MANAGEMENT OF LABOR. 363 



coucheraent at Paris. Its employment too is followed with no incon- 

 venience; when I have occasion for it, I direct one drachm of the 

 juice or extract of belladonna to be triturated with one ounce of 

 cerate or hog's lard; with the fingers I easily introduce a portion 

 of this ointment, as large as a filbert, up to the os uteri, the whole 

 circumference of which is soon anointed with it. The belladonna 

 acts here as it does upon the iris, when applied betwixt the eye lids 

 a few hours previously to performing the operation for cataract, and 

 often with a promptitude that is really surprising. 



In the spring of 1825, a young woman of good constitution was 

 seized with labor pains at five o'clock in the evening; the labor went 

 on regularly all night. The next morning, at six o'clock, the os uteri 

 was as large as a three livres piece at least; from that time the dilata- 

 tion progressed slowly, although the force of the pains did not di- 

 minish at all; a vein was opened in the arm; the agitation of the 

 patient went on increasing, and the orifice continued in nearly the 

 same state. M. Ribail, who had the care of the woman, sent her 

 to the hospital, where I saw her at half-past six in the evening: the 

 OS uteri was a little larger than a five franc piece, and formed a thin 

 circle, almost sharp, hot, and extremely sensible; the pains still 

 continued; the ointment was applied at seven o'clock, and before the 

 clock struck eight the delivery was completed. 



Conclusive as was this result, it nevertheless appeared to me dif- 

 ficult to attribute it exclusively to the action of the ointment, but 

 since then I have used it in five diff'erent cases, and in all of them 

 the efl^ect has been, if not altogether as prompt, at least quite as un- 

 deniable. 



850. I have elsewhere said in what manner the premature rup- 

 ture of the membranes or their too long continuance in an unbroken 

 state, might retard a labor or render it a bad one. In tlie former 

 case we ought to do every thing in our power to favor the dilata- 

 tion of the orifice without increasing the power of the uterine con- 

 tractions, for it is important to relieve the foetus as soon as possible 

 from the dangerous compression it has to suffer; to fulfil this indica- 

 tion, it appears to me to be proper to direct the woman to walk 

 about, to moisten the parts in some way, and especially to have re- 

 course to the ointment of which I have just been speaking. 



In the latter, that is, where the point of the ovum is too slow in 

 giving way, it must be ruptured. To be done without inconveni- 

 ence, this little operation requires the combination of the following 

 conditions: 1. That the dilatation shall be, at least, very much ad- 

 vanced; 2. That the pains shall be maintained, without any threat- 



