Hemorrhages of the mucous membrane, whether of the bladder, the bowels or lungs, generally yield to the following mixture:——
NO. VIII.
| Take: | Gallic acid | 4 scruples |
| Tr. of digitalis | ½ ounce | |
| Fluid ex. of ergot | 1 ounce | |
| Simple syrup | ½ ounce |
Mix, and give a teaspoonful in a little water every four hours; children in proportion.
URINARY FISTULA.
By this is meant a permanent unnatural opening into the bladder from without, through which urine escapes.
The situation of the female bladder, just in front and over the vagina, and also its attachment to a portion of the cervix or neck of the womb, exposes it to injuries, especially from pressure of the child’s head during delivery. By referring to Plate II, it will be seen at a glance how easily an accident can take place from this cause. It was at one time supposed that delivery by forceps was the most fruitful cause of this lesion. That this is likely to happen only where the instrument is in incompetent or bungling hands, there is no reasonable doubt. A thorough acquaintance with the entire subject has proved that there are other causes that are the mainspring of this, sometimes very serious accident.
Indeed, the opposite view is now entertained by the profession; that is, that prompt delivery by forceps will prevent the parts from being injured, when the soft parts, and particularly the bladder, is under severe and prolonged pressure by the child’s head. There is no question that there is greater peril to the mother and child, in undecisive delay, provided the attendant has the requisite judgment and experience to act intelligently.
The hypothesis upon which this is based is the restorative property that living tissue possesses, to regain its vitality, after it has been subjected to severe and inordinate pressure. This we may observe in our daily experience; when, for instance, we jamb or crush our finger, or a child has its fingers momentarily crushed between a closing door, the fingers are sometimes crushed flat, but upon being released, they rapidly regain their shape and vitality. If the pressure were continued for any length of time, the blood in the tissues would have become congealed, and the circulation permanently shut off, so that recuperation would have been impossible, and the tissues would have sloughed or mortified.