BY HARRIET L. HARRINGTON, M. D., BOSTON, MASSACHUSETTS.

September 25, 1887, 9:15 P. M.: Mr. P. called at my office and asked me to see his wife, who he said had been sick all day. The family physician had been attending the woman, but as he was out in the evening when sent for, word had been left at his home that he need not call again, as Mr. P. felt that his wife was not receiving proper attention.

Feeling that there was no particular need of hurrying, as the woman had been ill so many hours, and had been under treatment, as I supposed, I took my time, walking slowly to the house, which was only a few doors away. I never can forget the sight which met my eyes, as I entered the sick chamber. The woman, whom I could not recognize, although I had met her several times before, was lying on the bed, her face almost black, tongue protruding from mouth, eyes open, but pupils rolled up into head, so that only the whites of her eyes showed; neck badly swollen; entire body terribly distorted, writhing in a horrible convulsion. I did not stop to ask questions, but sent for ether, and in a very few moments the poor creature was sleeping quietly. She was so thoroughly exhausted, that it took but little ether to affect her at this time, although later it did not act as well.

I then listened to the history of the case, which was as follows: Mrs. P. was about seven months pregnant with her sixth child. She had been suffering for several days with severe pains in head and eyes; left foot had been badly swollen, bat this last was common in her former pregnancies. She had been troubled with nausea for some time past, and went to the bathroom at 5 A. M. on this account; her husband heard her fall, and going to the bath-room he found his wife crowded in between the bath tub and the radiator, head down. It was with difficulty that he lifted her out, and laid her on the floor in the entry; she was then in her first convulsion, and he said she did not look like a human being. As she remained unconscious, the family physician, Dr. W., was sent for. He saw her while she was in a second convulsion, told the husband it looked like congestion of the brain, and left some medicine in a tumbler, to be given every hour as ordered. A second visit was made during the forenoon, when he changed the medicine. He said he was quite busy, so sent a brother practitioner, Dr. B., to see the patient in the afternoon. This physician changed the medicine in the tumbler a second time, saw the woman have a convulsion, and agreed with Dr.-W.'s diagnosis. These were both homoeopathic physicians, each having a large practice. The nurse had tried to give the medicine as ordered; the husband had also tried every hour regularly, but only one dose had she swallowed during the entire day. Why the medicine was changed so often I cannot understand. She had remained wholly unconscious since 5 A. M., with the exception of a few moments between 9 and 10 A. M., when she asked about her children. During this hour cold was kept on her head, and she had but a single convulsion; the cold seemed to help her for a time, but during every other hour of the day, from 5 A. M. until 9 P. M., she had had two, and often three, convulsions, each lasting about ten minutes or longer. As near as her husband could figure it, she was having her thirty-sixth convulsion when I first saw her. It was with difficulty that she was kept from injuring herself. The last two had been very severe; during them she had thrown herself from one side of the bed to the other, and would have thrown herself off the bed had she not been prevented from so doing. It was probably during these last that the child was born, as I found a male infant, with the membranes intact, between the woman's thighs, a part of it still within the vulva. There was no hæmorrhage, although the bowels had moved and the urine had been passed during the birth of the child. Temperature, 103°; skin

hot and dry. Pulse, 120; this soon fell to 80, after giving the ether a short time.

As I did not care to take the responsibility of the case under the existing circumstances, I asked to have Dr. Stedman, of Dorchester, see the case with me. He kindly came, and advised me regarding the patient. She was kept under the influence of ether. All that night and most of the following day she was very restless at times, although the ether was pressed. At 10 o'clock that evening thirty grains of chloral were given by rectum. This was retained, but did not seem to affect her much, so at 11:30 I gave one-fourth grain of morphia hypodermically. This took effect almost immediately. Ten grains of calomel were given in butter, by mouth. This way of administering the calomel was suggested by Dr. S., and I had no trouble in getting it down, although she would not swallow any fluid. She had no more convulsions until 2:15 on the following morning, September 26, when she had a severe one lasting fifteen minutes. The ether was pushed, but did not seem to affect her much, because she did not breathe for some moments, and I feared she would certainly die. A second dose of one-fourth grain of morphia quieted her after a time. At 5 A. M. a convulsion began, but was checked by the ether, and at 5:30 she seemed brighter, looked around a little, but in a dazed manner; would raise her head and try to get up if her baby cried. (Her youngest was four

teen months old.)

At 8 A. M. she was very restless. One-eighth grain of morphia was given at 10 A. M. Twenty grains of chloral and thirty grains of bromide of potassium, in one ounce of milk, by enema.

She had her next convulsion, the thirty-eighth and last, at 10:15 A. M.; this was the second that she had had since I took the case; it was less severe, and of shorter duration than the others, and was easily controlled.

At 10:30 A. M., as the bowels had not moved, the ten-grain dose of calomel was repeated. She had a free evacuation at 2:30 P. M., and urine was passed for the first time in eighteen hours. Milk was given, by enema, during the day; two ounces every hour when she was not too restless. Chloral and bromide were added to this as needed, and at 3:30 P. M. one-fourth grain of morphia hypodermically. Towards evening I began giving milk by mouth. Although she was still only partially conscious, I succeeded in giving her fluids with an ordinary dropper. At 4 P. M. ten drops of spirits of aromatic ammonia brought up much wind, and greatly relieved the restlessness; patient seemed

better, and slept quietly. The ether was discontinued. Bromide and chloral given as needed to quiet her, with an occasional dose of morphia.

At 3 A. M., September 29, she came to consciousness for the first time in forty-two hours. She took one pint of milk during the night. Temperature, 98.2°; pulse, 76. During the day she talked about different things, but in a dazed and strange manner. Complained of pain in back and legs.

At 9 P. M., September 29, I was sent for, as patient complained a good deal of being so cold; the lower part of body up to hips was very cold to the touch, and she was very nervous and restless. Temperature normal, but pulse 48 to 52. She had not flowed much since birth of child. Her husband told me that any kind of liquor affected her head badly, so I could not use it at this time, but gave hot ginger tea, also spirits of aromatic ammonia, put her feet in hot mustard-water in the bed, and flannels wrung out of hot mustard-water over her hips. She soon became warmer, and passed a quiet night, taking only oneeighth grain of morphia. Towards morning of the 30th she began to flow freely, and seemed quite comfortable. Temperature, normal; pulse 60. (She told me her pulse was always slow.) On examining her heart there was a blowing sound to be heard with the first beat; this disappeared after a few days.

Her urine was examined several times, but I never found even a trace of albumen, or any casts; the urine was scanty, and contained some oxalates.

After this, with the exception of slight trouble with her left breast, for which I used a bandage with camphorated oil, her convalescence was rapid. All that had passed was a blank to her. She complained of strange feelings in her head, and her memory was very poor for a time, but this all came right again. Rochelle salts was given to keep her bowels regular. The amount of urine increased rapidly. Later, I put her on two-grain quinine pills, three daily, and tincture ferri chloridi.

At the present date, January 12, she is feeling and looking as well as ever, with the exception of one leg and foot, which are still swollen, due to varicose veins. Her urine is normal in every respect, and appetite good.

I believe these convulsions were, in part, due to her close confinement, as it had been a rare thing of late for her to leave the house, for weeks and even months at a time, as she felt her three youngest children-all under four years of age-required her constant care and attention.

THE NOBILITY OF MEDICAL MEN.

BY W. H. SMITH, M. D., PH. D., SAINT CLAIR, MICHIGAN.

In making up a grand profession, if doing good's the test,
By sacrificing self for others, should medicine rank best,
Since really noble self-denial conspicuous is shown

When true physicians seek the welfare of others, not their own?
Although 'tis money in their pockets to have the people ill,
They lead the world in sanitation to guard away the ill;
Thus showing, by unselfish action, the highest type of worth,
And manifest self-abnegation, the grandest on the earth.
When other people, by invention, a useful thing may learn,
A patent helps secure the money which it, perchance, may earn;
But doctors' ethics look on patents as something low and base,
And say what they discover freely is given to the race.
Let others have the seats of honor, so says the code to-day,
While our self-denying calling will point a nobler way,
Avoiding even names in papers, inspired by love of man
Alone, and not for ostentation, we do the best we can.

In gaining wealth and worldly honors, esteemed by all so meet,
With those in other avocations physicians won't compete;
But, by unselfish, faithful labor, devoted to the last,

They strive to make the human future far brighter than its past.
Though others have their time for eating, and sleep when they're alone,
Physicians have no leisure moments which they can call their own;
Foregoing food and rest for others, despite the sneers oft hurled,
This class, in matchless deeds of mercy, forever lead the world.
Disgusted even with some patients, when loathsome tales unfold-
Though half, in truth, of what is sinful perhaps is rarely told-
They never let their hearts be soured against the erring man,
But sacred hold his guilty secrets, and help him when they can.
E'en in sublime and lofty courage physicians must excel,
Surpassing that of valiant soldiers amid the battle's hell,
As facing death in dread diseases, in hope to render aid,

They go alone upon their mission, thus brave without parade.

I've seen a soldier charge in battle, and scorn the cannon's breath,
Yet quail and fear to face the small-pox, more dreadful type of death;
But when our fellows are in anguish, and death is very near,
Physicians grandly do their duty, defying doubt and fear.

Amid the many scenes of sorrow by yellow fever made,
Though relatives their friends forsook, physicians nobly stayed;
And even from our northern free-land, responding to their cry,

Young men, though seeing death before them, went there to do and die.
When once, beside a burning dwelling, was heard a mother's cry:
"My little babe is in that building-oh, God, 'twill surely die!"
In answer sprang a hoble hero, amid those flames so wild,
Undaunted by the awful danger, and saved that precious child.