BY MERCY B JACKSON, M. D., BOSTON, MASS.

In May, 1862, I was engaged to attend Mrs. T, in her eighth pregnancy. She is a small delicate woman of highly nervous temperament, had puerperal convulsions during her last two confinements, and suffered since with severe congestion of the head and neuralgia. Called on her the 15th of May and, as is my practice, listened for the beating of the fetal heart; did not find it in the right or left iliac region, but found it beating strongly about two ches above and to the left of the umbilicus. On further examination found the back of the foetus to the mother's back, the small parts in front. On examination per vaginam, could scarcely reach the foetus, but from the little that could be touched believed it to be one of the nates. Was now satisfied that it was a breech presentation and felt the most intense anxiety, believing that convulsions would come on during travail if the child was born by the breech. The pains from which she was suffering when I called, soon disappeared under the administration of a few spoonfuls of Pulsatilla ³⁰, five pellets' in half a glass full of water.

I returned home intensely anxious on account of her tendency to convulsions, and made arrangements to call in a surgeon to take the child with forceps, it necessary to prevent them. Was called again on the 20th of May, and found her with quite severe periodical pains, but on examination found the os uteri undilated and the fetal heart still beating in the same place. Gave Pulsatilla as before, the pains left her and we all slept till morning. This time I could mark the point of one of the nates so as to assure myself of the part.

In the meantime had searched many books to see if any light could be gained that might avert the dreaded convulsions. On page fifty-one of “Croserio's Homoeopathic Obstetrics,” found that Dr. Bethman had given Pulsatilla to a woman in whom he found a shoulder presentation, before the membranes were ruptured, and in some minutes after she had experienced a violent pain with a sensation of overturning in the abdomen, and on second examination was agreeably surprised to find the head presenting. Dr. Croserio also believed he had obtained a similar result, by the same means, in one instance.

A new hope took possession of my mind, I thought it even probable that the position might be changed and the danger of convulsions removed.

I prepared a solution of five pellets, thirtieth, in half a tumblerful of water, one spoonful to be taken every three hours when awake. This was continued until the 23d, when she felt a great commotion in the abdomen, with pain and necessity to go to stool, and after a short time felt better and more natural than for a long time previous.

The next day was called. Arrived at eleven, a.m., found her far advanced in labor, and on examination to my great joy found the head coming down rapidly, and in thirty minutes a fine boy, weighing eight pounds, was born. Both mother and child did remarkably well.

Delighted with the success of this case, I determined to try Pulsatilla in every-case where mal-presentation was found, and also to ascertain the position of the foetus in all cases, possible, before the water sack was ruptured in order to save my patients unnecessary suffering. In September, 1862, another case of breech presentation was found, when Pulsatilla was used in the same way and similar result obtained.

This still further confirmed me in its use, and in May, 1863, another case of breech presentation occurred in my practice which was treated in the same way and with the same result. In August, 1863, another case, in a primipara, to whom I administered Pulsatilla as before and with similar result.

Mrs. P., who was delivered in September, 1862, informed me that she had had four children before, all born by the breech. Her child was still born, although no interposition was needed nor was the cord round the neck, and the travail was rapid and favorable in every respect. She thought the foetus died the day before when she had an ill turn. In her case there was disease of the uterus, and she had had two miscarriages preceding this. I think she has cancerous disease of the uterus.

It is worthy of remark that in all these cases the travail was delayed from eight to twelve days beyond the expected time, and in the last case the delay induced the examination, as the lady was perfectly regular in her menses and could not, I thought, have miscalculated. She being young and sensitive I had not made an examination before in deference to her delicacy, and presuming all was right; but as she had now passed the exacted time, ten days, I called to examine, and when the position v. as found, gave Pulsatilla and in twenty-four hours was called and found the head presenting. All these labors were shorter than had been usual with those who had had children before:

On the 20th of October, 1863, I attended the fifth case in which a breech presentation had been ascertained in the same manner as before, and Pulsatilla administered a few days previous and had the happiness to attain the same result. The child was born after a labor of three hours, vertex presentation, second position, all the others in the final position.

It is worthy of remark that the case above mentioned are all the cases of mal-position that have occurred in my practice since my first use of Pulsatilla to change the fetal position, and in ail it has been successful.

Hoping to call the attention of Obstetricians to the great value of Pulsatilla in mal-presentations, as well as in nearly all the sufferings incident to pregnancy and labor and thereby avoiding much suffering, I have given my experience in its use, and hope that others may be induced to make similar trial of it, and by publishing their cases perhaps confirm the profession in its use in similar cases. Although all the cases above named were breech presentations, I believe that Pulsatilla would be equally successful, in other mal-positions, still more unfavorable, and requiring manual interference to make delivery possible.

I would here remark that Pulsatilla³⁰, five pellets in half a tumblerful of water, one teaspoonful given every three hours, was the means used by me. Whether other dilutions would be equally successful I am unable to say, having never tried them.

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