on her back; and the broad bandage, to which allusion has already been made, will be spread evenly, and pinned or buckled sufficiently tight around the lower part of the person to give a comfortable feeling of support. Sometimes a little pad is put under the bandage: this should never be allowed, except directed by the medical man. I have known it produce, by its pressure, injurious consequences. The object of the bandage, as it is generally used by medical men, is simply to give moderate and equal support to the abdominal muscles, which have the pressure from within suddenly withdrawn, and to prevent the uneasy sensations which would arise on their relaxed condition. For this purpose the addition of the large pad is quite

unnecessary.

A little tepid gruel may now be taken, and the patient left to rest. If disposed to sleep she should indulge it, but if not, must be kept perfectly quiet, and undisturbed by conversation. The importance of quiet and sleep immediately after delivery is not sufficiently regarded.

How to proceed if the Child be born before the arrival of the Medical Attendant.-It not unfrequently happens, subsequent to a first confinement, that with some women their labours are so rapid and short (two or three strong and powerful pains being sufficient to bring the child into the world), that it is quite impossible for any medical man to get to them in time for their delivery. Under these circumstances, the friends are generally excited and alarmed. There is no occasion for this; still they ought to be acquainted with what is best to be done.

If the patient is not already in bed, let her get upon it as quickly as she can. Let her turn on her

left side. Let the clothes be arranged as far as time will allow, in the manner described before. And when the child is born let the attendant take care so to place it that there shall be a free access of air to its mouth. A few pains more may cause the after-birth to be expelled. If so, the cord may be tied and divided (of the mode of doing this I shall presently speak); the child, wrapped in its flannel receiver, may be carried away from the mother to be washed or dressed, as may be most convenient. Next, the bandage must be slipped round the patient, and, being pinned sufficiently tight to give comfortable support, she must be left quietly to repose until the medical man arrives. And all this must be done without hurry and bustle, or it will not be done well.

The Child may be born, but the After-birth may not be expelled.-If so, no nurse ought to be permitted to remove it. This hint cannot be too strongly borne in mind; for an injudicious interference with the after-birth may be attended with the most serious consequences. But, is the cord to be tied and the child separated, when this is the case? This must depend upon circumstances. If the patient is residing in the country, for instance, and a codsiderable time must elapse before the medical man can possibly arrive, if the child has cried or breathed vigorously, it may be done with safety. If, on the other hand, the medical attendant is shortly expected, the less done the better. Simply see that the infant has air; place it on its back.

And now with regard to the mode of securing and dividing the cord. Make two ligatures, each consisting of half-a-dozen threads of coarse thick cotton. Bring the cord within view, but be very careful not

to expose the mother. With the first ligature tie the cord about three fingers' breadth from the child's navel, and place the second about half an inch farther still from the child, and use just sufficient force to secure, but not to divide, the cord with the ligatures. The navel-string may now be cut with a pair of scissors between the two ligatures, and the child taken away.

Twins. If there should happen to be twins, the mother must, if possible, be kept in ignorance of the fact till both children are born. This is an established practice with medical men, as mischief might ensue from the apprehension with which the patient might contemplate the second labour. Unfortunately, however, the attendants in a lying-in room, taken by surprise (when informed by the medical man, after the birth of the first, of the existence of another child), often, by their incautious conduct, discover the fact prematurely to the patient. This, be it remembered, should ever be carefully guarded against.

After-pains. About half an hour or so after delivery, a patient must expect pain again to occur. Those pains, however, will differ from those which have just subsided, as they are not attended with bearing-down efforts, and are accompanied by slight discharge these are called 'after-pains.' They will continue off and on, with more or less frequency, severity, and duration, for about eight-and-forty hours. In this respect, however, they vary much in different individuals; but, whether mild or severe, they must be borne with patience, and must not give rise to anxiety, since they are useful and salutary. If, indeed, they should be violent, they are under the control of medicine, which will be accordingly ordered for that purpose.

These pains rarely occur with first children,

Sect. 3. From after Delivery to the time of leaving the Chamber.

Arrangement of Patient's Dress, &c.-The medical attendant having retired from the room, it sometimes happens that an inexperienced nurse proposes to make her mistress comfortable, and, if allowed, will change the linen about her person, and alter her position in the bed; in effecting which she will perhaps lift her off the bed, or, if not, place her in an erect or sitting posture upon it. Nothing can be so improper, or more likely to induce serious consequences. It is the duty of the medical man himself to leave his patient comfortable, as it is called; and it is in his power to do this without running any risk, or altering her situation in the bed; that is, if the previous directions about her dress have been attended to. Little things are often of great importance, and are sometimes found to be so when it is too late.

The

An hour, or an hour and a half, however, having elapsed from the time of delivery, the necessary alterations about the bed and dress may be made. soiled linen is to be removed, and the chemise and nightgown, previously folded around the chest, drawn. down. The patient is then to be carefully removed to the upper part of the bed; in effecting which, the horizontal position is to be strictly preserved, and on no account for one moment must the mother be raised upright. The patient herself must be entirely passive whilst this change is being effected; no effort must be made, or assistance given by her.

These arrangements finished, the room must be slightly darkened, the most perfect quiet observed, no

conversation, and least of all whispering, be permitted; the friend must guard the room from all intruders— the nurse take the infant into the adjoining chamber, if the arrangements will permit it-and the patient be encouraged to seek a long and refreshing sleep.

Passing Water.-Shortly after delivery, the patient must make an attempt to pass water; and whilst this is to be done as nearly in the horizontal position as possible, there is no objection to her turning round upon her knees for this purpose, if it is found to be

necessary.

If the labour have been tedious, there will sometimes be difficulty in evacuating the bladder. In such a case, a cloth should be wrung out of warm water, and applied to the lower part of the stomach and external parts. If, however, the fomentations fail to obtain relief, then the medical man must, without fail, be informed of the circumstance.

This inability occurs very frequently; and it is important that the patient do not deceive herself in this particular. Passing a little water drop by drop does not empty the bladder; and if it be not emptied, assistance is demanded. It would be a sadly mistaken delicacy which kept a patient from revealing such a circumstance to her attendant; even a very temporary concealment has often been most injurious, while prolonged delay has, in many instances, led to most disastrous consequences.

The Bowels. On the evening of the second, or morning of the third day, some aperient medicine should be taken; and this ought to be given though the bowels may have been previously moved, for they