About a year afterwards, however, the disease returned. Paracentesis was again performed several times, and a tumour was perceived to have formed in the lower part of the abdomen. The patient died in about five or six months from the re-appearance of the effusion. On dissection, much water was found in the abdominal cavity, which was lined by a dense, white, and rough looking membrane, of a fragile and diseased structure. The intestines behind this membrane, were unusually small, and of a dark leaden colour. The tumour above alluded to, was discovered to be situated in the region of the right ovarium; it was a tubercular, carcinomatous, and pale coloured fungus, possessing a structure not unlike that of the placenta, and was formed in the interior of the sac, which being traced further back, was found to be the cyst of a dropsy, originating in the right ovarium at the fundus of the sac, or "more properly speaking of its neck."
"The foregoing statement," Mr. O. remarks, "involves four facts and questions of considerable importance in pathology. 1st. The great quantity of fluids evacuated in so short a space of time: no less than ninety-six quarts in eight months, by four operations; and fifty-nine quarts from August to December, 1824, by three. 2nd. The variety in the nature, consistence and colour of these fluids. 3d. The possibility of curing ascites and dropsy of the ovaria, by exciting inflammation in the abdominal sac, either by the admission of air into it, or mechanical irritation; and 4th. The possibility of a thickening of the parietes of the abdomen by inflammation, or by an exudation of a carcinomatous sort, being mistaken for a tumour rising out of the pelvis."
33. Artificial Respiration.—Dr. J. Ware of Boston, relates in the New England Jour. for April last, that he was led by the experiments of the justly celebrated physiologist Mr. Brodie, to employ artificial respiration in the case of an infant 9 weeks old, whose system was prostrated from an over dose of laudanum. "The action of the heart was reduced to an occasional throb; the pulse had entirely ceased, and the efforts at respiration, which for some time had consisted merely in an occasional gasp, became more and more unfrequent." The child had been afflicted for five or six weeks with hooping-cough, and had been very sick and feeble when the laudanum (about 15 drops) was administered.
By means of the stem of a tobacco-pipe, artificial respiration was excited, and continued for several minutes: the action of the heart was immediately renewed, and the pulse could be again felt. At the end of an hour, during which the artificial respiration was repeated at intervals; "the respiration became natural, the pulse distinct and tolerably strong, and the heat began to return." A fit of coughing, preceded by a livid appearance of the forehead and face, arrested the breathing, "which did not return till assisted by the artificial process." The child, assisted by these measures, and by attention to the more usual means of recovery, struggled through the night, but died during a paroxysm of coughing in the morning.
The conclusions of Mr. Brodie are, that narcotics destroy life through the organs of respiration, and hence, if respiration can be artificially carried on until the effects of the narcotic subside, life may be preserved. Dr. Ware's case would seem to confirm this idea; for it is probable his patient would have recovered from the effects of the narcotic, if the paroxysms of coughing had not interfered.
34. Secale Cornutum.—Mr. Charles Waller has lately published (London Medical and Physical Journal, April 1826,) several cases illustrative of the action and efficacy of secale cornutum. We have not room for any of the cases, and content ourselves with transcribing Mr. W.'s inferences. These are: "That the secale cornutum is a remedy which is capable of increasing the force of the uterine contractions in a most remarkable manner, under certain circumstances; but that the effect is doubtful, unless there be some degree of action present. In other words, that, although it will increase the contractions when already present, it will not always renew them when they are suspended.
"That the effect is more certain if the infusion be of greater strength than is usually recommended; two drachms of the secale to six ounces of water being barely sufficient for the purpose.
"That it appears to be a stimulus peculiarly fitted for irritable, and what are generally termed nervous habits.
"That the fears entertained by some practitioners of its proving detrimental to the child, are groundless.
"But, although it is in general necessary, not only that there should be a disposition for labour, but that this process should have actually commenced, before we can expect the secale cornutum to have any effect upon the uterus, still one solitary case has indirectly come to my knowledge (and I will vouch for the authenticity of it,) where this remedy was given for the purpose of producing abortion in a female, about the second month of utero-gestation; and this effect was accomplished in a few hours after its exhibition."