MANAGEMENT OF THE CHILD. 561 



ARTICLE H. 



Management of the Child. 



The management of the child varies according to the state in 

 which it happens to be at birth, and accordingly as it is healthy or in 

 a diseased state. 



SECTION 1. 

 Of the Foetus in a Healthy State. 



When the child is born alive and in good health, which is known 

 by its cries and movements, after placing it properly between the 

 mother's limbs, the cord is the only thing that requires the accou- 

 cheur's attention at first. 



As soon as the child passes from the vulva, it should be laid cross- 

 wise, upon its side, with the face turned towards the foot of the bed, 

 between the woman's thighs. In this situation it can breathe and 

 run no risk of being suffocated by the matters flowing from the va- 

 gina. Should the cord be found coiled round the body, it must be 

 disengaged; it should be freed from any portions of the membranes 

 that it may have brought along with it, and also from the mucus 

 which sometimes obstructs the mouth or throat; and lastly, we pro- 

 ceed to tie and cut the umbilical cord. 



SECTION 2. 



On Tying and Cutting the Cord. 



1209. In the time of Hippocrates the cord was not cut until the 

 placenta was delivered. If the placenta was slow in coming away, 

 the child was placed upon a pile of wool, or on a leather bottle with 

 a small hole in it, so that by the gradual subsidence of the skin or 

 pile of wool, the weight of the child might react by almost insen- 

 sible degrees upon the placenta, and extract it without any kind of 

 violence. Deventer thinks the placenta should be extracted pre- 

 viously to dividing the cord; Dionis followed sometimes one plan, 

 sometimes another. Where the secundines required only gentle 

 pulling to extract them, he did not cut the cord until after they came 

 away, and pursued an opposite practice when he found it necessary 

 to introduce the hand in search of the after-birtli. Since the time of 



