PARTURITION. 
its agency lias not been ufed ; and Dr. Merriman inclines 
to the fame opinion. If this indeed be the cafe, it forms 
■at once an infuperable objedtion to its ufe, except in 
cafes where its fafety is well defined 5 and the fubjedl cer¬ 
tainly demands deliberate attention and ferious inquiry. 
But, in a matter of fuch importance, we ought not to be 
governed by conjedlure; but fiiould adopt or rejedl it, as 
its beneficial or deftruftive operation is tefted by expe¬ 
riment. “ My own experience (lays Mr. Prefcot) has 
been fuch, as to perftiade me that the above fuggeftion is 
unfounded. It is true, that in 22 cafes of firft labour, in 
which this medicine had any effedl, I loft four children ; 
and in 35, where it was given to women who had been 
previoully delivered, 1 have loft one. But all thefe deaths 
were attended with fuch circumftances as fully to excul¬ 
pate the ergot from any agency in the event. And, when 
it is recollected, that this medicine is not ufed except in 
cafes that are long protrafted, or are likely to prove te¬ 
dious and troublefome, it will not be thought, 1 conclude, 
that this unfortunate event happened more frequently, 
or in greater proportion to the whole number of cafes, 
than might reafonably have been expefted, had this me¬ 
dicine not been prefcribed.” 
The uniform operation of the ergot to reftrain uterine 
hemorrhage, has been noticed by other phyficians. It 
has in confequence frequently been prefcribed, a little 
previous to the birth of the child, or immediately after, 
to patients that have been accuftomed to flood immoderate¬ 
ly at fuch times, and it has always proved an effectual 
preventive. This Angular property of the ergot, to di- 
ininifh the enlarged cavity of the uterus, is never more 
ftrikingly exemplified, than when its agency is employed 
to reftrain thofe floodings which fometimes appear in the 
early months of pregnancy, when the aftion of geftation 
has ceafed, and abortion muft follow. In fuch cafes it 
fpeedily excites in the uterus fuch energetic aftion, that 
its contents are foon expelled, and the hemorrhage ceafes. 
In order to determine what operation it might have on 
a healthy male fubjedi, the decodlion of one drachm has 
been taken at a dofe, but it produced neither naufea nor 
other perceptible eftedl. After a few days, the fame per- 
fon took a like quantity, which proved equally inert; 
neither did the larger quantity of two drachms, at a few 
dofes, but all within the fpace of two hours, occafion 
naufea, vomiting, or pain in the female to whom it was 
prefcribed, for deficient catamenia. Its operative potvers, 
therefore, appear wholly confined to the uterine fibres, 
.when lengthened from an enlargement of that vifcus. 
In fuch cafe it fpeedily excites in them ftrong contradlile 
adlion ; andfo long as the (timulating effedf of the medi¬ 
cine lafts, this addon is unceafing. The uterus is thus 
made to comprefs clofely upon any fubftance whatever 
within its cavity; and this refiftance to its further col- 
lapfing will caufe violent pain in that organ ; but, if it 
.find no fuch refiftance, the contradfile adtion progrefles 
without any uneafy fenfations. The healthy unimpreg¬ 
nated uterus, having nothing within its cavity, will 
therefore not be affedted by the ergot; neither is it cal¬ 
culated to reftrain menorrhagia, proceeding from in- 
creafed arterial addon ; as the iize of the uterus, in fuch 
cafes, is nearly at its minimum. 
Until we clearly underftand the reafon why fome me¬ 
dicines pofiefs a greater affinity to one part of the fyftem, 
or to one organ, than to another, it will be difficult to ex¬ 
plain the modus operandi of the ergot. It is but a few 
years fince it firft attradted the notice of phyficians, as be¬ 
ing fubfervient to any ufeful purpofein medicine. Like 
all other adtive and valuable medicines, when firft made 
known to the public, it requires a long feries of judi¬ 
cious and attentive experiments, fully to develop its 
charadter, its qualities, and the precife manner in which 
it may affedl different parts of the human fyftem. Like 
them, while its ufe is beneficial, its abufe is deftrudtive. 
A cautious diredtion of its powers cannot, therefore, be 
too ftrongly recommended. If properly adminiftered, it 
679 
muft be efteemed an important and valuable acquifition 
to our materia medica, and is unqueftionably deftined to 
hold a high rank among the means which Nature has pro¬ 
vided for relieving the fufferings of her children. 
Plural Births. —It is requifite, after the firft child is 
born, (the funis being properly tied and divided to pre¬ 
vent bleeding,) and before any effort lias been made to 
draw out the placenta, that the accoucheur fiiould lay his 
hand on the abdomen of the mother, to afcertain whether 
there be another child left in the womb; and, when it fo 
happens, the abdomen will feel nearly as large as before 
the firft child was born. 
All the figns by which the exiftence of more than one 
child in utero can be afcertained, previous to the adlual 
commencement of labour, are fallacious ; and, in gene¬ 
ral, it is not till after the birth of one child that it can 
be determined that another remains in the womb ; and, 
unlefs under very particular circumftances, it is of no im¬ 
portance. The circumftances alluded to are where dif¬ 
ferent parts of both children are forced into the paflage 
at >the fame time. Of this a very remarkable cafe°is 
recorded in the book of Genelis, chap, xxxviii. ver. 27. 
When the womb appears to remain bulky and hard af¬ 
ter the birth of one child, there is reafon to fuppofe that 
it contains a fecond. But, if there beany doubt on the 
fubjedl:, the pradiitioner has it in his power to afcertain 
the point by internal examination : two fingers of the 
left hand are to be carried into the uterus guided by the 
funis ; and, if its infertion into the placenta be felt, it 
is hardly poflible for a fecond child to efcape detection, 
taking care not to be milled by a diftended bladder, en¬ 
larged ovary, or by the membranes containing coagula. 
If, therefore, the accoucheur (fill remains in doubt, he 
had better pafs his whole hand into the vagina : but it 
will generally be obferved, that, when there is no fecond 
child in the uterus, the further the fingers are carried 
up within the paffages, the more co.ntraded do they feel, 
whereas, if there be a fecond child, the more open they 
are found. 
Each of the twins is commonly fmaller than a (ingle 
child : this often occafions the birth to be rapid, and 
gives to the pradiitioner the firft idea that he is attending 
a cafe of twins. At other times, though it is evident to 
the touch that the child is (mall, and that there is .plenty 
of room for it to pafs, yet the pains, though frequent, do 
not propel it: hence the accoucheur is led to fufpect 
that the uterine adlion is impeded or fufpended by ano¬ 
ther child occupying the fundus uteri. 
When it is afcertained that another infant remains, 
the woman’s abdomen fiiould be immediately compreffed 
by means of a roller, in order to prevent faintnefs from 
the fudden relaxation of the parietes abdominis ; and the 
portion of. the navel-ftring remaining attached to the 
after-birth of the.firft-born (hould be carefully (ecured. 
Much diverfity of opinion has prevailed among practi¬ 
tioners of midwifery, refpedfing the belt method of ma¬ 
naging twin-cafes : but this difference exifts only with 
regard to the fecond labour; for the firft requires to be 
condudled precifeiy as if it were a Angle child. Thus, if 
the foetus prefents naturally, the cafe is to be left to na¬ 
ture ; if it prefents preternaturally, or if any other cir¬ 
cumftances occur, conftituting difficult labour, it will re¬ 
quire the kind of management directed in the various 
fedlions of Preternatural Labour. Should, however, the 
cafe be of fuch a kind as makes turning neceflary, the 
operator muft take care not to miftake the parts of the 
two children, left he bring down a limb of each, and add 
greatly to the embarraffment of the cafe. 
It is very well known that repeated inftances have hap¬ 
pened where the fecond child has been retained many 
hours or days after the birth of the firft, and no mifchief, 
nor danger, nor much of inconvenience, has followed. 
In the London Medical Journal for April 1811, a cafe of 
twins is related, in which the fecond child was retained 
for fourteen days after the birth of the firft ; and the au¬ 
thor 
