To Prevent Subinvolution.

While I do not always approve of routine in the treatment of any class of cases, I have been in the habit of giving every patient, after confinement, beginning with the expulsion of the child, from eight to ten drops of a good fluid extract of ergot, every hour, for perhaps thirty-four or forty-eight hours, when the patient is awake.

While this course is not original with me, I have though it productive of good results and justifiable in most cases.

COMMENT:—It seems to me that the above course in every case, would hardly be demanded. There are two results to be accomplished with this remedy; one, the prevention of postpartum hemorrhage, and the other the securing of complete involution.

While the first result is being attained, the remedy will quite frequently so materially increase the after pains, as to make it necessary to administer some remedy for their relief. As to the latter in securing involution, I do not think a physician is justified in treating a condition unless it exists. If he is assured later that involution is not sufficient then, and then only, should he prescribe for that condition.

I should advise all physicians to consider every case by itself, as to whether ergot is demanded or not. I at one time made it an arbitrary rule to give, perhaps, twenty minims of ergot in all cases immediately after the expulsion of the head. Later I applied the above rule to that procedure, and considered the demands of each case, concluding the correct course to adopt was to use the remedy only when it was indicated.

I have obtained excellent results from the remedies which I used in preparing the patient for confinement, and from the previous influence of these remedies the normal processes have been carried on after labor, without any further assistance.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.