ERGOT. 
Such are the remedies by which we can, with certainty 
and without danger, secure uterine activity and contraction 
under all those conditions in which ergot might possibly be 
used, and even in all such as are usually supposed to indicate 
a resort to that drug. 
Having these means, which are in their action more safe 
and certain, more rapid and precise, covering every indica¬ 
tion which is met by ergot, and, in addition, useful in a much 
wider field, why discuss the possible merits of ergot, and 
mark out with care the utmost limits to its use ? 
Let us see how, by massage and expression, by injections, 
by external and internal manipulations, the desired result 
which ergot is supposed to further may actually be accom¬ 
plished and the object attained without risk to the patient. 
As we have seen, ergot is often given needlessly by the 
impatient attendant to hasten labor; or, more injudiciously 
still, in the early stages of breech and shoulder presentations 
—in both instances with most unfortunate result—and with¬ 
out the slightest reason or benefit, often under conditions 
where no interference whatsoever is indicated, certainly not 
of such a kind. All the injuries resulting from this very 
frequent manner of its abuse would be completely avoided 
by condemning the use of ergot in the gravid womb; no 
substitute is necessary. 
When it seems desirable to regulate labor-pains, opium or 
quinine is to be recommended; to stimulate and excite the 
uterine muscle to action, a judicious massage, friction of the 
fundus, is harmless and successful; hot carbolized vaginal 
injections serve the same end, and are especially useful if 
labor is delayed by rigidity of the os ; to aid in the expulsion 
of head or breech, massage and expression can not be too 
highly recommended. 
Better by far than ergot, and without possible evil result, 
for the purpose of securing separation of the placenta, its ex¬ 
pulsion, and contraction of the uterus in the third stage, are 
external manipulations, the following down of the fundus 
uteri with the hand—friction and kneading of the globe_ 
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