Cases Illustrative of the successful employment of Oil of Turpen-
tine, in Puerperal Tympanitis, fc. By Joseph Smith, M. D.,
of Danville, Kentucky.
I submit the following cases to the profession, in which the
oil of turpentine was advantageously employed in various puer-
peral affections, accompanied by tympanitis, and symptoms of
incipient metritis, or peritonitis. I do not advance that the cases
in question were the typhoid puerperal fever; and my object is
simply to call attention to what I deem the undoubted value of
the remedy in question, in various forms of abdominal disturbance
after labor.
1.	Mrs. II. was confined July 10th, 1850. The birth was pre-
mature, but there was nothing unusual in the labor. She seemed
to be doing well, until the next day; when, on calling, I found
her abdomen much enlarged, and very tender, and painful. The
lochial discharge was not suppressed; the pulse not over 85 ;
and the skin not hot. Believing the case one of simple tym-
panitis, I directed the oil of turpentine and castor oil, of each a
teaspoonfull every four hours, with fomentations to the abdomen.
After some three or four doses had been taken, the swelling
and pain were almost entirely dissipated. There were some
partial relapses on the 13th and 14tb, which were readily re-
lieved by a dose or two of the same mixture. This combination
caused one or two actions from the bowels, more laxative than
purgative.
2.	Mrs. S. was confined May 21st, 1852, with a natural labor.
On the third morning, the 23d, she imprudently rose in bed, and
exerted herself. She was taken immediately with a most violent
chill, which lasted some two or three hours. Some three hours
after the attack I saw her, and found her with hot skin, pulse
120, thirsty, womb very hard, and exceedingly tender and pain-
ful. Abdomen not swelled, excepting in the right groin, which
was also very tender to the touch. Great restlessness and
anxiety of countenance. Lochia and milk both present. This
patient I knew from constitutional peculiarities could not use
mercurials or opiates; and, as I thought her too weak to bear
the lancet, I concluded to try the oil of turpentine. She was
directed to take thirty drops of this medicine every two hours,
with hot fomentations to the bowels. It was given in a spoonfull
of buttermilk.
Being with the case pretty constantly, I was enabled to watch
its course. From the second dose, there was evidently some
relief of pain and heat, in eight hours there was a decided change,
in twenty-four hours there was scarcely a vestige of pain or
fever. From that time the turpentine was gradually withdrawn.
No relapse.
3.	A negro woman of Mr. S.’s was confined about the 25th
of July last. Did not attend her. She was reported as doing
very well, until August 3d, when I was called to see her. I
found her complaining much of her abdomen; the womb was
enlarged, hard and tender; pulse 95 ; tongue coated ; skin dry
and warm. She had been complaining several days; said the
lochia had ceased the night before ; some milk. Gave calomel
and ipecac, pretty freely, and directed fomentations.
August 4Ah. Found her in much the same condition as on
yesterday, only the abdomen more enlarged and painful; stomach
still irritable ; no milk. Directed fomentations, spirits turpen-
tine 30 drops, with a teaspoonful of paregoric every two hours.
This was continued until the 6th, when the stomach became so
irritable that the turpentine was suspended. But there was evi-
dent and great relief of pain, swelling and fever. Mustard, &c.,
soon relieved the stomach, and the patient gradually improved
until the 12th and 13th ; she had a slight relapse, when the
turpentine and paregoric was again given, with early relief.
This patient took one or two mercurial potions during her
attack.
4.	Mrs. S------was confined, Sept. 15th, 1852. First child,
easy labor. On the 22d was taken with a severe chill, followed
by much pain in abdomen ; the womb hard and painful, and
strong bearing down sensations, almost like strong labor pains.
Of this there has been a good deal since her confinement. Her
skin hot and moist; pulse ranging from 120 to 130 ; thirsty ;
very restless. Directed spirits turpentine, 30 drops, laudanum,
20 drops, every three hours; fomentations. In twenty-four
hours the fever, pain and swelling were almost entirely gone.
The bearing down tenesmus in this case was very peculiar.
It was present at intervals for ten days after labor, some-
times slight, at others very severe. I could not account for
it. There was no smell in the lochia indicating the remains
of the membranes, or a clot. Nor could I detect anything of
the kind by the examination per vaginam. Five grains cam-
phor, and one-eighth morphine were the only means that gave
relief. Larger doses of morphine narcotized her too much.
5.	Mrs. G------was confined Dec. 2d, 1852. First labor; did
not last an hour. Being absent, another physician was called;
birth before he arrived ; he removed the after-birth. Calling
next day, I found her suffering much from after pains, and some
excitement. Left portions of morphine to be used as occasion
demanded.
4th. Found her worse; high fever; pulse 130 ; skin hot;
abdomen swelled and painful; womb hard; right groin giving
much pain on pressure; bowels confined. Directed senna to
be used until free purgation; then to use oil of turpentine,
25 drops, and sulphate of morphia one-fourth grain every three
hours.
5th. Found her much easier, less pain and swelling; pulse
still frequent; continue turpen. and morph., with fomentations.
Blue mass at night, x. grs. 6th. Still some fever and pain; pulse
120 ; tongue coated ; no operation ; abdomen still enlarged, but
not so tender. Omitted turpentine and morphia. Directed a
purgative, and spirits nitre, and wine ipecac, every four hours;
calomel, ipecac, and camphor pill at night. This case continued
to alternate for some two weeks. The lochia continued, sometimes
almost ceasing, and then too free. Secretion of milk ceased
after the fifth day. The oil of turpentine was not used after
the sixth day, excepting when there was much increase of the
pain of the womb, when a few doses almost invariably gave re-
lief. The general treatment after this day was fomentations,
warm hip bath, spirits nitre and ipecac., when there was fever.
Laxatives.
Dec. 20. She was entirely convalescent.
6.	Mrs. A-----, confined February, 10, 1853. Tedious labor.
Had pain in the side during labor. Twelfth morning was sud-
denly taken with severe pain in back; no fever. Camphor and
turpentine on cotton applied to it, relieved the pain in the course #
of an hour. At noon the womb became very painful; skin hot;
pulse 110 ; headache. Directed to take 30 drops spirits tur-
pentine every two hours until relieved. She took three portions
with entire relief of the womb.
Remarks.—The ages of these cases varied from eighteen to
thirty-two. It will be seen that, in all of them but one, the tur-
pentine was commenced early in the attack. The negro woman
had been sick several days before she was seen. I am satisfied
that this treatment will be successful as it is promptly used.
If the remedy is delayed until the inflammation has advanced to
structural lesion, it will have to be withdrawn, or, at any rate,
combined with mercurials and alteratives with opium.