FLOODING. 383 



general symptoms are gradually allayed, the liypogastrium becomes 

 more firm without increasing in size, and provided the womb is not to 

 be emptied, the woman only experiences a feeling of tenesmus, strain- 

 ing and weight in the pelvis, and sometimes slight colic pains; while, 

 in the opposite case, pretty smart pains, and real contractions of the 

 womb supervene; in consequence of w hich the clots, the tampon, 

 and the product of the conception are all expelled one after another 

 from the genital organs. 



In some women it is followed by such a degree of uneasiness, 

 even although there may be no uterine contractions, that they insist 

 upon its being removed; in general, their entreaties should be re- 

 sisted, provided no evidences of internal hemorrhage are discovered, 

 unless, indeed, the pain is so acute as to give rise to certain nervous 

 aflections, or convulsions; complaints in these cases are rather to 

 be desired than feared. After some time the functions are seen to 

 return to their natural state; and, in order to avoid the risk of a 

 return of the flooding, the tampon is left in situ as long as possible, 

 at least for several hours, or even a whole day; then, when it is 

 no longer considered to be indispensably necessary, the T bandage 

 only is removed, for the tampon, being no longer kept in the organs 

 by an external force, it escapes spontaneously and gently. 



884. Dilatation of the os uteri, and rupture of the membranes. 

 Before proceeding to forced delivery, Puzos recommends the trial 

 of a practice which is, in his opinion, much more simple, and par- 

 ticularly much more consonant to the nature of the organism; in- 

 troduce, says he, first one, then two, then three fingers into the 

 orifice, Avhich you should titillate and irritate, but very gently; and 

 you will often find that this alone will suffice to stop the hermorrhagy, 

 and to induce the womb to contract. If this does not suffice, begin 

 to dilate it, enlarge it with all the care and gentleness that the seve- 

 rity of the symptoms will admit of your using, and if you still do not 

 succeed, perforate the membranes, and the vacuum that will take 

 place in the membranes will rarely fail to be followed by the expul- 

 sive contractions of the womb. You will have, it is true, a prema- 

 ture delivery, but which will be less dangerous both to the mother 

 and the child than if the practitioner had undertaken to deliver the 

 foetus. 



885. This conduct is particularly adapted to cases where hem- 

 orrhage takes place during labor, or where the pregnancy is very 

 much advanced, and the placenta is not attached near to the neck. 

 Notwithstanding, it is evident that with the exception of the rupture 

 of the membranes, the tampon fulfils pretty nearly the same indica- 

 tions, and that where the flooding is violent it would be wrong to act 



