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GESTATION AND PARTURITION. 451
When hemorrhage occurs after delivery, from reten
we must de
tion or partial adhesion of the placenta,
liver it by introducing the hand, guided by the cord,
first removing the clots of blood. This operation, with
the application of the cold compress to the abdomen, the
use of the vagina syringe, and the wet bandage, with a
compress under it, will cause the uterus' to contract and
the hemorrhage to cease.
The signs of internal hemorrhage are great chilli
ness, bloodless lips, a small, quick pulse, and faintness.
The uterus may be felt—a large irregular mass. We
shall find it filled with clotted blood, and the afterbirth,
which must be removed.
It is useless for me to give directions for the use
of instruments—I have only to say that they are only
to be resorted to in case of imperious necessity to save
the life of mother and child, if possible ; the mother
alone, if there must be a choice ; or the child, if the
mother can not be saved. Dr. Dewees, in the course
of his practice in Philadelphia, had three thousand
labor cases, and was never obliged to destroy the life
in the
of a child. One of our fashionable malaperts,
same practice, would have killed scores.
In all cases of labor of moderate duration, it is better
for the patient not to eat, but be content with an occa
sional draught of water. When all the power of the
system is, or should be in the uterus, the stomach can
not digest. When food has been taken shortly before
L-ibor, it is generally vomited.
In summer, if the water at hand is not very cold, we
should have ice to cool it, in case of need.
All attempts to dilate the vagina are irritating, and