68 OBSTETRICS. 



the practitioner should resort to frictions, cold aspersions, or water 

 poured from a height upon the epigastric region, artificial respiration, 

 &c. Should these means fail, he may try the effeet of bleeding, by 

 cutting the cord and allowing about a table-spoonful of blood to 

 escape ; if this is unsuccessful, the case is probably hopeless. 



The third condition is most frequently produced by long-continued 

 pressure, or, from an interval elapsing between the birth of the head 

 and that of the body. Under these circumstances, the action of the 

 heart is weak, and the pulsation in the cord feeble and oppressed, the 

 surface is blue and the face livid, and occasionally it happens that 

 the form of the head is altered. Bloodletting is here obviously 

 indicated, and it should be done by cutting the cord and allowing 

 from half an ounce to an ounce to escape ; when it will generally be 

 found, that the surface becomes of a natural hue, the pulse quicker 

 and firmer, and attempt is made to respire. If the child does not 

 breathe, a sudden puff into its face, or a slap upon the buttocks, will 

 often establish respiration, or the means above mentioned may be 

 resorted, to. 



The tumour that is often found upon the scalp of new-born chil- 

 dren, called caput succedaneum, and which is produced by the 

 extravasation of blood, or effusion of serum beneath it, generally 

 disappears spontaneously, or by the application of spirit or some 

 stimulating lotion. 



Hemorrhage from tlie navel after the separation of the cord is 

 sometimes very troublesome, and may be treated by means of 

 astringents, cautery, compresses, &c.; if these means fail. Dr. 

 Churchill recommends to stretch open the navel and fill it with 

 plaster of Paris, either dry or moistened, allowing it to remain 

 till solid. Others propose to cut down upon the vessel and tie it. 

 A less formidable operation has been successfully practised in this 

 city, by passing two needles through the navel parallel with the sur- 

 face of the abdomen and at right angles to each other, and applying 

 a ligature beneath them, as in the operation for aneurism by anas- 

 tomosis. 



Tedious Labour. — The labour is often prolonged beyond the usual 

 limit by a delay in one of the three stages, and yet may be completed 

 without either manual or instrumental assistance. 



In the first stage it often depends on an undilated os uteri ; this 

 more frequently occurs with first labours, and also in women of 

 advanced age, than under other circumstances. On examination, 

 the OS uteri is found in one of two conditions, either thin and hard, 

 or semi-pulpy and oedematous, and but little influenced by the 

 pains, which may be frequent and very severe. It may also be 

 undilatable from the presence of cicatrices. 



One of the most effectual remedies for this condition is venesection, 

 which may be carried sometimes to a great extent, provided there 



