Volume 1

Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    THE MANAGEMENT OF THE NORMAL PUERPERIUM. JN a former chapter we stated that the physician should not leave his patient until he was satisfied that there was no danger of hemor- rhage, syncope, etc. She should then be left in perfect quiet, and wiU soon sleep, and this sleep should not be disturbed, since she is exhausted by the efforts of labor. It is often a good plan to administer a little stimulant before she goes to sleep. The physician should make his next visit within six or eight hours after labor, and if delivery has occurred during the night, the first morning visit should be made to the last woman delivered. It is customary with many physicians to give a dose of ergot to the patient before leaving. We do not believe this at all necessary, and we do not give ergot except where the uteras seems in- clined to relax. [The object of the administration of ergot being to guard against such relaxation, and the physician never knowing in what special case such relaxation may occur, it seems the better plan to administer the drug immediately after the delivery of the placenta, not before, as a rou- tine measure. Ergot, so far as is determined, can do no harm, and it may do good. At any rate we feel more satisfied with the future of our patient if we leave her protected by ergot. In those cases where there is a tendency to relax, and where in consequence we may have hemorrhage, we would give a double dose by the mouth, or, better still, one drachm subcutaneously, deep into the abdominal muscles always, never super- ficially for fear of causing abscess.—Ed.] We apply over the abdomen a sheet, folded a number of times, or else a moderately tightened binder. The patient should lie on her back for a number of hours after delivery, and the toilette of the vulva should be attended to at least four times in the twenty-four hours, and carbolized water, one part to 100, should be used. [On account* of its unpleasant odor, carboHc may be dispensed with, and corrosive sublimate, 1 to 4000, substituted. In private practice we question if pure boiled water be not amply sufficient. As for the dressing for the reception of the lochia, to which no reference is made in the text, the old-fashioned napkin should be rejected, and absorbent cot- ton substituted. A pad of this cotton, antiseptized or not, according to individual taste, should be laid against the vulva, and retained in place by an ordinary T bandage, which is pinned in front and behind to the abdominal binder. This makes a clean and comfortable dressing, and the cotton should be changed as soon as saturated, and this will vary with each patient according to the amount of the lochia.—Ed.]