[Reprinted from the New York Journal of Gynecology and Obstetrics 
for March, 1894.] 
A CASE OF EXTRA-UTERINE PREGNANCY.* 
By E. L'H. McGinnis, M. D. 
On the morning of April 15th last there came to my office Mrs. 
X., a large, rather heavily built woman about thirty-three years of age, 
married about eighteen years, having had three children in that time. 
She had menstruated pretty regularly every twenty-eight days, the flow 
lasting, however, from only half a day to a day and accompanied by 
nothing more than ordinary discomfort. Her flow had been decid- 
edly more free and normal since the laceration of her cervix was re- 
paired and the uterus curetted by the late Dr. James B. Hunter, from 
whom she came directly to me. Her general health was far above 
the average and she seemed to complain only of a backache and 
headache occasionally, which were caused by a retroflexion and which 
did not bother her when she wore a pessary. The perinseum was 
somewhat relaxed and a rectocele was making its appearance. 
Her object in coming to my office at this time was to ascertain 
the cause of a dull, severe pain in the left inguinal region and a 
wretched feeling of nausea which she had noticed for a couple of 
weeks previous to her visit; she had also had only about a half-day's 
flow five weeks before and none one week before. 
My nurse having arranged her on the back upon the table I ex- 
amined her very carefully and found a fluctuating mass to the left of 
the uterus exquisitely sensitive on pressure and giving a distinct sen- 
sation of something floating in the mass. Taking into consideration 
the lack of flow and nausea as well as the pain, I became convinced 
that she had a tubal gestation and, being an unusually sensible patient, 
I explained to her my fears. She was perfectly satisfied to accept 
what I told her but, at my own request, she consented to see Dr. 
Clement Cleveland in consultation, which she did; he fully verified 
* Read at the annual meeting of the Alumni Association of the Woman's Hos- 
pital, held January 17, 1894. 2 
E. L'H. McGinnis, M. D. 
my diagnosis, agreeing with me that it was probably in the ninth or 
tenth week. 
As you may know, my belief in the use of the galvanic current for 
the destruction of foetal life in the tube up to the end of the third 
month of gestation and my previous success in seven cases when I 
used it led me to recommend it in this instance and, with the ac- 
quiescence of Dr. Cleveland, I proceeded as follows : A ball electrode 
was placed to the left of the cervix and connected with the positive 
cord of the galvanic battery, and the negative cord was attached to 
the clay pad and placed on the abdomen to the left and over the 
mass. The current was then turned on till it reached sixty milli- 
amperes and was administered for ten minutes, being broken at in- 
tervals of about one second. This I did daily for four days, using a 
milder current each seance, and at the end of that time I substituted 
the faradaic current, my idea in doing so being to hasten absorption. 
At the end of ten days I asked Dr. Cleveland to see her again with 
me, and we agreed that there had been a rapid diminution in the size 
of the mass to about two thirds of its original dimension (which I 
neglected to say was somewhat larger than that of a hen's egg), and 
the patient had suffered very little if any pain, even seriously object- 
ing to remaining in bed although I should have preferred to have 
had her do so. 
I continued this treatment daily until May 23d, when the mass had 
diminished sufficiently to warrant my belief that it would be safe to 
operate on her rectocele, which I did with the assistance of Dr. 
Bissell and Dr. Adams. All went well, so far as the operation was 
concerned, and the patient had no temperature or pulse above ioo° 
and no symptoms of septicaemia. On the evening of the fifth day 
after operation the nurse told me that the patient had had one sharp, 
cramp-like pain in the left groin, followed ten minutes later by the 
discharge per vaginam of about a half-ounce of black, putrid matter, 
resembling decomposed flesh and a few drops of clear blood with 
some odor, which continued to come away by drops for about twelve 
hours. There was no pain following the expulsion of this broken- 
down pabulum and no symptoms of shock or rupture of the tubes 
nor of septic trouble. 
Some days after, when removing the sutures from the perfectly 
healed perinaeum, I very carefully examined the seat of the gestation 
and was delighted to find the mass had entirely disappeared, only a 
moderate tenderness on pressure being left. This was on June 1st, 
and before my departure for Europe (July 1st) all tenderness had dis- A Case of Extra- Uterine Pregnancy. 
3 
appeared and the patient has been a well woman ever since, with the 
exception of a metritis caused by sudden exposure to cold about six 
weeks ago while unwell. 
The time allowed me to-day is limited to but three minutes or I 
would follow the description of this case by another similar one which 
I treated at the same time that I was occupied with the one herein 
narrated and with perfectly satisfactory results. 
Now, there may be those of you who will say that the diagnosis 
was incorrect or such a happy result could not have been reached. 
To those I will simply say that, had they seen the patient, there is no 
doubt in my mind that they would agree with Dr. Cleveland and my- 
self, and the result proves the correctness of the diagnosis and also 
the fact that this method of dealing with ectopic gestation before the 
fourth month is certainly to be resorted to by those conservative men 
who have their patients' welfare at heart. I can not close without ref- 
erence to the excellent and exhaustive report and statistics of Dr. 
Brothers, published in the January number of the American Journal 
of Obstetrics, showing but one death (Janvrin, 1886) in seventy-eight 
cases of ectopic gestation treated by electricity without puncture, and 
in his case there were marked symptoms of haemorrhage before the 
current was resorted to, as Dr. Brothers says. After the expiration of 
the third month, or when there are symptoms of rupture, surgery is of 
course imperative, and one should always be prepared to operate at 
once should necessity arise while treating with electricity. 
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