MIDWIFERY. 
by her laughing, crying, sobbing, &c. whicli 
characterizes hysteria. If the fainting pro- 
ceed from either of the above causes, vola- 
tile alkali rouzes the patient, and nothing 
more is necessary ; neither should any ap- 
prehension be felt for her safety. 
Fainting may be the consequence of the 
great agitation of mind which tlie patient 
has suffered from fear of the approaching 
pains, and, as she thinks, dangers. In such 
cases nourishing things should be admini- 
stered, as a small quantity of good broth, 
with a table spoonful of wine in it ; or some 
volatile alkali. ■ 
Whenever there is reason to suspect that 
the fainting arises from loss of blood, the 
practitioner should never leave it to proba- 
bility, but instantly examine the truth of 
his suspicions, not only on the surface lying 
next to him, but the upper part of the fur- 
ther thigh, as the blood will sometimes run 
over the side of the thigh that is furthest 
off; when the practitioner, not perceiving 
any discharge from that part whence it ^is 
generally observed to flow, has not the least 
idea of his patient’s situation. When upon 
examination it is found that hasmorrhage 
has taken place, the placenta being got 
away, it is to be treated in the common 
way by acids, &c. 
In some rare instances it has happened, 
that immediately after delivery the patient 
has sunk , into a permanent syncope, from 
which she never has recovered, dying with- 
out a groan. When there is reason to sus- 
pect the approach of such a state, the pa- 
tient should be made to swallow a large dose 
of volatile alkali ; it can do no harm, and 
is generally highly beneficial, let the faint- 
ing originate from whatever cause. The 
spiritus ammoniae comp, and tinct. laven- 
dulae may also be administered, and harts- 
horn drops should always be kept in a lying- 
in room. 
After delivery it is advisable to apply a 
certain degree of pressure to the parts. This 
circumstance has been variously received 
and very generally misunderstood. A cer- 
tain degree of pressure is useful ; but if that 
pressure be too great, it will occasion worse 
consequences than the w'ant of pressure al- 
together. The pressure required is, more 
properly speaking, a support, and is of the 
same kind as we like to feel from a waist- 
coat in winter. The intention to be had in 
view in making it, is just tlie same as after 
tapping in dropsy ; and pressure judiciously 
applied in both cases will often prevent 
fainting. 
Suppression of Urine. In the country it 
often happens, that the practitioner does 
not see his patient any more after leaving 
her safely delivered. In such cases, it will 
be necessary for him to leave general direc- 
tions with the attendants ; the most mate- 
rial of which is, that the nurse shall send for 
him, if, upon trying, the patient finds her- 
self unable to make water, at the distance 
of eighteen or twenty hours after delivery. 
If the patient be neglected, the bladder 
swells to an enormous size, and at last 
bursts, in which case death is inevitable. 
AFhen the practitioner has been sent for, 
he must not be satisfied with the patient’s 
telling him that she has since made water, 
and that a tittle escapes frequently ; all this 
amounts to nothing, and must not excuse a 
moment’s delay in the introduction of the 
catheter. It will generally be necessary to 
draw off the water once or twice a day ; 
but from distance of residence this will 
sometimes be impossible. In such a case it 
is not very difficult to teach the nurse how 
to perform this operation, by shewing her 
the parts, and pointing out the little orifice, 
at the same time telling her, the instrument 
must be passed up carefully and slowly till the 
water flows from the other end of the tube. 
Effusion of Blood into the Cellular Mem- 
brane of the Lahia Pudendi. This is an acci- 
dent which now and then happens after deli- 
very. It is merely a mechanical effect of pres- 
sure, and very rarely occurs. In one case 
where the parts had been previously much 
strained, the swelling was first observed by 
the patient’s finding herself unable to close 
her thighs together. This blood, if left to it- 
self, will first coagulate round the orifice of 
the bleeding vessel, and afterwards the whole 
quantity of effused blood becomes fixed. 
There are two ways by which the parts may 
get rid of this blood, if its quantity be con- 
siderable ; either by the skin sloughing off, 
by which part of the blood may escape, or 
by the part inflaming and suppurating. 
IVlien the latter circumstance happens, and 
it is determined to open it, the orifice made 
cannot be too small, so that the matter be 
allowed to escape ; for the constitutional 
weakness at such a time as this will give a 
tendency to gangrene in any part which is 
divided. Cold is the only application that 
is to be at all regarded. It has been re- 
commended to cut and scarify the part ; 
but this is objectionable, because, should 
the artery continue to bleed after the open- 
ings are made, the situation of the patient 
at once becomes serious, for we must ne- 
