556 DELIVERY OF THE PLACENTA. 



allowed to rush into them with great force; or upon the circumstance 

 that the blood must in some sort accumulate mechanically in the 

 uterine vessels, which being no longer supported, pour it into the 

 empty space which a few moments before was occupied by the 

 ovum — or perhaps on the fact, that together with these dispositions, 

 there may be some irritating cause present in the cavity of the uterus 

 itself. 



Upon this hypothesis, the best means of preventing a hemorrhage 

 would not be to rub the navel and the hypogaslrium with a spoonful 

 of brandy or cologne water, as advised by A. Leroy, but promptly to 

 apply a pretty tight bandage to the belly, and place the woman with 

 her head very low immediately after delivery. 



1200. After having extracted the placenta, if the flooding continues 

 to such a degree as to excite apprehensions relative to the welfare of 

 the paiient, provided the womb remains soft and inactive, or a sina- 

 pism applied betwixt the shoulders has been tried in vain, we may 

 without hesitation introduce the hand into the organ. De la Motte 

 had well remarked that this is the most certain method of putting a 

 stop to the inertia; pressure made by the hand, and in various direc- 

 tions upon the hypogaslrium, which is lauded as an important dis- 

 covery in the Journal des Savans of 1722, can never be a complete 

 substitute for this means of relief. 



Lijections of oxycrate, of pure vinegar or iced-water, which are re- 

 commended by Saxtorph; alcohol, and sulphuric or nitric acid di- 

 luted with water, with which Pasta advises us to cauterise the ute- 

 rine vessels; the introduction of a hog's bladder, to be afterwards 

 filled with air, water or astringent fluids, while within the womb, as 

 proposed by MM. Rouget and Vernet, would ofier much fewer ad- 

 vantages, and expose the patient to many more accidents, and are 

 not so easy of application as the hand; let us add, along with MM. 

 Pasteur and Evret, that Avhere we have any fear lest the hand alone 

 should not sufiice, we may always introduce, along with it, a peeled 

 lemon, or a sponge dipped in vinegar. 



1201. But provided there should be no inertia, we ought to have 

 recourse to the treatment indicated at the article on hemorrhage in 

 general, that is, to revulsives, refrigerants, and even the tampon. 

 Perhaps it would be well, where the flooding is overwhelming, to 

 compress the aorta above the sacro-vertebral angle, while waiting 

 until other measures might be put in practice; immediately after the 

 birth of the child, the abdominal parietes are soft, and in many 

 women it would not be difficult to act upon the aorta with the 

 thumbs; so that without attaching so much importance to this mea- 

 sure, which has already been spoken of by Boer, Madame Lacha- 



