Licence: Public Domain Mark
Credit: Woman : her diseases and their treatment / by John King. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![4. Under no circumstances should Ergot be given to expedite delivery, until the perineum is soft and yielding, and the head presenting properly, low down in the pelvis. 5. When the head is at the inferior strait and the uterus is acting with sufficient energy to expel the child, the female should he advised not to bear down with force, especially when the perineum is unyielding. Indeed, in such cases, it will be better not to bear down at all. 6. When the uterus is rapidly and forcibly expelling its contents, the soft parts not having had time to become yielding, the action of this organ ma^'' be much diminished by doses of Opium, or by the inhalation of Chloroform, in accordance with the circumstances and idiosyncrasies of the patient. 7. A rigid hymen may eventually give rise to laceration, but which may be avoided by incising it in a transverse or oblique direction; using a blunt-pointed knife. 8. All manual or instrumental aid, should be given without violence or roughness ; and no one should attempt them until he is thoroughly versed in the proper obstetric rules concerning the indications for such interference, as well as the most effica- cious methods of conducting the operations. Treatment. In the .earlier period of surgery, this accident was deemed incurable, and even in Merriman's time, we find the following in his Synopsis, page 110,—The cure of a lacerated perineum is very difficult—in some cases impossible. If, indeed, the rent does not extend through the sphincter ani, •the torn parts will sometimes coalesce so as to form a tolerable perineum; but when the laceration passes quite into the rectum, a cure is rarely perfected. But at the present period, perineal laceration can be remedied by the resources of modern surgery. Rest, the recumbent position, and cleanliness, generally succeed in curing the slighter varieties of laceration, as has already been named, but in the more severe forms an operation is the only reliable mode. Various methods of operating have been advised by surgeons, among whom may be named Ambrose Pare, Guillemeau, Saucerotte, La Motte, M. M. Dubois, M. Roux, Trainel, ]Noel, Dieftenbach, Menzel, Morlanne Osiander, Langenbeck, Yerhaeghe, Davidson, Mettauer, Lever,](https://iiif.wellcomecollection.org/image/b21061932_0063.jp2/full/800%2C/0/default.jpg)
