Dr. Pierson read a history of a clinical case. The clinical committee, consisting of Drs. Hitchcock, Bauer and Rowe, after examination, reported the case to be one of chronic pleuritis with adhesions and effusion, and recommended alterative treatment.
Dr. Fisher read a report of a case of puerperal convulsions, in which venesection had been resorted to with favorable results.
In the discussion which followed, Dr. Shively said he did not believe in blood-letting, but would rely upon drastic cathartics and anæsthetics.
Dr. Wright, in a practice of fifty years, had employed blood-letting in a few cases with good results.
Dr. Everhard had seen several cases, and favored the use of anæsthetics, but objected to the use of morphine on the ground of the supposed uræmic pathology of puerperal convulsions.
Dr. Howard thought Dr. Fisher’s treatment of the case good, and believed emphatically in blood-letting, and also in the use of arterial sedatives, such as verat., vir., etc.
Dr. T. C. Miller believed in thorough narcosis, giving morphine hypodermically until the effects were noticeable on the respiration. Anæsthetics are good, but can not be given continuously. The physician giving the anæsthetic, when the convulsions cease will not crowd the anæsthetic, and almost before he is aware of it the convulsions will return. We have much to learn about the pathology of puerperal convulsions. The speaker does not believe it to be uræmic. All of his cases in which he gave narcotics thoroughly from the first recovered; cases in which he used blood-letting died.
Dr. Vance believed that the treatment advised by Dr. Miller would result disastrously in many cases, and spoke at some length, showing that the latest authorities believed the true pathology of the trouble to be uræmic.
Dr. Pixley asked, after hearing so many opinions from so many distinguished speakers: “What is Dr. Pixley going to do to-night if he meets a case of puerperal convulsions? One speaker swears, if you bleed, your patient will die; another swears, if you don’t bleed, your patient will die; a third says, you must give opium; another says, you must not; another says, you must give anæsthetics; another veratrum, another cathartics.” Now, after all of this light upon the subject, he would do as he always has done—apply cold to the head, warmth to the extremities, maybe give a little opium, possibly bleed a little, equalize the circulation, and deliver as soon as possible. Some of his patients will live and some will die.
Dr. Howard submitted to the society, for signatures, a petition to the State Legislature in the interests of what is known as the “Sharpe bill,” for the creation of a State Board of Health and a State Board of Medical Examiners.