III. Lesions of the foetal circulation constitute a no less dangerous class of causes of apparent death. These may consist in ruptures of the placenta or of the umbilical cord which affect the life of the child while yet unborn; or if the hemorrhage should be arrested in any way before proceeding to so fatal an extent, the child may be born alive but in a state of syncope. In these cases the child is very pale; the muscles are relaxed; it may make a few short respirations and utter some feeble cries; but unless saved by the administration of the proper remedy, it soon perishes.
There is still another class of lesion of the foetal circulation, entirely opposite in its nature and apparent symptoms to that just described; but far less dangerous. This consists in a real strangulation of the foetal circulation; which may occur from the cord being wound tightly round the neck, or from the spasmodic contraction of the cervix uteri around the child’s neck; in the former case the face may be merely congested and the eyes bloodshot and protruding, in the latter the countenance may so remarkably resemble that of a negro, as to throw the mother into maniacal convulsions, if it is incautiously exhibited to her.
Treatment The following remedies may be given, dry on the tongue, in accordance with the conditions present.
Aconite The child is hot, purplish, pulseless and breathless, or nearly
so.
Arnica This remedy should be given, if the child appears to be much bruised.
Belladonna The face is very red, and the eyeballs are much congested and red.
China In cases where much hemorrhage has been the apparent cause.
Opium The face is purplish and swollen; in other respects like Tart.e.
Tartar e. When the child is pale and breathless, although the cord may still pulsate.
If the child does not soon respond to internal remedies, it had better be immersed suddenly in very cold water; or better still, pure cold water, or even ice-water may be poured over it. In some pale, and apparently lifeless children, pouring cold water upon the head and allowing it to pass down over the body, produces a redness of the skin, and establishes the circulation and respiration; the child should then be at once wrapped in flannel blankets till quite restored. Of course in all those cases where respiration is prevented by accumulation of mucus in the nose and mouth, these obstructions will have been noticed and removed as soon as possible after the delivery of the child, or even while yet the head only is delivered. And the various efforts to restore life in cases of suspended animation, should be persevered in for some time; for although ineffectual at first, they often prove successful after a while.
Artificial inflation of the lungs, effected by holding the child’s nose and blowing into its mouth, the operator fitting his own mouth closely to that of the infant, has proved efficacious in some instances.
