B. LE BARON BAYLIES, M.D.

      The first allusion of which I am informed by a medical author to the power of Pulsatilla to correct mal-presentation of the foetus, is the familiar statement of Creserio that Dr. Bethmann, in the Homoeopathic Gazette, reports an observation which should encourage us to follow his example. A woman in labor sent for him. The membranes were not yet ruptured, and the orifice of the womb but slightly opened, notwithstanding the presence of severe and protracted pains, and by an examination, he recognized a shoulder presentation. "Not willing to precipitate anything" (the foetus, I suppose), he gave a dose of Pulsatilla; some minutes after, the woman experienced a violent pain, with such a sensation of overturning in the abdomen that she was frightened; then, after some time of quiet, the pains recommenced regularly, and on the second examination Bethmann was greatly surprised to find the head presenting; the delivery terminated naturally." "I, myself," continues Creserio, "obtained, five years ago, open a lady in the rue St. Denis, a similar result by the use of the same means under the same circumstances".

      CASE I. -in the American Homoeopathic Review, May No., 1864, Dr. mercy B. Jackson, of Boston, reports the case, May, 1862, of Mrs. T., in her eighth pregnancy, who had puerperal convulsions in her last two confinements, and suffered since with severe congestion of the head and neuralgia. The doctor listened to the beating of the foetal heart, and found it not in the right or left iliac region, but beating strongly about two inches above and to the left of the umbilicus. On further examination, she found the back of the foetus to the mother's back, the small parts in front, could scarcely reach the foetus per vagina, but from the little that could be touched, believed it to be one of the nates. Pulsatilla, 30th, five pallets in half a glass of water. Dr. Jackson returned home and made arrangements on account of the tendency to convulsions, should it by necessary to take the child with forceps. Being called five days later, found the patient with severe periodical pains, the os uteri undilated and the foetal heart beating in the same place; gave Pulsatilla as before; pains left and all slept till morning. She could then mark the points of the nates and assure herself of the presentation. In the meantime, she had searched for light on means to avert convulsions, and finding the record of Dr. Bethmann's case, hopefully gave Pulsatilla 30, in solution, a teaspoonful every three hours when awake. On the third day of its regular use, the patient felt a great commotion in the abdomen with pain and necessity to go to stool, and soon felt better and more natural than for a long time previous. At 11 A.M. the next day, she was far advanced in labor, the head coming down rapidly; in thirty minutes, a boy, weighing eight pounds, was born. Both mother and child did remarkably well.

      CASE II. -Mrs. P., September, 1862, who had four children all born by the breech; was on this occasion, also of breech presentation, treated in the same way, with similar result.

      CASE III. -May, 1863. Another case of breech presentation was treated in the same way, with similar result.

      CASE IV. -August, 1863. Another breech case, primipara, was treated by Dr. Jackson with Pulsatilla 30 with similar result. The patient had passed the expected time ten days, when the malposition was discovered and Pulsatilla given: twenty-four hours later, the head was found presenting.

      CASE V. -October 20th, 1863. The fifth case in which a breech presentation had been ascertained in the some manner as before, and Pulsatilla administered, had the happiness to attain a few days later the same result. The child was born, after three hours labor, with vertex presentation, second position, all the other mentioned cases in the first position. These five were all in which she had, at that time, used Pulsatilla, and all successfully.

      CASE V. -October 20th, 1863. The fifth case in which a breech presentation had been ascertained in the same manner as before, and Pulsatilla administered, had the happiness to attain a few days later the same result. The child was born, after three hours labor, with vertex presentation, second position, all the other mentioned cases in the first position. These five were all in which she had, at that time, used Pulsatilla, and all successfully.

      CASE VI. -August 19th, 1866, A case of labor begun, yet delayed; foetus lying across the abdomen head to the left, back upwards, only the knee within reach, the breech being high up on the right side, heart heating on a line with or a little above the umbilicus. Gave Pulsatilla 30 in half a tumbler of water, a teaspoonful at 2:30 P.M., continued every hour. At 6 P.M., the head had come down on the left side, so that it could, with great exertion, be touched; the knee had receded, and the pelvis on the right side was empty. At 12 P.M. examination showed the head fully down; at 4 A.M. a girl was born, after only 2 1/2 hours of much pain. When asked if she had suffered much, the mother replied, "No! but a tremendous commotion." This was the seventh case, six breech and one transverse, in which Pulsatilla 30 had changed the presentation to the vertex before the membranes had been ruptured.

      CASE VII. -May, 1870. A woman, eight months pregnant, with breech presentation, took Pulsatilla 30, as always prescribed by Dr. Jackson, every three hours: evolution was accomplished in a week, child born at full term by the head.

      CASE VIII. -March 2d, 1871. Mrs. H. expecting confinement in a week, trunk presentation, back in front, head to the right. Pulsatilla 30, in solution, every six hours. At the end of five days evolution nearly accomplished. Five days later she was delivered by the vertex, after short labor.

      CASE IX. -March 15, 1871. Mrs. McL. expecting confinement daily. Breech presentation. Pulsatilla 30. In three days examined, found the vertex presenting; delivered on the 23d with rapid labor, child born by the head. Fourteenth trial by Pulsatilla, states Dr. Jackson, resulting with perfect success but one, in which Pulsatilla had been omitted some time before delivery, after a trunk presentation had been converted into a foot.

      CASE X, by Dr. A.W. Woodward, of Chicago, Med'l interest., Vol. VI, p. 139. -Mrs r. with fourth child, large, muscular woman, two weeks previous overtaxed herself in lifting, and subsequently felt no motion; was taken in labor at 12 M., with severe pain until 7 P.M., when seen. Examination-Os so high the hand had to be introduced to reach it; it was closed through soft and dilatable; unchanged during pain. By external examination, uterine tumor found nearly transverse, head at the right upper side, pelvis and feet in the left. During pain the doctor could feel the contraction to be transverse, longitudinally with the tumor. Pulsatilla 2nd, in solution in water, after every pain for an hour. At 8 P.M. a gradual correction of the shape and position of the uterine tumor; medicine continued another hour; position fully corrected; long axis of the tumor in the median line, os descending, dilation one inch. The head presenting, pains much less frequent and less severe, patient sleepy. At 6 A.M., found the woman delivered, having been awakened from a five hours sleep by pains which did not leave her till the child was born in about five minutes.

      CASE. XI -Dr. W. H. Burt, in Med'l Investing., Vol. VIII, May, p. 71, gives the case of a woman who, two years before, had borne a child with presentation of the feet. She had now, february 21st, a cross presentation with the head in the left iliac fossa. The form of the child could be traced with eye and hand. The mother said the child had lain in that position during the whole period of gestation. I quieted her mind as much as possible and said I would give her something that would turn the child, and gave Puls. 30, about thirty small pellets dry on the tongue, and left the case, never believing that Pulsatilla would change the child's position.

      February 27th I was called, and to my great astonishment found the breech in the epigastric region, the head in the first position and labor progressing naturally. I asked the lady if she could tell when the child turned to the natural position? She replied, "Oh yes, in less than half an hour after taking the dose of medicine, there was a great commotion in the womb, and the child turned with his feet to my stomach".

      CASE XII. -Dr. W. F. Dodge detailed the following case in the medical Investigation Vol. VIII, p. 80;Mrs. B. of bilious lymphatic temperament. Melancholy, a Nux patient, has four children; always troubled with labor for two or three days; had lost two children with hydrocephalus. She was found sitting in a chair. She said: "The child is not right; it is across, the head is here,S putting her hand on her left side; the os was found undilated. There was without doubt mal-presentation; I gave Pulsatilla 2nd and awaited results, expecting a tedious time. In about half an hour she gave a scream, drew a long breath and exclaimed: "the child is turned," went to bed and in four hours was delivered of a healthy, living child.

      CASE XIII. -Dr. H. W. Martin, in 1866, had a case of labor in which he thought he detected a shoulder presentation; gave a dose of Pulsatilla 200, and went after Dr. M.L. Kenyon. On returning, the woman said that the medicine had produced a great commotion in the abdomen. Dr. Kenyon found the vertex presenting, and the child was born in fifteen minutes.

      CASE XIV. -Dr. Kenyon stated that having a case of breech presentation-it was a boy, as he could feel the genitals -he gave Pulsatilla and went home, and returning in a short time the woman complained that a great commotion had occurred in her abdomen. He quickly made examination, the pains being urgent, and received the head of the child in his hands, it being, as predicted, a boy.

      CASE XV. -Dr. Baylies' case: I was called September 6, 1873, at 11:30 P.M., to Mrs. S., a black-haired brunette, who had suffered severely with pains, attended by great anxiety and apprehension, since 6 A.M. The wall of the uterus acquired no tonicity or firmness during the pains, which were without expulsive effort. On digital examination, the os uteri could not be distinctly felt, but a tuber ischii just within the brim of the pelvis, near the left acetabulum. By palpation though the abdominal wall, i traced the child from above the brim of the pelvis, n the left, to a point above the crest of the mother's right ilium, where I unmistakably grasped its head, the back of the child presenting toward the anterior uterine wall. I prescribed Pulsatilla 200 in half a glass of water, a teaspoonful every two hours. Was called in haste the following morning at half-past four o'clock, and found the patient in active labor, the pains regular and efficient, the child's head occipito anterior in the upper strait. The birth was completed and placenta delivered at 5:30 a.M. The mother stated that she felt a turning movement of the child after the second dose of Pulsatilla. She Had formerly required Sulphur, though not recently, for head symptoms and hemorrhoids; was at the time of labor and had for some days been troubled with a cough which seemed to come from the upper sternum, and caused soreness in the abdomen. Without regard to the malposition and the inefficient pain, her temperament, fretful and worried state of mind and the cough from the upper sternum might have suggested Pulsatilla. 

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