564 MANAGEMENT OF THE CHILD. 



nearest the abdomen should not be so tight as the other. Sometimes 

 it has been recommended to draw it very tightly, at others very loose- 

 ly. One person is content with a single turn and a single knot; 

 another thinks there should be two turns and a double knot; a third, 

 like Plenck and M. Desormeaux, makes first one turn and one knot 

 and then bends the cord into a noose to tie another knot upon it. Some 

 would not dare to use any thing except tape, whereas wiser persons 

 make use of what they can find at hand; but in fact, is this liga- 

 ture really necessary? 



No animal can have recourse to it. At the period of the con- 

 quest of Brazil travellers reported that the aborigines merely chewed 

 or tore off the cord with their teeth, and that they did not tie it up. 

 If a careful attention be paid to what happens after an ordinary birth, 

 it will be seen that the pulsations grow weaker, and soon disappear 

 in the cord, beginning at the placenta, and that after a few minutes 

 it may be cut without being followed by the least hemorrhage. This 

 remarkable phenomenon, which is attributed to the change of direc- 

 tion of the iliac arteries, and to the difficulty experienced by the blood 

 in passing into the aorta through the ductus arteriosus, and into the 

 cord through the umbilical arteries, always takes place where every 

 thing occurs in a natural and regular order, but in reality depends 

 upon the circumstance that the attractive force exerted by the pla- 

 centa upon the blood, is replaced by that of the respiratory organ; and 

 that the after-birth is no longer any thing more than an inert sub- 

 stance, without vitality, which is abandoned by the blood, as it aban- 

 dons a gangrenous or asphyxiated limb. 



It is so independent of any mechanical change in the arrangement 

 of the vessels, that if, as was done by Vesalius, the belly of an ani- 

 mal at the full term of gestation be opened, the pulsations of the 

 cord are seen to continue as long as the fogtus continues to live 

 without respiring, and on the contrary, to cease as soon as the air 

 enters freely into the lungs. Beclard has seen the same thing in the 

 dog. I once received a human foetus, at the sixth month of preg- 

 nancy, enclosed within its membranes. The umbilical arteries con- 

 tinued to beat strongly as long as the membranes were unruptured; 

 but ihey fell into inertia as soon as the lungs and chest, upon coming 

 in contact with the air, attempted to perform some respiratory 

 movements. And do we not every day see the blood flow or stop 

 spontaneously in the same child, accordingly as the respiration is 

 free or embarrassed? 



1214. Whatever may be the fate of the explanation, it is not the 

 less true, that if the cord were left to itself without any ligature, it 

 would not expose the foetus to any hemorrhage, or any accident, 



