previously dipped in spirits of wine, and ammonia or hartshorn may be held to the nose.

Inflation of the lungs.-The above means not having been successful, and the pulsation in the cord having ceased, the infant must be separated, and inflation of the lungs resorted to. This is to be effected gently and cautiously as follows:-The child, wrapped in flannel, is to be laid on its back upon a table placed near the fire. Its head is to be slightly extended, and the nostrils held between the fingers and thumb of one hand, whilst with the fingers of the other slight pressure is to be made upon the pit of the stomach, so as to prevent the air from passing into that organ. The lungs of the child are now to be filled with air, by the operator applying his own lips-with the fold of silk or muslin intervening, for the sake of cleanliness-to those of the child, and then, simply blowing in its mouth, he is to propel the air from his own chest into that of the infant. Previously, however, to his doing this, he should make several deep and rapid inspirations, and, finally, a full inspiration, in order to obtain greater purity of air in his own lungs. When the chest of the child has been thus distended, it is to be compressed gently with the hand, so as to empty the lungs; and then the inflation, with the alternately compressing the chest, must be repeated again and again, until either the commencement of natural respiration is announced by a sneeze or deep sigh, or until after long-continued, steady, persevering, but unavailing efforts to effect this object, all ground of hope for a successful issue is removed. Whilst these efforts are being made, some other individual must endeavour to maintain or restore the warmth of the infant's body, by gently but constantly pressing and

rubbing its limbs between his warm hands. And after respiration is established, the face must still be freely exposed to the air, whilst the warmth of the limbs and body is carefully sustained.

It will sometimes happen-and to this circumstance the operator should be fully alive-that when the child begins to manifest symptoms of returning animation, its tongue will be drawn backwards and upwards against the roof of the mouth, filling up the passage to the throat, and preventing further inflation of the lungs. This is to be remedied by the introduction of the forefinger to the upper and back part of the child's tongue, and gently pressing it downwards and forwards, by which the difficulty will be removed, and the air again passes.

The warm bath.-More reliance may be placed upon the above measures to restore animation than upon the warm bath. Still this is sometimes useful, and therefore must not be neglected. Whilst inflation is going on, the bath may be got ready, then resorted to, and if unsuccessful, inflation may and ought again to be followed up. If the bath is useful at all, it will be so immediately upon putting the infant into it; respiration will be excited, followed by a cry; and if this does not occur at once, it would be wrong to keep the child longer in the bath, as it would be only losing valuable time which ought to be devoted to other efforts. The temperature of the bath should be about 100°; and if, upon plunging the infant into it, it fortunately excite the respiratory effort, it should then be taken out, rubbed with dry but hot flannels, and, when breathing is fully established, laid in a warm bed, or, what is still better, in its mother's bosom; letting it, however, have plenty of air.

We should not relinquish our endeavours at resuscitation under two or three hours, or even longer; and if ultimately successful, the state of the infant should be carefully watched for two or three days.

Sect. 2.-Injuries received during Birth.

If a labour be long and tedious, the head and body of the child may be bruised and disfigured.

The shape of the head is frequently altered by the compression it has undergone, so that it may be elongated, and measure from the chin to the back of the head as much as six or seven inches. This always excites surprise, sometimes apprehension, in the minds of the attendants; there is no ground for it. It must be allowed to regain its natural shape without interference.

Tumours or swellings upon the head are very common. They arise from pressure upon the part during the labour. The only treatment that is required, or safe, is, freedom from all pressure, and the application of cold lotions composed of brandy or vinegar and water. The swelling will gradually subside. It will be right to direct the attention of the medical man to this circumstance.

The face may be frightfully disfigured from the above cause, exceedingly black, and the features distorted. Nothing is necessary here; in a few days the face will recover its proper appearance.

Sect. 3.-Bleeding from the Navel-String.

Bleeding from the navel-string will sometimes take place hours after it has been supposed to be carefully secured. This will arise either from the cord being

carelessly tied, or from its being unusually large at birth, and in a few hours shrinking so much that the ligature no longer sufficiently presses on the vessels. In either case, it is of importance that the attendants in the lying-in room should understand how to manage this accident when it occurs, that it may not prove injurious or fatal to the child.

The mode of arresting the bleeding.-The clothes of the child and the flannel roller must be taken off; the whole cord without delay must be unwrapped; and then a second ligature be applied below the original one (viz., nearer to the body of the infant), taking great care that it shall not cut through the cord when drawn very tight, but at the same time drawing it sufficiently tight to compress the vessels. The ligature should be composed of fine linen threads, three or four thicknesses, and not of tape or bobbin, or any substance of this nature, as it cannot be relied on for this purpose.

Sect. 4.-Ulceration, and Bleeding from the Navel.

Ulceration, or imperfect healing of the navel.The cord separates from the navel generally some time between the fifth and fifteenth day from delivery, and the part usually heals without giving the slightest trouble.

This, however, is not always the case, for sometimes a thin discharge will take place which, if the part be examined, will be found to proceed from a small growth about the size, perhaps, of a pea, or even less. This must be removed by applying a little powdered alum, or, if this fail, it should be once or twice slightly touched with blue stone, and afterwards dressed with calamine cerate.

At other times, though fortunately very rarely, excoriation of the navel and the parts around takes place, which quickly spreads, and assumes an angry and threatening character. If, however, the attention of the medical man is called to it early, it will always do well: until his directions are given, apply a nicely made bread-and-water poultice.

Bleeding from the Navel.-A day or two after the cord separates, or at the time of separation, bleeding may take place from the navel; fortunately, this rarely occurs ; and I only mention it, to observe that, upon its occurrence, the point of the finger should be placed over the part, and pressure steadily applied until medical assistance is obtained.

Now and then, in these cases, a growth sprouts up and bleeds. Let this be touched with lunar caustic, or any other astringent application, or let pressure be employed, still it will bleed,-not freely or in a stream, but there will be a constant drain from the part, and the infant as a consequence will waste, and be brought to death's door. Excise it, it will only make matters worse. The treatment in this case consists in simply winding a piece of very narrow tape round the growth, and then leaving it untouched. The bleeding will soon cease; the fungus will sprout over the upper margin of the tape; in a very short time it will, as it were, strangle the disease, which, subsequently falling off, a complete cure is accomplished.

Sect. 5.-Jaundice.

It frequently happens, during the first or second week after birth, that the skin of the child becomes very yellow and it has all the appearance of having