10 
the danger arising from idiosyncrasies, he should observe its 
effect before leaving his patient, giving ergot after the expul¬ 
sion of the placenta, after he has resorted to other means to 
stimulate uterine activity; and then, if satisfactory, the rem¬ 
edy should be left in the hands of the nurse—to be given 
occasionally during the first twenty-four hours — to guard 
against the possibility of relaxation and hemorrhage, to secure 
thorough, firm, and permanent contraction, to hasten involu¬ 
tion. 
This is the one condition under which ergot should be 
used. Later, in case of sepsis, it may be again given, to 
prevent absorption of putrid matter by contraction of the 
vessels, and to further the expulsion of such matter from the 
cavity. 
I will add that the drug might be given during the third 
stage of labor, when, barring the danger of incarceration of 
the placenta, it thoroughly fulfills the existing indications. 
But let us not enter into possibilities. Let us adhere to the 
maxim that ergot should only be given in the non-gravid 
uterus. This is demanded by the exigencies of the case. 
We must deal with facts, not theories. We must decide what 
it is best to do, not under what conditions ergot might be 
used, or how far we may push this use. 
Let its dangers be clearly demonstrated; let it be under¬ 
stood that ergot is nowhere indispensable ; that we have more 
safe and direct means of attaining those ends for which it 
has been so indiscriminately administered; but that it may 
be given, as an additional guarantee of safety, to secure uter¬ 
ine contraction and guard against hemorrhage after the ter¬ 
mination of labor. 
The advantages of massage and expression, of posture, 
and the disinfectant douche will soon be appreciated, and it 
will no longer be necessary to insist on the axiom that the 
use of ergot must be confined to the non-gravid womb. 
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