OHIO STATEWIDE FILES - Lindsay Journal #3, PART 3 *************************************************************************** OHGENWEB NOTICE: All distribution rights to this electronic data are reserved by the submitter. Reproduction or re-presentation of copyrighted material will require the permission of the copyright owner. *************************************************************************** File contributed for use in USGenWeb Archives by Helen Silvey Helen_Silvey@macnexus.org http://jpaul.gwdi.com/silvey/ January 8, 1999 *************************************************************************** Continued Case of Retention of the Placenta which I was called to remove 36 hours after Parturition. Jany. 17th. 1835 HIstory of the case -- Mrs. Mabbit of Union Co. some 10 or 12 miles south of this place. Having had a dificult & somewhat protracted labor, the child still born. The Placenta after the labor was thro' was found to be retained & by all the means made use of by those in attendance could not be disengaged. Under this sate of things I wa sent for & found a Midwife and her Physician Dr. Tardy then of Liberty in attendance. The patient I found in a state of considerable prostration, (having suffered under the weakening effects of a free Puerperal Hemorrhage.) & much mental solicitude accompanied by considerable gastric derangement. On obtaining all the information I could of her situation from Dr. T. I proceeded to make a manuel examintion. I found the uterus to have strongly contracted on the Placenta, so much so that the hand could not at all be passed into the uterus by any thing like moderate force or exertion. The Secale had been given to as great an extent as the stomach would bear, and no bearing down had been induced. but seemed rather to have induced a stronger contraction of the uterus, such in labor as would be called the hour glass contraction, but such as in other situations would be called the Tonic contraction. I next proceeded to gently dilate the womb & introduce the hand this was indeed a formidable undertaking, and required several hours to accomplish it, & having made use of the right hand u(n)til it was useless, owing to the great resistence & contraction made by the uterus, next introduced the left and operated with it until it in turn was diabled, by this time the right one had so far rested & regained its use that I was enabled to operate in this way first with one & then the other until I at last had overcome the contracton so far as to be able to introduce a hand; when I found the Placenta strongly adhering by its whole surface to the womb. This In my practice I have always found a dificult & unpleasant operation under the most favorable circumstances, but in the present situation it was truly so. Which was doubly perplixing owing to the great pressure of the uterus being constantly kept up. No one can properly or correcty judge of the great dificulty of an operaton, & the astonishing force which the uterus strongly contracting is capable of exerting on the hand of an operator, unless he has had the experience of a case. I was fully 2 hours in dilating the uterus, and fully another hour in detaching the placenta after having dilated the uterus sufficiently to introduce the hand. The operation was attended by excruciating surrfering to the patient, and I felt sometimes fearful that she would be unable to bear up under it, and I was several times compelled to desist a short time owing to the exhausted and sinking exacerbations induced by the operation; I remained with the patient all night, and in the latter part of it she seemed to get some rest. This was the only concern or part I had in the case. however she recovered, but she was quite an enfeebled delicate female, and her recovery was tedious. I think her health is now tolerable, and for any thing I know as good as it was previous to this accouchment. Castrotomy. Case of Mr. H. Hoover of the viscinity of Indianapolis. Operaton July 1838 History of the case. When I first saw him. he was reduced quite low, had been 6 or 8 weeks confined to his room & the greater part of the time in bed. And at the time I saw him had sinking spells, which were preceded by much restlessness, & something like a Febrile paroxysm, accompanied by a kind of neuralgic exacerbation severe pain in the back & kidneys, in the Right Testis, being the one affected, shooting up the spermatic cord, somtimes extending to the head, & sometimes attended by a tremulous quivering agitation of the whole body. On my enquries concerning what was the primary injury, I could not learn any thing satisfactorily, the patient spoke something of having strained himself at heavy lifting, ad I think I learned also that the testis had received some direct injury, but have now forgotten the particulars of the case. He had been seen by several Physicians and the prevailing opinion was that it was Hydrocele Some supposed that it was sazrcocele. On my first examination it was my opinion that it was a case of Schirrous testicle. I also gave it as my opinion that an operation was imperatively necessary to a recovery, tho' I really feared that it was now too late. I operated, being assisted by Dr. Wilson, who was now the attending Physician. -- nothing occurred particularly worthy of notice during the operation. The testis was found highly diseased, and on cutting into it was found to contain some supurative matters, also some fluid of a serous appearence. But the operation was delayed too long; tho' for some days, subsequently, strong hopes were entertained of his recovery, the hope turned out to be fallacious, in the course of 6 or 7 days he sank in the arms of death. As an operator & surgeon I gained nothing by this case. At least such is my opinion, had I been successfull. the result would no doubt have been diferent. But on reflection I dont think I have any thing to accuse myself for on the score or recommending an operaton. As I could not foresee that it would terminate as it did posatively, and that he could never have recovered without an operation nothing is more certain so it is, we frequently get applause from the world where there is but little of merit. while again our best efforts & real skill go neglected and unrewarded. Richmond Ia. Mr. 11. 1839 N.B. The Testicle when detached I should suppose would have weighed about 8 oz. Case of Emphysema Patient W. King senr. In winter of '38 & '39 produced from injury & supposed fracture of the Ribs. Jany 10th. 1839 was called to see the above individual, and learned the following by way of history of his case, some days previous he had been spreeing and geting into a rough kind of spoart between play & earnest, or probably more correctly of the Medodrama character. It so turned out that he was considerably injured. Apparent injury, was a large extent of surface entending from the spine & small of the back forward to the anterior extrematies of the Short Ribs, , and immediately above the Illium. but this was too low to satisfactorily account for the Emphysema which had so extensively thrown the air into the celular tissue. This surface was so bloated, that it was truly a sight to behold him, even his Eyelids were puffed to the degree that his Eyes were enclosed, and exluded from the sight. The breathing was sterterous and labored, at this time I think he complained of onsiderable pain unter the right shoulder, also besides the general distress in the thorax and its dependencies, think the patient complained considerably of pain in the upper art of the Sternum, and along the course of the left clavical, however, there was no apparent bruise on the surface beside the one first mentioned. The suffusion had not began to make its appearance as least was not noticed until between 36 & 48 hours after the injury. and when I first saw him the suffusion had then been in progress and extending itself for about the same period of time. On being called myself I proposed that several others, Physicians of the Town should be called in to consult concerning the case and was met by Drs. Salter & Plummer & Smith the result of which was that it would be expedient to make a few incisions into the celular tissue with a view of giving exit to the air suffused. Consequently I made a puncture about the centre of the sternum, & one or two over the spine, by this means we succeeded in pressing out a portion of the suffused air. And of the punctures made it was found that the one on the Sternum admited the exit of the suffused air much more readily than those over the spine There being some cough present, an expectorant was prescribed, and for the present the bowels were kept gently open by means of oil. And some days after this when from an increased action of the pain and of pain in the Throrascic cavity, & that there was rather an indication of inflamation taking place in the Lungs, depletion was resorted to, and for a short time the patient was put on Tinct Digitalis & Antimoniads. About this period the right Lung which must have been in a state of collapse, had now began again to inflate as was supposed, & the suffused air had been to a considerable extent absorbed. The inflamation which had been feared was threatened, was counteracted in a few hours, and in a night had subsided with the exception of the Vol. Linament as an application to the breast & side to the surface where bruised, but little medicine was now administered. ocasionly, giving a little oil to keep the bowels soluable. At the termination of about three weeks when the suffusion had almost entirely subsided and when I had almost remited my attentions, I was almost discouraged on having my attention called to the upper point of the sternum, & along the course of the clavicle extending to the margin of the axilla, to find that this whole extent of surface red, highly inflamed, tumefyed, & in a high degree painful. And besides this, a point just a little below the right shoulder blade and two or three inches forward from the spine, extending over two of the ribs where there was an evident swelling, which was quite prominent when compared with its surrounding connexions. Added to this, his appetite which had been pretty good now failed again, all these things to run together were calculate to somewhat alarm me. In a day or two after this state of things, the upper part of the sternum was the seat of a collection of supperative matter. which was evident from fluctuation &c. In a day or two longer I lanced it. & found the matter to be within the celular membrane. The discharge was abundant, which required Emoluent soothing poultices, to keep up the discharge. About the time that this was done discharging. a second tumefaction was becoming prominent near the margin of the axilla, being a concentration of the inflamation in this region as first described. in a few days more this was also opened and gave outled to a free discharge of matter, which was treated with Poultices first, & next simple cerate, in the same manner as the other. This tumour in a day or two from the period of lancing it, from the dischage gave much relief to the system. To the swelled & tumefied surface under the shoulder blade, was applyed freely the vol. Lint. apparently with much advantage. This was now about the end of 4 weeks from the time I was called in. Now at the time I make this record two months & more has elapsed. and for the last month he has been slowly on the recovery. Today I called to see him found him much inproved in general health & in every respect. The tumefactions are done discharging, & are completely sicatrised. The tumefyed or swolen point under the shoulder, is quite gone down, and the pain which was here felt deep within, & as was supposed from the fracture of two of the Ribs, has subsided. The patient has not yet been beyond the dooryard. but says he expects soon will be able to sally out. As just intimated it seems quite probable that these two Ribs were fractured, yet there was no bruise or ecchymoses perceptable, and admitting these Ribs to have been fractured; then the next conjecture is that these fractured Ribs accounts for the rupture of the right Lobe of the Lungs, & the consequent Emphysema-- I will make a remark or two in reference to the Emphysema. In the first place would just say that it is the only case I have any recollection of ever seeing. The appearence was indeed novel. The patient is about 63 years of age I think, his face much wrinkled & furrowed with age. While the suffusion was at its highest from the loins up to the Eye brows the suffusion and distention, particularly over the Thorax, in the neck, & face, it was great the skin on these parts, & the arms, also, highly distended, no wrinkles now, his wrinkled face was now a perfect bloat. puffing like a man out of breath. Articulation too was changed, his voice seemed to be like a cracked bell. squeaking. as if he were practising on lessons of ventriloquism and he seemed to be respiring through the noses (sic) & mouth at the same time. Richmond Ia. Mr. 11th 1839. Case of varioloid, In an individual who attended Capt. Gunter, a mixed Cherokee Indian, in the Small Pox, on board the tecumseh History of the case. this Cherokee was part owner of the Tecumseh. Capt. G. & his wife had taken passage on board this boat at Webbers falls which is a place of some notoriety on the Arks. River. 25 or 30 mile above Fort Smith, & the same distence, by the way of the River, West of the boundary, seperating the U. S. & Arks. from the Cherokee nation of Indians. The Tecumseh, which was commanded on her downward trip by Capt. Stephens, sailed from Webber's Falls to Vicksburgh. Which was her place of destination, while at this plac(e) Capt. Gunter was taken sick; & by the time the boat reached Little Rock on its return. it was accertained that Capt. G. was laboring under small pox. or at least it was a matter of suspicion here, that his disease was small pox, and shortly after the boat left Little rock, the matter was reduced to a certainty that it was small Pox, as the eruption now began to develope itself on the skin. Incidentally it is mentioned that, Capt. Mc Cullough took charge of the boat when she left Little Rock on her return to Webber's Falls.--At Little Rock a Physician shiped on board the Tecumseh a lot of Freight. and himself took passage in charge of it. and was called to take charge of Capt. G. also, professionally. The River being now low & still on the fall. the boat was 2 or 3 days & nights in making a distence of about 75 miles by the River, & not more than 40 by land. At this point the boat was compelled to stop. and await a rise of the river. while at this point Capt. G. died with small Pox, being about 5 days after leaving Little rock, & on the 9th of the disease; on the 31st of Dec. 1837. The disease was of the confluent Character. The Physician who attended the case had been vaccinated only, and that some 33 years previously. Having attended to Mr. G. in the capacity of nurse, as well as Physician, was much exposed to the Contagion. having been up half the night at least during each night. The Tecumseh remained at this point of the River some 7 or 8 days longer waiting a rise, when she put out her Freight on shore, or rather into a Large Keel Boat, which was cabled to the shore and returned back to Little Rock with the officers & crew. The Physician remained with his freight waiting a rise of the River, and for the arrival of a Steamer from below. During his stay here of 6 days, he was attacked by varioled. Previous to the death of Capt. G. On retiring one night to his Birth to rest, he felt a peculiar tingling pricking sensation, which passed over the whole body. but was more sensibly felt in the bottoms of the feet, and next all over the head through out the scalp. On the day the Steamer Tecumseh returned for Little rock he was taken with a severe chilling, which lasted about 48 hours. alternated with flashes of febrile excitement, attended by thirst. The first night after the accession of these Chills and rigours, he spent it quite restless. The next day he was still more mirerable, And spent the greater part of it sitting in the chimney corner, burning his shins drawn up close to the fire, while, his kind hostess, as if she wished to keep his misery company, sat nearly the whole of the day in the opposite chimney corner smoking her pipe, and nursing a dear ragged & dirty young one, But she was very kind, and seemed disposed to render her indesposed & transient guest as comfortable as she knew how. and Cooked plenty of strong fare, with Coffee, which for the want of the usual Machine for Pulverising it, she broke it down in a Tin cup with the end of the rolling Pin, or mush stick, the Dr. has forgotten which. But it was a matter of indiference (only for the sake of precision,) for this Arks. adventurer, had lost his appetite being only able to taste a little of the more substantials while he sipped a little of the Coffee on account of his thirst. It was in the month of Jany. but it will be recollected that the weather was in the lattitude of the N. W. was unusually fine. there, in the Latitude 31 or 32 (degrees) the weather must have been delightful to those who were well and able to enjoy it. as an evidence of the pleasentness of this part of the Rackensack as the State is sometimes familiarly called in that country. The houses or dwellings are generly Log, the interdices without any chinking, all open, no windows, generly, or where found, seldom have sash or glass. This Rackensack Farmer, with whom our variolid sojourner now sojourned, was in moderately good circumstances, was the reputed owner of a fine track of Arks. bottom land, had been there some 20 years, Kept a wood yard from which he sold abundence of fine ash & cottonwood from $2(.)50. to $3 per cord. the the steam boats on the River, was one of your good natured accommodating kind of men, without any slaves raising annually, probably, 10 acres of corn, and this abundantly more than he could use for bread & other purposes. for his cattle, Hogs, & horses, had any quantity cainbreak to luxuriate in, winter & summer, what food is found here for hogs among the cane, & out of it, the writer is not informed. but that hogs here are generly killed right out of the woods, and good eating at that, he had sufficient evidence, But when our Landlord wished to change for something in the wild meat department, he could at pleasure repair to the cane or the wood, & select from the numerous herds of Deer, the venison, or the vagrant flocks of Turkey that were alwa(y)s near at hand in any quantity, or quality, at will. To be continued Helen, Sacramento ***********************************************************************