妊娠後期に特発性脳脊髄液減少症を発症した1例を経験した．39歳，G1P0，妊娠33週4日に突然の強い頭痛で発症し，入院管理した．臨床症状から脳脊髄液減少症と診断し保存的治療を行った．症状は改善せず，妊娠38週2日に硬膜外麻酔下での帝王切開分娩を行った．硬膜外麻酔時に一時的な呼吸抑制をきたし，術後の頸椎単純MRI検査でC7付近に硬膜穿孔を疑う所見を認め，診断を確定した．児は3,006gの女児で，Apgarスコア1分後8点，5分後9点であった．母体は術後1日目に頭痛が軽快し，育児に支障なく退院した．同疾患の妊娠合併例での管理に具体的な指針はなく，保存的治療で改善しない場合は症例毎に治療方針を検討し，選択することが必要である．

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This article reexamins the rise of coolie trade in mid-19^<th> century Amoy (Xiamen), the problems it generated and the role played by the British and Qing local officials in the process of solving those problems through a discussion of the social and economic conditions that China's coastal regions faced. The coolie trade in Amoy began as the formation of a network between Chinese and foreigners in the coastal regions met and intermingled with the traditional process of migration, becoming embroiled in the chaotic events that plagued these regions from middle of the century on. As a migrant labor demand-supply gap was created between expanding demand for low wage workers and growing unpopularity of the coolie trade, local Chinese brokers began resorting to such practices as abduction in order to secure good quality labor. However, due their indiscriminatory nature, these illegal practices were cited as draining the coastal regions of crucial human resources, forcing the powers that be to take measures for dealing with the coolie trade. The Amoy Riots that broke out in reaction to the coolie trade presented an opportunity for the British and Chinese authorities to cooperate in solving the problem, and this opportunity was made possible by a lack of any strong xenophobic sentiment in the region. Upon a request from the Qing local officials, the British Consulate took steps to drive out such Cantonese forces as large-scale coolie brokers and pirates, applying pressure on ships and merchants under both the British flag and those of other countries, resulting in the decline of the coolie trade. On the other hand, the emigration had already begun to concentrate in Southeast Asia under the blind eye of the local authorities, since this new source of labor posed no threat to regional security. Therefore, within the process of regulating the emigrant coolie trade, Qing local officials not only requested the British Consulate to take action against foreign merchants, but also commissioned the immigrant labor business. These tasks "commissioned" to Western countries and individuals, in particular the British, can be interpreted as a crackdown on smuggling and the pacification of piracy, both of which led to the reinstitution of Qing government control over its coastal regions. The introduction into China of modern institutions by the West that can be seen both as beneficial and coercive in nature was in fact implemented in the form of projects "commissioned" by China to Western governments, bureaucrats and private individuals.

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