574 MANAGEMENT OF THE CHILD. 



the skin becomes slightly colored, the heat returns, and then some 

 respiratory movements, feeble and irregular at first, then more and 

 more decided, soon make their appearance; cries are soon heard, and 

 the child is saved. It would, however, be imprudent to cry out vic- 

 tory too soon; I twice succeeded in restoring the motions of the 

 heart, and the respiration, for more than three hours, by means of 

 inflation and galvanism, in two children, which I nevertheless was 

 at length compelled to abandon.* 



§. II. Of the Apoplectic State. 



1227. Instead of coming into the world pale, anemic, or exsan- 

 guious, the child is sometimes born in quite a contrary condition; 

 its skin is of a bluish red or liver color, of various degrees of inten- 

 sity, especially on the face, and appears as if thickened. All the or- 

 gans seem to be the seat of a general congestion, the limbs are soft 

 and motionless; the circulation is suspended, either wholly or in part, 

 in addition to which, all the other signs just now indicated are found 

 to be present. 



It should also be understood that the disease may exhibit itself 

 under various degrees of intensity, and produce various changes in 

 the interior of the body. Upon opening the dead bodies of such 

 children, fluid blood is often found extravasated between the menin- 

 ges or in the very substance of the brain. In other cases, and that 

 most frequently, the blood is not found to have escaped from the ves- 

 sels, or only forms slight ecchymoses in different parts; but it is in 

 excess in all the organs, which are engorged, and, as it were, soaked 

 in it. 



The apoplectic state is met with, especially in strong children, 

 after long and difficult labors, the application of the forceps, and 

 pelvis labors, either spontaneous or artificial; where the child has 

 remained for several hours under the direct influence of the uterine 

 contractions after the discharge of the waters; where it has pre- 

 sented in a bad position; where it is too large to pass with ease 

 through the various passages; where a loop of the cord strictures 



* There are a great many real resources for the recovery of the child, hut they 

 are often applied without success, because they are persevered in after the signs of 

 death are complete. In general, it is safe to abandon all attempts to resuscitate, 

 if there be no audible pulsation of the heart, no sensible beating of the umbilical 

 vessels close to the belly — if the child be without muscular tone or resistance — 

 and especially if the sphinctorian contraction is gone. — But no truce should be 

 allowed, while there remains the least sign of muscular action in any part of the-- 

 body.— M. 



