MIDWIFERY. 
a third power, by the presence of which 
tlie Imnian uterus differs from that of all 
other animals. It is right, however, after 
tiirninc, and bringing down tlie feet, to al- 
low the child to remain undelivered for a 
short time, attending to the least pain that 
may be felt, and gently assisting in the for- 
warding the expulsion; and when the child 
is born, to wait the action of the uterus 
again for the expulsion of the placenta ; for 
we must still recollect the grand object is 
the contraction of the utenis, without 
which, its being emptied would produce 
very little good. It will then happen, that 
the same contraction which expels the pla- 
centa wilt diminish the area of the vessels, 
and the danger from flooding ceases. But 
if this contraction do not take place soon, 
and the liacmorrage continue for some mi- 
nutes after the extraction of the child, we 
must consider whether the strength will not 
be lost, and the safety of our patient en- 
dangered : if so, the placenta without de- 
lay must be separated by introducing our 
hand. 
Immoderate Discharge of the Lochia. The 
next view of uterine haemorrhage, is that 
where it does not stop on the extraction of 
the placenta. Such cases as these are very 
rare ; there may be a sudden gush of blood, 
and often is, following the placenta; the 
reason of which is, that the uterus, at the 
time it expels the placenta, forces down 
every particle of blood with it; and in this 
w ay a pound or a pound and a half may es- 
cape, but that need not be regarded in the 
least; it does not affect the conkitution, 
because it was not evacuated immediately 
from vessels; it was lying in tlie uterus. 
So when we amputate a limb, there is no 
loss of blood to the constitution, because 
the whole of the blood which is taken away 
is necessary to the limb, and no longer ne- 
cessary than while the limb w'as to be sup- 
plied. But supposing that from the vessels 
not being properly secured in the opera- 
tion, there is a bleeding afterwards from the 
stump, then it is that the constitution suf- 
fers ; there is a demand made upon the mass 
of circulating fluids, which must be replaced 
before the heart can recover its proper ba- 
lance in tlie system. Apply this to the 
uterus, and we shall consider the blood as 
belonging to the gravid uterus, and not to 
the circulating system. This is what is, in 
the practice of physic, called an immoderate 
discharge of the locia. Such haemorrhages 
frequently arise from the cord being pulled 
with two great violence, by which the pla- 
centa comes to be injured ; and this happen- 
ing when die uterus is not disposed to con- 
tract, the vessels will, for a time, remain 
exposed and bleed. This is the reason why 
it happens so frequently in the hands of bad 
practitioners, as inidwives ; and that it is so 
rare when no improper treatment is adopted 
in regard to the placenta. 
Now supposing the haimorrhage yet re- 
mains, that is, after the uterus is emptied, 
the child born, and the placenta come 
away ; what are the means next to be em- 
ployed to restrain the hanuoiTliage? the ap- 
plication of cold, and the abstraction of heat 
in every possible way ; we should take tlie 
clothes from the bed, leave nothing but a 
sheet to cover, and that from motives of 
decency alone. If there be a fire in the 
room it must be put out; the windows kept 
open to preserve a cool and fresh air, and if - 
the patient be faint she may have a cup of 
cold water. 
Cold water and ice are the proper appli- 
cations both to the parts themselves and the 
body round theiri. The coldest water made 
colder by throwing two handsful of salt into 
a couple of quarts of it, may be used by 
cloths many times doubled dipped in this, 
and laid over the back and abdomen ; be- 
sides which, we may with the greatest ad- 
vantage expose the body to a great degree 
of cold, ifit can be done. 
If these means do not answer, we must 
introduce ice into the vagina, or even uterus ; 
t'as will often succeed ; if this be ineffectual, 
we must as the last resource plug up the 
vagina with lint or tow, or something capa- 
ble of entangling the blood ; for while there 
is a clear channel there will be no coagulum 
formed. If the flooding still continue, the 
best plan is that of carrying something per- 
manently cold into the uterus itself ; a large 
dossil of lint, dipped in the cold solution, 
will carry up a degree of cold ; but the best 
thing is to carry up a piece of ice, and allow 
it to thaw in the uterus. Dr. Baillie, of 
New York, who was tliefirft who introduc- 
ed the use of cold applications here, was 
in the habit of using a ball of snow for this 
purpose, which often stopped it directly, 
when nothing else wotdd. Ice being intro- 
duced into the vagina, will often prevent 
abortion; this then is the best and last re- 
medy in floodings ; if none of these things 
will stop it, there is nothing else that will. 
After the hseraorrhage has ceased, the 
patient will be so reduced, so exhausted, 
