MANAGEMENT OF THE CORD. 563 



there could be no advantage obtained by tearing off, bruising, or 

 sawing of the cord, as some authors have recommended, with the 

 view of more closely imitating the quadrupeds, even although we 

 intend to dispense with the use of a ligature. 



1212. The cord being cut, it should be squeezed between the 

 fore finger and thumb, if there should be any disposition in it to 

 bleed, the other three fingers take hold of the breech; the other hand 

 is placed under the shoulders and nape of the child's neck, which is 

 thus removed from the lying-in bed, and commonly deposited on the 

 nurse's lap; there it can be examined at leisure. Previously to put- 

 ting on the ligature, we ascertain that no loop of intestine has got out 

 through the umbilicus, that there is not an omphalocele. Should such 

 a tumor exist, we ought to try to reduce it, or at least not to include 

 it within the ligature we are about to place on the cord, as happened 

 to some children under the notice of M. Sabatier and Madame 

 Boivin. In the time of Aristotle the midwives were in the habit of 

 forcing the blood contained in the cord into the belly of the foetus be- 

 fore they tied it, and pretended by means of this practice, which has 

 been revived at the commencement of the present century, to restore 

 strength and vigor to feeble children. Some again have maintained, 

 along with Rhazes and the other Arabian physicians, the Abbe Bi- 

 zance and M. Sarton, that this blood ought to be very carefully 

 squeezed out instead of forcing it in; that it is particularly necessary 

 to evacuate the kind of serosity or lymph, more or less of which is 

 contained in the cord, either by covering it with punctures, or squeez- 

 ing it with the fingers, either naked or covered with a piece of rag, 

 for they attributed to the retention of these matters the property of 

 producing the small pox, crusts on the head, tetanus, and convul- 

 sions. Levret, also, thinks that by squeezing out these humors we 

 may prevent the occurrence of infantile jaundice, that at least which 

 he compares to ecchymosis; but this opinion, which M. Desormeaux 

 seems to partake in some measure, cannot be maintained, and scarce- 

 ly deserves to be discussed. 



In my opinion it is of very little consequence whether we take this 

 precaution or omit it: if it is sometimes of use, it is so because it 

 admits of the ligature being applied upon the vessels more exactly, 

 without its being so easy to cut them off, and admits of their drying 

 sooner, and without putrefaction. 



1213. As to the ligature itself, De la Motte advises us to apply it 

 at the distance of one inch, Deventer, Levret, and the moderns at 

 the distance of two fingers breadth, others at three, four, five, six, 

 and even twelve inches from the abdomen. Some persons have re- 

 commended the application of two, and in such a way that the one 



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