INTRODUCING Dr. EDWARD E. CONRAD’S CpRIYATE T/FaTERNITY. -j J * w FOR THE MANAGEMENT OF OBSTETRICAL CASES BEFORE AND DURING CONFINEMENT. FOUNDED IN 1889. 264 West Thirty-Fourth Street, NEWYORK. physicians have known for some time from statistics furnished annually, that married women can pass through a period of confinement with a much greater degree of safety in a well-regulated select Maternity, where all the antiseptic pre- cautions and rules can be much more rigidly enforced, than in their own home surrounded by all the aids that wealth can command. And last, but not least, another class of cases in the domain of Obstetrics, for the accommoda- tion of which the Maternity furnishes special advantages, are those that for some reason or other may require an operation before or during labor. In fact, any convenience or assistance that a thoroughly equipped, well regulated Maternity can offer a physician in the management of his obstetrical cases, we are ready to furnish at as short a notice as is required to make complete arrangements for the reception of the patient. JVo emergency cases received into the Maternity. 4 ACCOMMODATIONS. All the conveniences and advantages that may recommend other places of this nature to the profession, we offer in a superior degree at our Maternity. Our purpose is to make it impossible for the prospective mother to disobey those laws the knowledge and respect of which are essential to her own and her child’s physical welfare, i. e., by conforming her to all the rules and precautions as to diet, dress, sleep, exercise, baths, etc., we insure the future health and happiness of herself and child. Further, because at times the pregnant woman’s need of a physician becomes very urgent indeed, I am almost constantly present day and night in the Maternity building. None certainly should receive more rigid attention or be in a position to receive more prompt attention from her physician than the pregnant woman. For that reason I am in almost uninterrupted attend- ance here, and all patients are under my direct observation. Not only because of this superior advantage 5 do I ask your consideration, but we offer you better accommodations as regards Table, Rooms, Home Comforts, Pleasant Associations, Mental Employment, Expert Nursing and, above all, perfect privacy of surroundings than you would End elsewhere. TABLE.—No time or expense is spared to fur- nish the proper kind and properly cooked diet that is all-important to the pregnant woman, embracing all nutritious, easily digested articles of food, being careful to avoid anything that would increase the tendency to the many dis- comforts attendant upon the digestion during the pregnant state. Either extremes as to quan- tity are carefully guarded against. ROOMS—are large, well-lighted, temperature carefully watched, and furnished with every comfort, so that by combining the sanitary ar- rangements with the convenience of a private, home, wc are able to please and. accommodate the better class of patients we desire. EXERClSE,—Patients after entering here are not subjected to a strict code of regulations, but beside being allowed to receive their friends at any reasonable hour, are encouraged to take gentle out-door exercise in order to obtain a 6 sufficient supply of pure air, which at this time is needed to a greater degree than when not in the pregnant state, to make up for the increased amount of carbonic acid eliminated HOME COMFORTS AND PLEASANT ASSO- CIATIONS, are of prime importance to the preg- nant woman. When extremely sensitive and seemingly irritable and unreasonable, the result purely of nervous derangement due to the many physiological changes in the system at this time, the surroundings and associations here will assist much to make the patient feel contented and satisfied. The greatest gentleness and consid- eration is necessary, especially in those cases where we know the natural tendency there must be to self-reproach and dissatisfaction. We fur- nish all the interesting and instructive books required for her mental employment, and en- courage light gymnastics and useful employment in order to make her stay with us peaceful, pleasant and full of contentment. We aim in every particular to protect the character of our patient and she need see no one unless she so desires, and, although, as stated before, the Maternity is not a prison, still the utmost secrecy can be maintained if necessary. 7 OBSTETRICAL PRACTICE IN THE MATERNITY. To insure the smallest possible rate of mortal- ity in the management of our cases, the utmost sanitary precautions have been observed, first of all, to keep the rooms scrupulously clean, spa- cious and perfectly ventilated. Direct inocula- tion is not the only source of danger to parturient women, but in a great number of cases of puer- peral septicaemia or putrid intoxication, where the history of the case and the management of the physician and nurse was in accordance with the strictest antiseptic principles, proved the infection by direct inoculation to be out of the question, and-pointed to the atmosphere charged with septic fungi as the source of the trouble. The lying-in chambers are therefore provided with large quantities of pure, warm air and plenty of light. Then again, beside furnishing our patient with a wholesome room for her confinement, her surroundings, in every detail, are of such a na- ture as to insure a speedy and thorough recovery. 8 Before being used for a new case, each bed is scrubbed and disinfected, the linen used having- been subjected to thorough disinfection by pro- longed boiling, and if at any time a patient should get up any suspicious symptoms, the room occupied, before being again used, is emptied, the floor and walls scrubbed with a bi- chloride solution and fumigated with sulphurous acid, and the linen burned. The patient under observation being isolated and being placed ia charge of a special nurse and physician. Last, but not least, every precaution is observed by myself and nurse to protect the patient from every possible form of direct contamination. To review our practice in detail here would be out of place, sufficient to say that I take great comfort in the fact that, owing to this antiseptic method, I have been enabled to handle over a thousand cases in obstetrics in the past two- years without being compelled to report a death. Although in a small per cent, of cases febrile symptoms manifested themselves, the precise cause of which I was unable to determine, still no alarming case of puerperal trouble has ever occurred in our Maternity. A number of the cases demanded heroic measures of treatment,, especially those requiring premature expulsion. 9 of the ovum, and the general condition of the patient was very unpromising; still, skillful nursing, conscientious medical attention and, above all, the most rigid antiseptic treatment, enabled us, up to this time, to return all of those placed in our care to their friends, thoroughly well and free from any of the complications so apt to result in private practice, where the patient is not so completely under your control. As a rule, patients are allowed to return home in two weeks after their confinement. Operative cases require about a week or ten days for con- valescence, subject to condition of patient. ADOPTION OF THE INFANT. Arrangements can be made, subject to the will of the mother and persons interested, to board the child with some responsible person until relations are ready to receive it; or the mother can give up all claim to the child, and we can place some respectable family securely in legal control thereof. Mother will only be allowed to nurse the child if she expects to take it with her at her dismissal. 10 MATERNITY FEES. The entrance fee, payable at time when the patient is received for treatment, is $lOO,OO. This covers all medical attendance, medicines, nursing’, laundry, care of infant and everything required except board during the two weeks of confinement. Board at either $15.00 or $20.00 weekly, sub- ject to room occupied. Meals are all served in the patient’s room and every attendance assured. If mother wishes us to adopt the infant, an extra fee of $50.00 is charged. Laundering is done in the house at $l.OO per dozen. Baby clothing furnished at $lO.OO, if needed. We employ a sufficient number of nurses to insure perfect comfort and good attendance dur- ing confinement. If desired, hovyever, a private nurse will be furnished at $25.00 per week during confinement. Application for board in the Maternity should be made at lea,st two days before expected en- trance, and it is desirable that patients enter at least two weeks before expected confinement. Any further particulars desired by the profes- sion, cheerfully furnished on application. 11 OPERATIVE CASES. The Maternity offers special advantages for the successful management of those cases in obstetrics that requires an operation. ARTIFICIAL ABORTION has been performed by me in . the past year a large number of times for the profession. The indications for this treat- ment are known to all practitioners, and it has been sanctioned by all civil and religious author- ities, where it offers the only hope of saving the life of the mother ; consequently long disserta- tions as to the morality of this proposition is entirely unnecessary. If the pathological or threatening conditions exist which might render the induction of abortion necessary, and the attending physician is uncertain as to the course to pursue, we will be pleased to receive the case for examination, and advise as our experience directs. The indisputable causes for the operation are : i. A prolapsed or retroflexed uterus that cannot be replaced. 2. Any of the diseases of preg- nancy that are rebellious to milder measures 12 and imperil the life of the mother, as uncontrol able vomiting, and different affections of the heart, kidney and lungs, when these assume an alarming degree of severity. 3. In those cases of extreme pelvic contraction, or in cases where large tumors render the passing of the child impossible, it is always better to induce abortion before the fifth month, than to subject the mother to the risks attending a Caesarean section, no matter how favorable the surround- ings. PREMATURE LABOR sometimes becomes necessary. It is considered good practice to induce expulsion of the foetus immediately after the seventh month or 28th week, in cases of 1. Moderate degree of pelvic contraction, where the passage of a full term child would be difficult and dangerous, thus improving the prognosis for both mother and child, which at this time is ready for an extra-uterine existence. The time selected for the induction of labor depends upon the conditions in each individual case, amount of contraction, etc. 2. Certain diseases of the mother, which attain a threatening degree of severity as pregnancy goes on, are conditions ■ ? ■- ■ >, ■ 1 which call for a premature expulsion of the foe- 13 tus, a measure which sometimes saves the life of the child, as it also is affected by £he dangers threatening the mother. Such conditions are chronic affections of the heart and respiratory organs, multiple pregnancies, hydramnion, tu- mors, ascites, antemia, hemorrhages, . chorea nephrites, etc. As stated before, we offer the profession special advantages for the management of those cases 'of pregnancy that, on account of some physical abnormality or some other reason, require an operation. If you have any such case under observation and you cannot conveniently treat it on account of inadequate surroundings, you are cordially requested to communicate with us in regard to the case. We will take entire charge, relieving you of all responsibility, and manage the patient with that expertness of procedure that is necessary in this class of cases. All pre- cautions are taken and antiseptic measures are rigidly employed to the end of the treatment, in order to rid these cases of their danger and make the risk a merely nominal one. Everything is done to insure health and recovery to the pa- tient. No chances are taken by us, and we allow none to be taken by the patient; conse- quently we have been enabled to handle a large number of these cases without a death or even serious illness resulting. Our nurses are all trained for this special line of duty and are ex- pert in their management of the patients. The rooms for this class of patients are pleasant,, comfortable and thoroughly sanitary, being reg- ularly completely disinfected by scrubbing and fumigation, and everything about the patient is scrupulously aseptic. The meals are all served in the rooms of the patients and everything is managed in a way to insure absolute privacy and protection to our patrons. Cases especially solicited, where difficult for- ceps manipulation or version is anticipated, or embryotomy or Caesarean section has been decid- ed upon. No statement can be made here as regards terms or charge for the treatment of these oper- ative cases, as those will be adapted to the con- ditions of each individual case. If you should be managing a case fit for this department, and decide to place it here, I should be pleased to hear from you and satisfactory arrangements can be made. Or send patient with one of the enclosed cards to the office, and we can arrange for a satisfactory management of her case. IMPORTANT. Office hours are held daily from 12 M. until 8 P. M. at my private office in the Maternity build- ing, where patients may visit me for purpose of consultation or examination. Recent cases of pregnancy, where operative interference has been decided upon, can be treat- ed at the office if not resident at too great a dis- tance, and the after treatment can be attended to by the local physician. This plan will answer where an absence from home for purpose of treatment at the Maternity cannot be conve- niently arranged. Charges for office treatment governed by the developments and conditions that exist in differ- ent cases, and will be furnished on application. Patients in sending for terms should be explicit in stating the particulars of their case, in order that I may obtain a proper understanding of the conditions. It is always best for physicians to send their patient directly to the office for pur- poses of consultation and examination, as a per- sonal interview is always more satisfactory to both patient and physician. If this is impossi- ble, all correspondence will be dealt with in per- fect confidence and will receive my personal attention. Address all correspondence to Dr. Edward E. Conrad, 264 West 34th street, N. Y. City