568 ACCIDENT a AFTER PARTURITION. 



When the envelopes form a somewhat large mass hanging from the 

 vulva, it may be anticipated that early and spontaneous removal will 

 take place ; though it sometimes happens, as has been 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 

 induces 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 

 favourable, primiparaj are often irritable and impatient, the presence 

 of the secundines in the vagina and vulva increasing the restlessness, 

 and occasioning 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 delivery, 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, it is almost cer- 

 tain that there is 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 its removal ; though it may be 

 necessary, in order to prevent imprisonment for some time, through the 

 closure of the os uteri, to introduce the hand into the uterus, and if it 

 is already partially detached, to extract it. If it remains 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 outside the vulva. 

 This prevents the os from closing, while the cord will assist in effecting 

 artificial removal at a later period, should such be required. 



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 placenta ; and their administration has been recommended before 

 resorting to manual force. 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, sue- 



