536. It might be asked,—Does the inhalation of chloroform retard the patient’s “getting about”? I emphatically declare that it does not do so. Those who have had chloroform have always, in my practice, had as good and as speedy recoveries as those who have not inhaled it.
537. One important consideration in the giving of chloroform in labor is, that a patient has seldom, if ever, while under the effects of it, been known to die; which is more than can be said when it has been administered in surgical operations, in the extraction of teeth, etc. “I know there is not one well-attested death from chloroform in midwifery in all our journals.”[[97]]
538. One reason why it may be so safe to give chloroform in labor is, that in the practice of midwifery a medical man does not deem it needful to put his patient under the extreme influence of it. He administers just enough to ease her pain, but not sufficient to rob her of total consciousness; while in a surgical operation the surgeon may consider it necessary to put his patient under the full influence of chloroform: hence the safety in the one, and the danger in the other case. “It is quite possible to afford immense relief, to ‘render the pains quite bearable,’ as a patient of mine observed, by a dose which does not procure sleep or impair the mental condition of the patient, and which all our experience would show is absolutely free from danger.”[[98]]
539. There is another advantage in chloroform,—the child, when he is born, is usually both lively and strong, and is not at all affected by the mother having had chloroform administered to her. This is a most important consideration.
540. The doctor, too, as I before remarked, is deeply indebted to Sir J. Simpson for this great boon: formerly he dreaded a tedious and hard labor; now he does not do so, as he is fully aware that chloroform will rob such a lying-in of much of its terror and most of its pain and suffering, and will in all probability materially shorten the duration of the confinement.
541. Chloroform ought never to be administered, either to a labor patient or to any one else, except by a medical man. This advice admits of no exception. And chloroform should never be given unless it be either in a lingering or in a hard labor. As I have before advised, in a natural, easy, everyday labor, nature ought not to be interfered with, but should be allowed to run its own course. Patience, gentleness, and non-interference are the best and the chief requisites required in the majority of labor cases.
HINTS TO ATTENDANTS IN CASE THE DOCTOR IS UNAVOIDABLY ABSENT.
542. It frequently happens that after the first confinement the labor is so rapid that the child is born before the doctor has time to reach the patient.
543. It is consequently highly desirable—nay, imperatively necessary—for the interest and for the well-doing both of the mother and of the baby, that either the nurse or the lady friend should, in such an emergency, know what to do and what NOT to do. I therefore, in the few following paragraphs, purpose, in the simplest and clearest language I can command, to enlighten them on the subject.
544. In the first place, let the attendants be both calm and self-possessed, and let there be no noise, no scuffling, no excitement, no whispering, and no talking, and let the patient be made to thoroughly understand that there is not the slightest danger; as the principal danger will be in causing unnecessary fears both as to herself and her child. Tens of thousands are annually delivered in England, and everywhere else, without the slightest assistance from a doctor,[[99]]—he not being at hand or not being in time; and yet both mother and child almost invariably do well. Let her be informed of this fact—for it is a fact—and it will be a comfort to her and will assuage her fears. The medical man, as soon as he arrives, will soon make all right and straight.