Injection Anesthesia in Obstetrics.
I have had considerable experience with the use of the new antiseptic, H-M-C, in obstetrics. I believe the arbitrary prescription of one-hundredth of a grain of hyoscin, one-fourth of a grain of morphin, and one-sixty-seventh of a grain of cactin is a little too large, hypodermically, for the ordinary woman. However I have given the tablets of the original strength in many cases.
When I find the patient with labor pains, whether the os is dilated or not, I give one tablet. In about 25 minutes the pain will be less severe, but true labor pains will exercise a greater force. Erratic pains will disappear entirely. I usually repeat this dose after an hour or two if needed, and as the second stage approaches I sometimes give one-half of a tablet more. This has included all of my cases recently.
For after-pains if the above anodine is not sufficient I give twenty drops of the fluid extract of jaborandi in a little water. This I may repeat in two hours. In one severe case I did not get but little effect from the tablets. I gave the woman a full tablet every two hours, from 6 a. m. to 2 p. m., and then was obliged to resort to chloroform, when she was very quickly delivered.
J. M. KIRBY, M. D.