The plan of treatment which we have found most certain is first to clear
out the bowels by a full dose of calomel and colocynth, then to give the
patient a warm bath, in which she may remain twenty or more minutes, after
which the abdomen should be well rubbed with stimulating liniment as she
lies in bed, and the secale cornutum given in doses of a scruple of the
powder in cold water, repeated every half hour for five or six times.
Contractions of the uterus rarely fail to follow, and although they
generally require the secale to be renewed after a few hours, they will be
found to have effected several very important changes preparatory to
actual labour;--the abdomen has sunk, the fundus is lower, the cervix is
shorter or has disappeared, and not unfrequently we feel the head has
already passed the brim and is now in the cavity of the pelvis; the vagina
and os uteri are lubricated with a copious secretion of remarkably pure
and albuminous mucus; and in these cases especially, we frequently meet
with those little lumps of inspissated mucus which were formerly called
the _ovula Nabothi_. All these precursory changes are so many preparations
of nature for a natural labour, and contribute not a little to the
successful termination of the case, advantages which cannot be enjoyed
where the membranes have been previously ruptured. If, however, we do not
succeed in producing more than a slight dilatation of the os uteri, if the
repeated exhibition of the ergot only produce vomiting, or constant pains
which have no other effect beyond preventing rest and inducing exhaustion,
the separation of the membranes from the uterus, as proposed by Dr.
Hamilton, will now have the best effects: even if this fail and we are
compelled to puncture the membranes, it will now be performed under so
much more favourable circumstances, from labour having already commenced
to a certain extent.
A warm bath and the other usual means for recovering the child should be
in readiness. In most cases the secretion of milk follows as after labour
at the full term, which is a great advantage; for the thin watery
secretion of this early period is much better adapted to the weak
digestive organs of the premature child. It is frequently a matter of some
difficulty under these circumstances to make a child take the breast at
first, and this is the chief reason why their digestive organs so soon
become deranged. "In case no milk be present, a good substitute may be
made by beating up fresh eggs and milk, boiling them over a gentle fire
and straining off the thin fluid." (Reisinger, _die künstliche
Frühgeburt_.)
Public-domain text, read in full here on John Shaqi.
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