or junket.  During the next few days, chicken (white meat), scraped beef or mutton in small quantities, baked potato, rice and cereals may be given and by the end of the week a gradual return to the ordinary diet may be made.  Should there be any tendency to constipation, the bowels should be opened by a simple enema (as before stated) or glycerin enema, etc.; or by one or more doses, 2 drams, of the compound licorice powder repeated in three or four hours, if necessary; or a half ounce of castor oil, or a half glass of hunyadi water.  Cooked fruits for the constipation may also be given.

Bleeding After Delivery, Post-Partum Hemorrhage.—­Bleeding from the womb occurring six hours after delivery is called post partum and after that time, is known as puerperal child-birth bleeding or hemorrhage.

Causes.—­A relaxed condition of the womb, the retention of clots or parts of the membranes, etc., in the womb, a full rectum or bladder, fibroid tumors, deep tears of the cervix.

Symptoms.—­If the bleeding is profuse, the pulse is fast, the woman looks pale, anxious and feels cold, restless, gaping, usually it comes from a relaxed, softened and enlarged womb.

[Obstetrics or midwifery 541]

Treatment.—­In severe forms no time must be lost in securing contraction of the womb and the method employed for expelling the after-birth should be employed to expel clots.  Grasp the womb over the abdomen, employ firm but gentle kneading, pressing downward.  The pillows should be removed, the foot of the bed elevated twelve to eighteen inches, a preparation of ergot given by the mouth or hypodermically in the thigh.  If these measures fail the hand and arm should be sterilized and inserted in the womb, all clots, etc., removed and pressure made over the abdomen on the womb while the hand is still there.  This pressure and presence of the hand close the bleeding vessels in the womb.  The hand should remain, while the kneading goes on externally, on the womb.

This kneading should be kept up until the womb contracts.  The hand can then be removed from the vagina, while gentle kneading is slowly kept up over the womb.  The womb should be closely watched for hours after.  Bleeding very seldom occurs again, but it might.  If the bleeding is more of an oozing, an injection of very hot water, 120 degrees F., through a long douche nozzle, directly into the womb cavity may be given.  This is very effective for any kind of bleeding.  Lemon juice or boiled vinegar can be added to the injection.  Everything used must be perfectly clean or child-bed fever may be caused by these measures.  After the womb has thoroughly contracted, it is sometimes of benefit to place a rubber bag filled with cold water over the pubic bone to prevent subsequent relaxations of the womb.  Weakness can be met by hypodermics of whisky or brandy and strychnine, one-thirtieth of grain, injected hypodermically to stimulate the heart.