In most cases the placenta c6mes away favourably after the expulsion of the child, when Ergot' has been administered, but occasionally the contractions of the uterus, which were so favourable towards the expulsion of the foetus, subsequently continue, and the placenta is in consequence retained. Dr. Churchill mentions a case of the kind, and Dr. Harvey relates one in which the placenta was detached, and lying in the cavity of the uterus, and yet the contractions were so vigorous, that its removal could not be effected for an hour, until relaxation took place. It is inadmissible when the placenta is retained in consequence of morbid adhesion. Dr. Catlett considers that it causes hour-glass contraction. "When, however, the placenta is retained, in consequence of the feebleness or absence of uterine contractions, a dose of Ergot (gr. xxx.) will often cause its speedy expulsion. HAemorrhage after the birth of the child is very rare, when Ergot has been employed; and, indeed, it does not seem, in the great majority of cases, to interfere in any way with the speedy recovery of the mother, or with the subsequent uterine functions.
* Edin. Med. Surg. Journ., Jan. 1, 1842. Dub. Quart. Journ. of Med. Sci., Feb. 1851.
Edin. Med. Surg Journ., Jan. 1, 1840, p. 143.
2468. In HAemorrhage occurring during Labour, the Ergot proves of great service, inducing contraction of the uterus, and arresting the discharge more rapidly than any other remedy. If, however, there be any great nervous exhaustion, Opium should be first given; but if the hAemorrhage still continue after the exhaustion is removed, the Ergot may be had recourse to with evident advantage. Dr. Beatty * observes that, to act beneficially, the Ergot should be employed early: "It will not do," he adds, "to wait until the system is exhausted, and the vital powers are reduced to the lowest ebb; for then the effect of the Ergot may be more prejudicial than advantageous, owing to the power it possesses of depressing the action of the heart." Dr. Beatty also considers, that the Ergot will prevent the occurrence of hAemorrhage in certain cases, where, from previous experience, we have reason to know that it is likely to occur. This view is supported by the opinion of Prof. Meigs and other writers.
Ely strongly advises a full dose of the Ergot to be given immediately after the rupture of the membranes. "Here," he observes, "until the os uteri is considerably dilated, the bleeding can only be stayed by the plug; but when the os is open, thin, and yielding, if we rupture the membranes, the descent of the head will so compress the bleeding vessels as to place the patient in safety." To effect this more rapidly and certainly, the Ergot is advised.