Mitchella as a Parturient.

[The following brief reports of observations made on the action of mitchella in preparing a patient for labor, have been brought out by the excellent article from Dr. Quigg, which was published in the August number. I publish them all together here, under this title.—ED.]

J. S. NIEDERKORN, M.D., VERSAILLES, OHIO

Let me add my indorsement of what Dr. Quigg says of Mitchella in the August number of the THERAPEUTIST.

Mitchella certainly is a grand Partus Preparator, and can be relied upon for its efficiency before, during and after labor. I would rather my patient would take Mitchella than a course of restricted diet, for I consider her safer from any unpleasant parturient and postpartum complications, and there will follow no uterine disorder to affect the subsequent health of the woman.

Digestion, and kidney elimination need be looked after, of course, but I find that when Mitchella is being taken there is no digestive trouble nor albuminuria nor auto-toxemia. Baths are always in order, pregnancy or no pregnancy. I have never used a drop of anything as a local application to the abdomen during pregnancy for the simple reason that there has been no reason for using it.

I give spec. med. Mitchella in five to ten drop doses three times daily for two months or even three months before confinement and continue its use up to the beginning of labor.

But, mitchella is not our only preparatory remedy; of that I am certain. In fact it is here just as it is in every other part of medical practice—use the indicated remedy.

In macrotis and helonias we have two remedies that are hard to beat. In fact I would not want to say that mitchella is better than macrotys, or macrotys better than mitchella or helonias, or helonias better than either of them. There is no need of giving all three of them; one will do all the three possibly can when correctly prescribed. With me the case before me decides which I shall give and the selection is made for the following reasons: I give macrotys where the patient complains of soreness, backache, leg ache, with occasional pains through the lower part of the abdomen, especially during the latter month of pregnancy, and I give it in from three to five drop doses three or four times daily.

I give helonias where there is a history of some chronic uterine disorder and where there is a pelvic fullness and weight and a feeling at though the parts are about to fall out. The dose is ten drops every three to four hours.

I give mitchella where the woman complains of a dragging, heavy weight feeling over lower abdomen; or, as a uterine tonic in cases where there is no complaint, still the patient wants "some medicine to help her in her confinement." Rather an indefinite indication I admit, but the results are definite and everything desirable.

In addition to the above we have other splendid remedies. Senecio, viburnum, cypripedium, aletris, caulophyllum, etc., to be selected as the case requires. If there is a physician who must use drugs in combination, as a uterine tonic or to prepare his patient for her accouchement, I suggest to him the Compound Syrup of Mitchella.

Let me add that any expectant mother who will take for two months previous to her confinement mitchella or the comp. syr. of mitchella, will be free from any of the unpleasantries which so commonly attend, during the last few weeks previous to labor, and her labor will be of shorter duration, free from erratic pains, and there will be no delay in her lying-in-period and no chronic painful uterine condition to follow. My use of mitchella and other preparatory remedies extends over a period of about twenty years, and I speak with confidence when I advocate their use.

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C. H. RIGG, M. D.

I saw in the last number of your journal an article from Dr. C. E. Quigg, Toma, Wis., on mitchella as a parturient, his observations extending over a period of fifteen years, and as you ask any others who have made observations to submit them, I want to say that for twenty-one years I have used mitchella as a preparatory remedy for pregnant women (usually syrup mitchella comp.) with cascara, nux, or such other remedy as I thought indicated in each individual case. I have used it in hundreds of cases and I unhesitatingly say it is our best remedy in these cases. I usually begin as Dr. Quigg does, six weeks prior to confinement, but in extreme cases I give it as much as three or four months with never bad results from its use, but not always with results desired.

I am very sure that women are better after confinement who have taken the mitchella, and it helps the child too, however, I think that Dr. Quigg's claims are excessive in part; for instance when the remedy is given six weeks prior to the confinement, do you think that the child in utero, if malformed, would be changed of its malformation? I hardly think so and I surely think if a child has malformation, that malformation exists long before the beginning of the treatment. If a child has two heads, more or less fingers and toes, or any real malformation, you can readily see that no remedy can change it; but to sum up, I am certain that both mother and child are the better off if the above treatment be given.

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GEO. F. SAUTER, M. D.

I have read with interest the article on mitchella in the last number of your always welcome journal. Before entering the E. M. Institute I was practising hydro-therapy and at that time had very little faith in medicine. I began the study of medicine when I was 37 years of age. I attended Prof. Wintermute's lectures on obstetrics during my first year. During my sophomore term a lady asked me whether or not I would take a confinement case. Of course I took the case, but when I was told later on that she had two doctors at the last two confinements I felt as though I ought to give up the case.

Just at that time Prof. Bloyer lectured on mitchella and I made up my mind to stick to the case and try mitchella. The case came off without trouble. I have used the remedy in a few more cases where the preceding labors were difficult or protracted—always with the same result—easy labor. In my last case the preceding labor lasted 18 hours and there was a torn perineum. Three months before the expected time I put this patient on mitchella. The duration of the labor was one hour and fifteen minutes.

Of course I cannot speak of more than about 14 cases, for I did not have yet the opportunity to try the remedy oftener. But I have made up my mind for the future to give mitchella during the last three months of every case, where I am engaged. I don't think I will find any contra-indications.

COMMENT:—I have always followed the rule that if there were no indications for treatment, no treatment should be given. There are patients who normally have speedy, almost painless and satisfactory labors. I should not prescribe for these at all, except some unusual condition should arise toward the end of the term—where the previous labors have been protracted or difficult, or with very young primipara or with primipara where I had reason to fear complications I should prescribe preparatory treatment. While I should want a reason for prescribing in each case, this remedy is so mild that no harm could come from its use, especially in primipara; where we do not know what the normal termination will be.

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A. L. RUSSELL, M. D., MIDWAY, PA.

For a number of years I have been accustomed to treat with medicines those pregnant women whom I had attended in previous labors where uterine inertia, or slow or difficult labor had been experienced, either by reason of excessively large children or from any slight deformity in the pelvic outlet.

I am convinced that I have accomplished much. Those women who have taken the treatment once, always ask for it in succeeding pregnancies. I am convinced that I have fewer complications, and easier labors, where this treatment has been employed. I use the squaw vine, mitchella repens, and if there has been any deficiency in the expulsive force, or if there have been repeated pregnancies at short intervals, I give strychnine phosphate, in 1/20 grain doses, three times a day during the last two months.

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S. L. SEGRAVES, M. D., ERA, TEXAS

I take pleasure in giving to Dr. Ellingwood and the readers of THE THERAPEUTIST a few lines on the preparatory treatment of pregnant women. I have been using mitchella repens and macrotys combined for several years with the best of results. I always commence treatment at least eight weeks before confinement, giving the above medicine at each meal, and if there is any abnormal condition I will commence the treatment much sooner. I have given this course during the entire nine months. I always continue the same treatment a week or ten days after confinement. Of course I give other medicines as I find them indicated.

I have given this treatment to very many ladies and without the least deleterious effect, always with good results as to mother and child, cutting the time of labor as compared with previous cases one half, and two-thirds of the time as when left to nature. I have had ladies say to me, after taking the medicine, "Doctor, I would not be without that medicine under any consideration." I have several ladies in the Panhandle region in Oklahoma and in various parts of Texas that use it before each confinement. As Dr. C. E. Quigg says, almost every lady to whom you have given the remedy once during pregnancy will insist upon taking it again. May be they have moved to some other part of the country, but they will write back requesting that I send them the medicine. Many times and wherever I have sent the treatment to one lady, her lady friends, seeing the good effects and easy labor, will wish for the same medicine when pregnant. I do not pay any attention to the diet of the patients unless digestive disturbances come up. I believe with Dr. Quigg that the remedy has a beneficial influence on the growth, nutrition and development of the child. I have never seen other than a healthy child when the mother has taken this treatment. I have never had a case of postpartum hemorrhage under this treatment. I have been in the practice about 30 years, and sometimes I tell my patients that I would rather give them the medicine free of charge than for them to be without it, especially if I had to attend them, for I know they have a much easier and quicker time.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.