570 MANAGEMENT OF THE CHILD. 



cold; a little wine may be added to the water to be used in washing 

 it, and nothing is to be done that might in any way whatever inter- 

 fere with the freedom of its respiration. 



But the weakness may be carried to the extreme; sometimes the 

 foetus neither cries nor respires, its skin is pale; the circulation is 

 languid, the heart scarcely beats; and but for the heat which remains, 

 and the obscure motion of the umbilical arteries and heart, the death 

 of the child would be evident. 



1221. This is the state which is called asphyxia of new born 

 children, which M. Gardien prefers to denominate syncope, and 

 which others have denominated anemia; but which in fact differs 

 from those three morbid states in a great many respects, and which, 

 rigorously speaking, are much more nearly allied to the latter than to 

 the two former. 



It is met with particularly after very precipitate delivery, where 

 the child has been turned, when it is born before the full term, where 

 there has been a flooding during labor or several days before it, espe- 

 cially that kind of flooding which is caused by implantation of the 

 placenta over the os uteri, or that which comes direct from the ves- 

 sels of the cord. 



Its cause therefore is, on the one hand, a deficiency of blood, 

 which does not pass through the brain and lungs in sufficient quan- 

 tity to keep those organs in a state of action; on the other, the want 

 of incitation of the inspiratory muscles, and perhaps also, in some 

 cases, the presence of too great a quantity of mucus, or water of the 

 amnios in the trachea, as supposed by Heroldt and Scheele; M. 

 Desormeaux seems to agree with Freteau, that the compression of 

 the cord may also occasion it, by closing the passage for the blood in 

 the vein, whilst it leaves the arteries more or less permeable; but I 

 have elsewhere shown what ought to be thought of this view of the 

 subject. 



Upon the whole, it seems to me that asphyxia of new born children 

 ought to be attributed to the affection suffered by the blood in the last 

 moments of the labor, its placental modification, and its having ceased 

 to be subjected to that sort of internal respiration which, under ordi- 

 nary circumstances, is kept up, until the real respiration becomes 

 positively established. 



1222. Treatment. The first thing to be done is to remove the 

 viscid mucus from the mouth by means of the finger, or with a brush, 

 either dry, or dipped in a solution of common salt; there is no rea- 

 son to believe that it is either safe or useful to turn the foetus with 

 the face downwards to force the matters contained in the trachea to 

 escape therefrom, nor to suck them out into a tube as Heroldt and 



