48 OBSTETRICS. 



If the ovum is not discharged with the tampon, and cannot be 

 reached with either the finger or hook, it is recommended to leave 

 such occurrences in the hands of nature, rather than use force. 



The prophylactic ireatme^it consists in the avoidance of all causes 

 of excitement, both mental and bodily. Small bleedings and rest if 

 she be plethoric ; a nutritious diet and tonics if otherwise, together 

 with careful cold sponging. When the abortion is habitual, and the 

 uterus is irritable, an efficient remedy has been found in the adminis- 

 tration of an opiate enema every night, consisting of forty-five drops 

 of tr. opii, in a wineglassful of starch water, rest, tonics, &c. 



PATHOLOGY OF THE FCETUS, AND SIGNS OF ITS DEATH. 



The foetus is liable to many of those diseases that attack the child 

 after its birth. Many of these are entirely independent of the mother, 

 but there are also many with which the child is affected seriously 

 through her. As examples of the latter may be classed, those cases of 

 premature expulsion which occur during the prevalence of epidemic . 

 diseases, and where the foetus appears to have participated in the dis- 

 ease of the mother. Dr. Churchill has observed a considerable quick- 

 ening of the action of the foetal heart, some days after pregnant women 

 have been attacked with fever. Examples are not wanting of cases 

 where children have been born with small pox, or measles ; and 

 according to Duettel, Schweig, Zurmeyer, &c., children born of 

 mothers, who were suffering under intermittent fever ^ have exhibited 

 the same disease immediately after birth. 



There is scarcely an internal organ that has not been described as 

 the seat of inflammation ; the brain and its membranes, the lungs and 

 pleura, the peritoneum, the mucous membranes of the lungs and 

 bowels, may all be the seat of inflammation during uterine life. 



In addition to these acute diseases, the foetus presents even more 

 numerous cases of chronic afl^ections ; general hypertrophy, or 

 atrophy, syphilitic diseases, worms, calculus, dropsy, jaundice, her- 

 nia, &c. Even the bones and joints may be the seat of disease ; 

 children are sometimes born with rickets, caries, and necrosis ; and 

 it has happened to many practitioners to meet with cases of fractures 

 of some standing in children just born. 



Unfortunately we possess neither the means of diagnosticating, 

 nor of treating these cases of intra-uterine disease. 



The signs of the death of the fcBtus, are also obscure and uncer- 

 tain. Absence of the sound of the foetal heart, is a negative sign, 

 and its value will depend much upon the skill of the auscultator. 

 If after repeated and careful auscultation of the abdomen no trace 

 of foetal pulsation can be detected, the death of the foetus may be 

 asserted on safe grounds. Cessation of the movements of the fcBtus 

 is no proof of its death, as the movements may be suspended for 

 some days without its death. The sensation of a weight in the 

 abdomen rolling about as she moves, is, with some rare exceptions, 



