THE METROPOLITAN POOR-LAW MEDICAL OFFICERS' ASSOCIATION

1866 The Lancet  
534 at once grasped and brought down to the vulva, and thus speedily completed the delivery. It was a male child, and had been dead apparently some time. No hæmorrhage whatever followed, and the pulse soon became more percept;Lle on the administration of beef-tea and brandy. The patient has not had a bad symptom, and is making a good recovery. The interesting feature of this case is the fact of labour having been allowed to go on so long without interference, for experience teaches one that an
more » ... eaches one that an accoucheur is generally summoned in cases of unavoidable hæmorrhage before the os uteri is half dilated. It is probable also that the placenta had been almost centrally implanted over the os, and this must be considered a rare condition. This case may be said to rest on the boundary line between those which come under the head of artificial extraction and spontaneous expulsion of the placenta before birth. The placental mass was certainly manually removed, but not until the mouth of the womb was fully dilated; an(ll I have little doubt that in this case nature would have accomplished the delivery had Wigand's method of plugging the vagina (and trusting as far as possible to the natural proces3) been adopted at the commencement of labour. Under such circumstances the haemorrhage would have been greatly diminished, and strong uterine action would have been provoked by the use of the tampon. The accurate record of all such formidable occurrences in parturition is surely a matter of the deepest interest, when we remember the words of Naegelé, that "the very action which nature uses to bring the cliild into the world is that by which she destroys both it and its mother." I am, Sir, yours obediently,
doi:10.1016/s0140-6736(02)68168-1 fatcat:awm6bmc5szg2ffhgifxtpj5gkq