CONVULSIONS. 395 



can be made use of. Where the woman is delicate and nervous, 

 we have recourse to sedative infusions and waters, narcotic prepa- 

 rations, &;c. Sinapisms, blisters, scarificalions and other revulsives 

 are, in severe cases, particularly useful as accessory in effect to 

 blood-letting, or as supplementary to those evacuations, where they 

 are themselves inadmissible. Finally, should there be manifest 

 symptoms of disordered stomach or bowels, without any of the signs 

 of inflammatory irritation, I do not perceive that there wouhl be any 

 temerity in promoting either the vomiting or the alvine evacuations 

 by means of gentle emetics and purgatives; but during the labor, the 

 best remedy beyond dispute is the delivery of the child. 



902. Where the disease comes on before the end of the sixth 

 month, we ought to do every tiling in our power to succeed without 

 soliciting the expulsion of the fcBtus, its viability being at a later pe- 

 riod possible, there is no longer any need for so many precautions 

 on this head. 



To admit of the child being delivered, either with the hand or 

 with the forceps, it is necessary that the dilatation of the cervix 

 should be very advanced, or at least that the os uteri should be soft 

 enough to admit of the womb being entered without the employment 

 of any great degree of force. However, if a trial have been ineffectual- 

 ly made of ointments, injections and baths; if the woman or the child 

 were in imminent danger, and a forced delivery the only means of 

 safety; and in a case where the os uteri should be thin, but hard and 

 undilatable, and obstinately resist the contractions of the womb, there 

 ought to be no hesitation in following the counsel of M. Bodin, to 

 make one or more incisions into its concave edge, or in resorting to 

 what has been called since the time of Simson and Lauvergeat the 

 vaginal-cesarian operation. 



§. III. Dystocia caused toy the Premattwe De- 

 scent of the Uintoilical Cord. 



903. Although not a rare occurrences, procidence of the cord is 

 not very frequendy met with, for it was observed to happen forty- 

 one times in 15,652 labors, at the Maternite at Paris; its being more 

 frequently met with in private practice seems to depend upon the 

 hasty maneuvres of the persons who assist the lying-in woman, 

 rather than any other cause: Black has even asserted, but it is evi- 

 dent erroneously, that the descent of the cord is always the effect 

 of attempts to hasten the delivery. A woman was brought to my 

 amphitheatre while I was delivering a lecture; she was compelled 

 to wait half an hour at the porter's lodge; no one examined her, 

 and when she was brought up to the ward, the cord formed a loop 



