P A R T U 
may have efcaped from the uterus, foft and well-aired 
napkins are to be applied to the labia pudendi, and above 
and below the nates, fo as to be interpofed between them 
and the wet clothes. 
Prefuming that neither hemorrhage or any other cir- 
cumftance requires a ftate of abfolute reft for a longer 
time, the woman may remain for half an hour in the 
fame fituation as when delivered; after which, her 
foiled linen may be removed, and the clean clothes, which 
had been previoufly palled round her cheft, may be 
drawn down, and (he very gently moved up in the bed 
by one afliftant at her Ihoulders, and another at her feet. 
Whilft thefe things are done, the patient ftiould be a 
pafjive being; and on no account be raifed from her ho¬ 
rizontal polition, as hemorrhage, fyncope, prolapfus, or 
inverfio uteri, may be the confequence. 
After this, ftie may take fome limple nourifhment. 
The room Ihould be kept dark, cool, well ventilated, and 
free from talkative friends; and the medical man, on 
feeing her before leaving (it being prefumed that he 
remains in the houfe until the woman is comfortably in 
bed), ftiould enjoin llriX quietude of body and mind. 
Dr. Merriman relates the circumftances of a fatal accident 
which arofe from inattention to this advice s The aged 
mother of a patient, contrary to the advice of her friends, 
was determined to be prefent at the labour, and was 
very much agitated and terrified by her daughter’s out¬ 
cries, though the labour was perfectly natural, and un¬ 
accompanied by any alarming fymptoms. Soon after the 
accoucheur had left his patient, quite fafe as he fuppofed, 
the complained of being faint; and begged to have fome 
hartlhorn to fmell. The trembling mother haftened to 
the bedfide with a phialful in her hand, and, in her 
hurry and perturbation, poured the contents into her 
daughter’s mouth and throat, as ftie lay on her back, 
and inftantly fuffocated her. Before the phyfician, who 
lived but in the adjoining ftreet, could reach the houfe, 
ftie was quite dead ; and, though means of recovery were 
diligently ufed, they failed of fuccefs.—Watts, in his 
Reflexions on flow and painful Labours, p. 69, mentions 
two fimilar accidents, from one of which the patient re¬ 
covered. 
Nothing can be more irrational than the too-prevalent 
cuftoin of exhibiting large and repeated dofes of opium 
to a woman after delivery. It is true that a patient after 
labour is found in a ftate of fatigue and irritability, and 
may therefore be benefited by a lingle and moderate dole 
of this article; but the frequent repetition of it is de¬ 
cidedly injurious, not only by producing the ordinary 
unpleafant effeXs of opium, but more efpecially by its 
influence over uterine aXion, which it fo enfeebles or 
fufpends, as to counteraX the efforts which it makes to 
expel coagula, and perfeX its reftoration to its original 
dimenfions by thofe fecondary and very falutary contrac¬ 
tions termed after-pains, and for the removal of which 
opiates are fo univerfally and fo generally prefcribed. 
Thefe fhould rather be encouraged (than counteraXed) 
by the occafional employment of friXion over the uterine 
and lumbar region, and by the exhibition of a purgative, 
which duringits operation materially aflifts and accelerates 
the contraXile energies of the uterus. 
On the fecond day fubfequent to delivery, the bowels 
Ihould be aXed on by a common domeftic enema, or by 
the exhibition of a moderate dofe of caftor-oil, or any 
other mild aperient. The early employment of purga¬ 
tives ,alfo moderates the fecretion of milk, by which 
the woman is faved from confiderable 1 'ufFering. Should 
it happen that the breads become extremely tumid, hot, 
and painful, it will be necefiary to aX more freely on 
fhe bowels, fo as to obtain feveral loofe motions daily, 
and this objeX will be belt fecured by repeated dofes 
of fome faline aperient. In addition to this, the brealts 
muft be kept very cool, and, every few hours, gentle 
friXion of them fhould be enjoined on the nurfe. This 
R I T I O N. 711 
may be performed by the hand, between which and the 
mammas there fhould be interpofed a little hair-powder 
or oil; and the latter may be medicated by the addition 
of camphor, as in the linimentum campliorce. 
The bladder now and then does not perform its func¬ 
tions as it fhould after delivery ; and this inability occurs 
fufficiently often to render it a part of the duty of an ac¬ 
coucheur, on his fir ft vifit, to inquire of the nurfe into 
the ftate of this organ, and to reiterate his inquiries until 
he is convinced by the moft unequivocal language, that 
his patient lias real-ly emptied the bladder, and not 
merely parted with a fmall quantity of urine by ftillici- 
dium 1 and, fhould any doubt remain on his mind, he 
fhould examine externally above the pubes. 
Many women fuffer during the remainder of their 
lives from the very general and reprehenfible cuftom of 
indulging themfelves too foon in an upright pofition; 
and even thofe who are folicitous to remain longer than 
is necefiary in bed, often do themfelves much mifchief 
by a half-recumbent pofture, prefuming that, if the lower 
extremities are kept horizontal, the pofition of the trunk, 
is unimportant. The abfurdity of this opinion is fo 
manifeft, that it needs no refutation ; nor can it excite 
furprife that procidentia uteri, fanious difcharge, and 
fubfequently leucorrhcea, fhould be the confequences of 
fuch mal-praXice, when the relaxation of the paffages, 
and the fize and weight of the uterus, are confidered. 
Still there can be no neceffity for a woman to be confined 
under the bed-clothes for a month; and, if the hori¬ 
zontal pofture of the pelvis and body be preferved, it 
may be done as well on the outfide of the bed, or on a 
fofa. 
The lochial difcharge (or cleanfings, as it is called by 
nurfes) is a fanguineous fecretion from the extremities 
of the fecerning veflels of the uterus, which, being mixed 
with detached and decompofed filaments of the tunica 
decidua uteri, continues to flow from the paffages from 
five to thirty days after parturition. At firft, it is de¬ 
cidedly fanious, but in a few days it becomes much 
paler and brownifh, or of a dirty green hue, fo as to ac¬ 
quire among women, the term of “ green waters.” The 
quantity of this difcharge varies very much in different 
women ; in fome being extremely fcanty, efpecially in 
thofe who have loft much blood by uterine hemorrhage ; 
whilft, in others, the fecretion is fo profufe as to require 
medical interference. The internal exhibition of the mi¬ 
neral acids, with catechu, often does good; and forae- 
times benefit is derived from a combination of myrrh and 
iron, as in the mijlura ferri compojita. 
With refpeX to the domejlic management of the puer¬ 
peral woman, it is important to obferve, that, for fome 
time after delivery, her food ftiould be lefs in quantity, 
and more limple in quality, than fhe was accuftoined to 
before, becaufe though a lying-in room is not abfolutely 
a lick room, yet fo fudden and fo great is the change in 
the habits of the patient, perhaps from high aXivity to 
perfeX quietude, that the fame diet which fhe has pre- 
vioufly taken could not now be borne without incon¬ 
venience. 
It is cuftomary to compel a woman under thefe cir¬ 
cumftances to live almoft exclufively on gruel or broths; 
and it is no uncommon thing for her ftomach to be moft 
involuntarily diftended with feveral pints of thefe arti¬ 
cles daily. The praXice feems extremely irrational, and 
is often highly injurious. It frequently not only en¬ 
feebles the ftomach, but, by keeping up conftant per- 
fpiration, debilitates the whole fyftem, and renders it 
very fufceptible of cold ; and is one caufe of an immo¬ 
derate fecretion of milk, which becomes a fource of great 
diftrefs to the patient. For fome days after delivery, 
therefore, whilft thefe articles may conftitute a part of 
her diet, their quantity may be lefs, if in the middle of 
the day a light pudding, containing an egg or two, be 
fubftituted. The components may be varied until the 
woman 
