation on the imaginary lines and diameters of the foetal head and their relation to the pelvis. Labor is a mechanical process, and the application of the laws of mechanics at this critical period by the accoucheur will overcome all obstacles compatible with nature's inexorable laws. What is more interesting and of far more practical value to the busy practitioner is, Can we benefit our patients? Can we shorten the stages of labor by preparatory treatment? This is a subject that deserves our profound attention, and if we can demonstrate to the satisfaction of our medical brethren that the pangs of labor can be in a measure alleviated and the hours of suffering lessened we will then have accomplished the object sought.

That the subject may be presented in a tangible form I will append an analysis of 270 confinement cases which have been recorded with an object in view of determining the comparative value of medicinal treatment and non-medical treatment during gestation on the parturient act.

Of the series of 270 cases reported, 200 had preparatory treatment, 70 had not preparatory treatment. There were in all 17 cases

of forcep delivery, 11 of which occurred in the group of 70 not having preparatory treatment, and 6 cases in the group of 200, all of which had treatment during the last six weeks of gestation. In other words, 14 per cent. of the labor cases not having preparatory treatment were delivered with forceps, while in those having preparatory treatment only 3 per cent. were delivered with forceps. The duration of labor in those not receiving preparatory treatment 7 hours; those receiving, 5 hours.

In justification of this seemingly large forcep delivery, which would be about 6 per cent. of all cases when Cazeaux & Tarnier place the instrumental deliveries at about three-quarters of 1 per cent., would say that the authors referred to evidently base their information on the reports of that class of physicians who do not possess a pair of forceps or do not know how or when to use them, but depend upon some foreign consultant when the life of the patient has been depaired of.

It has been my practice to use forceps in all cases when delivery has been delayed, provided there is full and complete dilatation of the os uteri, even in that class of cases where delivery would have been effected by nature, but only after hours of violent and exhaustive labor and at the expense of great vital loss. It is the duty of the accoucheur to conserve the vitality of his patient and by the judicious use of the forceps, as soon as he can with safety to mother and child, assist nature in her expulsive efforts.

The preparatory treatment referred to consists in the administration of Cimicifuga racemosa, 6x trituration, a 1-grain tablet three times a day during the last two months of gestation. Experience has taught me that in almost every instance where Cimicifuga has been given the first stages of labor are very materially shortened and the suffering greatly diminished. It has a powerful effect to relax the fibres of the os uteri, so that the dilatation is more readily effected. It gives vigor and tone to the expulsive efforts of the womb, and I am convinced that the first and second stages of labor are made more endurable by reason of this tonic effect imparted to the muscular fibres of the womb. Again, the psychic effect on the patient is beneficial. That miserable dejected feeling, fear of death, thinks she is going crazy, so common during the months of gestation, are usually dissipated and the present and future are devoid of those forebodings of evil that threateningly hover around and about the enceinte. Peace

of mind is conducive to health, and it is only when you have that restful feeling, the result of confidence, that the sympathetic nervous system vibrates rhythmically, and this insures harmonious action and perfect health.

Another important and exceedingly beneficial effect of Cimicifuga on the muscular fibres of the womb is to impart to them that property of contractility and elasticity so necessary in the expulsion of the child and also in the prevention of laceration of the cervix uteri. I am safe in saying that not one-half of the confinement cases in which laceration of the cervix uteri result would occur were Cimicifuga given in the last six weeks of gestation and Ergot banished from the armamentarium of every physician in the land.