RETENTION OF THE FCETAL ENVELOPES. 571 



place ; though it sometimes happens, as we have pointed out, that the 

 weight of the pendulous portion causes inconvenience in micturition ; 

 while it fatigues and pains the animal by dragging on the uterus, and 

 inducing expulsive but futile efforts. Schaack has shown that in nearly 

 all these cases it will be found that a loop of the membranes has become 

 twisted around the pedicle of some large uterine cotyledon ; and as this 

 is the obstacle to separation, it is necessary to release the loop as soon 

 as possible, in order to prevent accidents. 



It has also been remarked that, even when birth has been easy and 

 favorable, primiparae are often irritable and impatient, and the presence 

 of the secundines in the vagina and vulva exaggerate the restless, and 

 occasion frequent and energetic uterine contractions. In such cases it 

 will generally be found judicious to remove the membranes as soon as 

 possible — on the same day, or the day succeeding deliver)^, if necessary. 



If, after the birth of the foetus, nothing is seen at the vulva except a 

 thin cord, formed solely by the umbilical vessels, we may be almost cer- 

 tain that there is a strong adhesion between the maternal and foetal 

 placentae, and that the separation of the latter will be protracted — in all 

 likelihood require to be removed artificially. But even in such a case 

 there is no occasion for immediate interference ; on the contrary, it is 

 more judicious to wait, and allow time for the placentae to soften and 

 the adhesions between them to diminish : though the opportunity for 

 complete detachment must not be overlooked. 



When nothing whatever is discernible externally, there is reason to 

 surmise that the placenta is completely retained. But even in this case 

 there is no need to resort at once to removal of the membranes ; though 

 it may be necessary, in order to prevent imprisonment for sg>me time, 

 through the closure of the os uteri upon them, to introduce the hand 

 into the uterus, and if they are already partially detached, to extract 

 them. If they remain firmly adherent, however, it is better to .gather as 

 much as can be seized into a single mass, carry it through the os into 

 the vagina, and tying it there by a long piece of cord, to leave the latter 

 hanging without the vulva. In this manner the os is prevented from 

 closing, while the cord will assist in effecting artificial removal at a later 

 period, should such be demanded. 



Certain medicaments, more or less of the nature of emmenagogues — 

 such as rue, savin, laurel, stramonium, carbonate of potass, etc. — have 

 been for a long time credited with the power of hastening the expulsion 

 of the membranes ; and their administration has been recommended be- 

 fore resorting to manual force for the removal of the placenta. Some of 

 the recipes for these potions are very antiquated, and others are quite 

 modern, and lauded by the highest authorities. 



Zundel, for instance, extols laurel berries, and gives the following 

 recipe : 



Laurel berries - - - - 120 grammes. 



Aniseed 60 " 



Bicarbonate of soda - - - 120 " 



These are infused in 4 litres of water, and given in two doses. It 

 may be repeated the following day ; but, as a rule, the membranes are 

 expelled within twenty-four hours after the last dose has been given. 

 Zundel asserts that this infusion has rendered excellent service, succeed- 

 ing in sixty per cent, of his cases of retention. Hering and Stockfleth 



