COMPLICATED DELIVERY OF PLACENTA. 555 



hundred and third day; and in the other, until eight months and a 

 half after the birth of the child. Although its presence may be 

 found not to give rise to any accidents, some precautions ought 

 nevertheless to be taken in regard to it: for instance, the fingers 

 should from time to time be introduced into the vagina to ascertain 

 whether it be detached, and extract it as soon as it tries to engage 

 within the os uteri; in case the fingers cannot get hold of it, recourse 

 might be had to the pince cifauxgenne of Levret, or to Dr Dewees's 

 crotchet; injections with mallows water, or barley water sweet- 

 ened with honey, or even with decoction of bark, may be daily 

 thrown into the uterine cavity, to cleanse it, prevent absorption, 

 and bring away the detritus of the after-birth as they separate or pu- 

 trefy. 



It should not be forgotten, moreover, that these adhesions are the 

 result of a disease, and that after their violent destruction, the inner 

 surface remains in a pathological state calculated to excite some un- 

 easiness, and that they leave behind them a sort of suppurating 

 .wound that it imports us to cleanse and heal. 



1198. Hemorrhage may take place before the delivery of the 

 placenta, as a complication of any of the accidents heretofore men- 

 tioned; but it is also observed singly; whether it depends upon iner- 

 tia, spasm, plethora, or irritation of the womb, it is always a dan- 

 gerous phenomenon, which we ought to make haste to combat; 

 if the presence of the placenta is not the only cause, it at least serves 

 to keep it up and aggravate it; we should, therefore, be diligent in 

 extracting it, even although there should be inertia. Some authors, 

 however, have thought that the delivery of the placenta ought not 

 to be hurried while the womb does not contract, unless there should 

 be a partial detachment of the placenta. M. Lacour has lately en- 

 deavored to show, that artificial delivery of the placenta can only 

 have the effect of increasing inertia, and consequently to that, of 

 producing flooding; but daily experience is opposed to this view of 

 the subject, and the contrary opinion is generally adopted. I 

 have no intention of repeating here what I have already said con- 

 cerning the causes, signs, and general treatment of hemorrhage; but 

 I must speak of it as one of the complications of delivery of the after- 

 birth. 



1199. I am not sure that its mechanism has been well under- 

 stood; it is improperly attributed to the non-contraction of the 

 womb, in consequence of which the blood must flow in torrents 

 from supposed orifices that remain gaping upon the internal surface 

 of the organ; but is it not rather occasioned by the sudden cessa- 

 tion of pressure upon the hypogastric vessels, whereby the blood is 



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