GEORGE J. ENGELMANN. 
birth is hastened, as well as its expulsion; the sinuses are con¬ 
tracted and closed, yet there is one objection—the possibility 
of an incarceration of the placenta. Labor completed, the 
uterus emptied, the giving of ergot insures permanent con¬ 
traction, and relieves the physician of continued attendance. 
The idiosyncrasy alone is to be guarded against. 
In post-partum hemorrhage, the internal administration 
of ergot should be avoided, as it is powerless ; it is not even 
absorbed, and may seriously annoy the stomach, which should 
be carefully guarded. After the flow has been controlled, it 
maybe used, best hypodermically, to prevent recurrence, 
and in aid of other more reliable measures. 
In miscarriage and abortion, the danger is in tonic con¬ 
traction of the uterus, by which hemorrhage is indeed checked, 
but the separation of the ovum retarded and incarceration 
made probable. The expulsion is often checked and delayed, 
but abortion is not prevented. 
Of the lesser evils which result from the use of ergot we 
are rarely, if ever, informed, but they are many; they are 
not reported, not even recognized, so that the evil remains 
unabated. Extreme cases, even, are perhaps more frequent 
than generally supposed, as they are neither recognized nor 
published; rupture of the uterus alone, the most dangerous 
and fatal of the evils consequent upon the us6 of this drug, 
may occasionally be traced with certainty to its proper cause. 
In view of these facts, the only possible conclusion is that 
the use of this popular, powerful, and dangerous drug should 
be strictly prohibited in obstetric practice proper, and re¬ 
stricted to the non-pregnant womb / 
The obstetrician can give it with safety only after the 
placenta has been expelled, bearing in mind its injurious 
effects, and the fact that in all those cases where this insidi¬ 
ous poison is given, and thought to be necessary, we have 
other milder, more harmless, and more effective means to ac¬ 
complish with safety the purposes which ergot is thought by so 
many to serve; these are external manipulations, massage and 
expression; hot antiseptic injections, vaginal and intra-uterine. 
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