rst Stage of Labor Means-What the Second Stage of Labor Means-Length of the Second Stage-Duration of the First Confinement-Duration of Subsequent Confinements-Conduct of Patient During Second Stage of

fter Labor-Position of Patient After Labor-The Lochia-The Events of the Following Day-The First Breakfast After Confinement-The Importance of Emptying the Bladder After Labor-How to Effect a Movement of the Bowels Af

s. It is only just that he should have an opportunity to arrange his work so that he may be at liberty to give his whole time to your case when he is wanted. He may not be at home at the moment, but

orm some kind of miracle to relieve them of all pains at any stage in labor. This is a mistaken idea. No physician can hasten, or would if he could, a natural confinement. He waits until nature accomplishes her work, and he simply watches to see that nature is not being interfered

atient has adhered to the instructions of the physician given during the early days of h

c.,-everything in fact out-of-doors except actual exercise, for two weeks previous to the confinement date. The usual walk in the open air should be

r a certain time (estimated to be 280 days) it is ripe, or fully matured, and is ready to be born. The womb itself becomes irritable because it has reached the limit of its growth and is becoming overstretched. Any

in her abdomen; to some, the feeling is as if gas were rumbling around in their bowels; to others, the feeling is as if they were having an attack of not very painful abdominal colic; while others complain of actual pain. The fact that these sensations

al pain so that she will feel like standing still, holding her breath and bearing down. That is the first real labor pain and marks th

sists of dressing gown, night gown, stockings and slippers. These are worn as long as the patient is out of bed, when all but the night gown will be discarded. The entire body of the patient, from the waist line to the knees, should be thoroughly cleansed, paying particular attention to the private parts; first with warm water and castile soap, and then rendered asep

you may recall, was the more or less painless stage, or as it has been termed, the "getting-ready" stage. Inasmuch as it is an

s utilized by nature in op

tilized by nature in expelling

onfinements necessarily take longer, because the parts take more time to open up, or dilate, to a degree sufficient to allow the child to be born. In subsequent confinements, these parts having once been dilated yield much easier, thus shortening the time and the pains of this, th

ething, to hold her breath as long as possible, and to bear down. A good plan is to roll up a sheet lengthwise, and throw it over the top of an open door and let her grasp both ends tightly and bear down; or she can put her arms over the shoulders of the nurse and bear down. Instruct her to hold her breath as long as she can, bearing down all the time, and when she can't hold it any longer, tell her to let up, and then take a quick deep breath and bear down again, repeating this programme until the pain ceases. Tell her specifically to be sure to keep bearing down till the end of the pain, because the most important time, an

IERS OF

bridge from this ge

-fifth of an inch in diameter-is condensed the multitude of

romosomes. This nucleus is nourished by oils, salts and other inclusions, known as Cytoplasm. Floating in the cytoplasm may be found a tiny body known as

m, but it also has its nucleus and chromosomes, which carry

ale cell devolves upon the latter, which possesses what is known as a locomotor tail. In addition there are usually many sperms to one

he spermatozoan unites with the ovum. It is the very first stage o

TION OF A

on from "Genetics," Wa

ached a certain position, the expulsive pains will be so great that she won't be able to control them and nature then seems to take her revenge. So if a woman holds back, and begins to cry, and scream, when she feels a pain coming, she renders the pain to

seen, there are no two alike. It is one of the interesting psychological prob

cted, and they recognize that the advice is given for their benefit. They conscientiously try to ob

uct; and any prospective mother who, because of a willful trait in her disposition, refuses to profit by the kindly professional advice of her physician or nurse, should at least have some consideration for her unborn babe. It may seem unkind to criticise the conduct of any woman at such a time. It is not prompted by a lack of patience or justice however. These women permit, in spite of every assurance to the contrary, an unreas

the gown remains unsoiled, and saves what would be needless trouble if it proved necessary to change the night gown at a time when the tired-out patient needs rest. Much aid may be afforded the woman at this stage by twisting an ordinary bed sheet and putting it around one of the posts or bars of the foot of the bed. The patient may then pull on the ends during the pain; she may also find much comfort and aid by bracing her feet on the foot of the bed while pulling. It is desirable to instruc

sonable woman can do in the same time. She will not try to rest, but cries and moans and pleads for chloroform, until she succeeds in giving everyone except the physician and nurse the impression that she is suffering unnecessarily. Her husband or her mother, whichever is present, gets nervous; they begin to wonder if the physician is really trying to help; assume a long, sad, serious face! forget their promise to look cheerful, and mayhap offer sympathy to the woman. It is a trying moment and needs infinite patience and tact. The physician attends strictly to his duty, which will now be to guard the woman against exerting too great a force during the last few pains. About this time, or before it in many instances, the "waters will break." This means simply that the bag or membrane in the contents of which the child floated burst because of the pressure of a pain. This is a perfectly natural procedure and sho

refer. As soon as the head is born the physician should see that the cord is not round the child's neck; if it is, release it. The shoulders will most likely be born with the next or succeeding pain. The physician will permit the lower s

of a womb, immediately after a child is born, is simply a large bleeding wound. So long as the womb remains firmly contracted there is very little chance for an extensive bleeding to take place. As a rule the womb remains sufficiently contracted to preclude a hemorrhage until the after-birth is out. After the after-birth is expelled, the womb usually closes down firmly and the liability to bleed is very much reduced. Because there is a distin

elf from the after-birth; and some after-births are very firmly attached. Eventually it will come out with a little encouragement in the way of frictional massage of the womb through the abdominal walls. If the membranes remain in the womb after the body of the after-birth is out, do not pull on them. Take

rgot, which should be repeated in an hour. Should there be an excessive f

be between the two ligatures. The cord should be tied with sterile tape made for the purpose, or heavy twisted ligature silk, or a narrow, ordinary, strong tape, previously boiled. It should be tied firmly and inspected a number of times within one hour of its birth. It is possible for a baby to lose enough blood from a cord b

h.-As soon after birth as is practicable, wash the b

ent. solution in each eye, or argyrol, three drops 20 per cent. solution. This precaution is taken against possible infection during l

the boracic solution, and holding the baby up by the feet head down, insert this finger into the t

ket quickly, and immediately put in a cozy basket in a warm place, and left there undisturbed, with his eyes

ong, refreshing sleep. Nothing will contribute to the patient's well-being so much as a quiet, restful sleep after labor. The nurse will therefore take the baby into another room, fix the mothe

cts and forms clots in the uterine cavity which acts as irritants, exciting contractions in the effort to expel them. These contractions cause what are commonly known as "after-pains." These pains last until the womb is free from blood-clots. They may be sever

e mother. This should be made an absolute rule in every confinement. This is a period that demands the maximum of uninterrupted rest and repose. The world and all its concerns should remain a blank to a woman during the whole period of

ck for the first week. Sometimes an exception may be made to this rule by letting the patient move around on the side, with a pillow supporting the back, on the fourth day. These exceptional cases are those whose womb

ed for the first four or five days; for the succeeding two or three days it is yellow; for th

liar to these parts. If at any time the odor should become foul or putrid it is a

hia should be excessive

ietly steal away for ten or fifteen minutes, for these are precious, sacred moments. Motherhood-that angel spirit, whose influence every human heart has felt-that guards and guides the world in its sheltering arms-is born in its divine sense, into the heart of every woman for the first time, as she gazes in ecstasy and wonder at her first-born. She feels that she has beg

ul, smiling word, and do not comment upon mother's happy, thoughtful face, she will quickly col

ead. This will be the breakfast for the two following days also. The milk, or the cocoa (whichever is taken), must be sipped, while the attendant supports the patient's head. The cereal, or the egg (whichever is taken), must be fed to the patient out of a spoon. The patient must not make any physical effort to help herself;

n the right half of her head should be combed while the head rests on the left side, and vice versa. The water used for washing the hands and

ectify itself in a day or two; meantime, if this accident has occurred, it is essential that the bladder should be emptied from time to time until the patient can do it herself. To test this function place the patient on the bed pan into which a pint of hot water has been put, and give her a reasonable time to make the effort to pass her water. Should she fail, take an ordinary small bath towel and wring it out of very hot water, just as hot as she can tolerate, and spread it over

r three days, the object is to clean out the whole length of the intestinal tract, and an enema is limited to part of the large intestine only,-according to how it is given. If the small intestines are not thoroughly emptied, particles of food may remain there, and if so, they will putrify and the patient runs the risk of developing gas,-sometimes to an enormous extent. This affliction is painful, and dangerous, and nearly always unnecessary. It is always, therefore, more safe, and more desirable, to use some agent by the mouth, and we know of no better one than casto

nstructions. It would be better if he actually showed her just how he wanted this work done. The best way to cleanse the vulv? or privates is to take an ordinary douche bag at the proper height (about three feet) and allow the solution (1 to 2,000 bichlorid) to run over the parts into the douche pan, but do not touch any part of the patient wi

e vaginal douches after a confinement, there are good reasons why they should be given, and it is therefore absolutely essential that they should be given properly, and with the highest degree of aseptic precautions. If these

confinement, when the parts are bruised and lacerated, and when, as a

ry douche bag). Drain off the water after it has boiled for ten minutes, but instruct the nurse not to touch the bag or tube, to leave them in the pan, covered, till the physician uses them. When the physician calls, place the patien

an hour's nap. After the rest it is desirable to put the baby to the nipple, first carefully cleaning the nipple wit

a secretion known as "colostrum" which has the property of a

ld move during the first twenty-four hours and th

it distinctly aids in contracting it, and thereby expelling blood-clots

t of the breasts, it will favor

e breast is full of milk, and having once had the nipple it will be e

ustard or rice pudding. This will be the lunch for the two following days also. The same precautions are to be observed in giving this as were observed with breakfast and as will be observed

or a plate of clear consomme with a dropped egg, or a cereal, a l

been normal since the confinement, the patient can be put on an ordinary mixed diet, partic