348 HYGIENIC TREATMENT. 



sons add a slick, fixed cross-wise to rest the feet against during the 

 expulsive pains; but this fixture is more troublesome than useful, the 

 hands of an experienced nurse answer much better, for they can fol- 

 low the different degrees of flexion and extension of the limbs. In 

 the country, a bed is often made by placing six or eight chairs face 

 to face and laying a mattrass upon them. 



Indeed, a strong and well formed woman may be delivered in any 

 posture, on a chair, on the floor, a bundle of straw, on foot, and on 

 all the kinds of beds that have been proposed; so that it is only in 

 the cases where nothing interferes with the accoucheur's prescribing 

 just what he thinks best, that he ought to attach some value to the 

 composition of the lying-in bed; further, the only essential matter is, 

 that the woman should be as comfortable as possible, that she be not 

 incommoded, neither during the pains nor the intervals between them, 

 and that the perineum may have room to dilate. 



825. There is not, neither can there be any fixed period at which 

 all women should place themselves on the lying-in bed: some women 

 feel the necessity of going on to the bed as soon as their pains get 

 to be pretty strong; others not until a much later period, and most 

 women may be guided in this matter by what agrees best with their 

 own particular feelings; as long as they keep on the bed, or on foot 

 either, because they are more comfortable in either case respec- 

 tively, and not for the sake of gratifying some preconceived notion, 

 they ought to be indulged; it would be absurd to compel them to 

 remain on the bed from the beginning to the end of a labor, while 

 the only means of alleviating their distress consists in moving about 

 from place to place; on the other hand, by compelling them to keep 

 up till the close of the labor, their courage and strength are exhaust- 

 ed to no purpose, they are exposed to the danger of bringing on 

 flooding, to the prolapsion, and overturning of the womb, laceration 

 of the perineum, and to the too prompt and precipitate escape of the 

 foetus. 



Therefore, in regular labors, where there is no special indication 

 to be fulfilled, it is useless for the woman to lie down previously to 

 the rupture of the membranes, unless it be for the purpose of resting 

 when she feels fatigued. When on the contrary, the dilatation of 

 the OS uteri is complete, and especially when the head has descended 

 into the excavation, it is better, but not always indispensably neces- 

 sary, for her to lie down on the bed in readiness for it. Where the 

 pains are weak and far apart, and where the membranes give way 

 early, or the head remains very high above the superior strait, and 

 the OS uteri, although soft and very dilatable, opens with difficulty, 

 she ought to keep up and move about as long as her strength will 



