1989. In Many Varieties Of Natural Labour, Opium Proves Most Useful

For instance: - 1. At the commencement there may be irregular and spasmodic pains. "These," observes Dr. Lever, "are recognised by their acuteness; by the want of consentaneous action in the uterine fibres, some portion of the uterus during their continuance is hard and contracted, the other portion is soft and yielding; there is no distinct or regular interval of time between the occurrence of pain; and if untreated and unrelieved, the strength of the patient is exhausted before the establishment of true labour-pains; or the child, which, at the commencement, presented normally with the head, has its position changed to that of the shoulder, by reason of the uterus contracting on one side, and forcing its contents over to the uncontracting or yielding side." In such a case, the utility and value of Opium is most marked. It may be exhibited by mouth, or per anum. It will calm the spasm, subdue irregular action, alleviate pain, procure sleep, and, after this, true and regular uterine action will be established. 2. When the liquor amnii escapes early, before the os uteri has commenced to dilate, and the child, in consequence coming in immediate contact with the uterus, gives rise to intense pain and protracted labour, the judicious exhibition of Opium controls hyperuterine action, alleviates pain, and gives a better security for the welfare of the child. 3. When the os uteri is hardened and undilating, depletion, the warm bath, and the exhibition of Antimony, should be employed; and when, by these means, the relaxation of the os has been produced, Opium, given in a full dose, will render such permanent, and thus prove a most valuable agent in completing a safe delivery. 4. In women who have suffered from irritable uterus, where the vagina is generally hot and dry, although not over-sensitive, but the moment the examining finger touches the os uteri she shrieks out and suffers intense agony, Opium, either by mouth, or, what is better, per anum, acts like a charm. 5. In cases of transverse presentation, where it is necessary manually to interfere, to bring the long axis of the child to correspond with the long axis of the uterus, we may assist in relaxing the os uteri, and abate uterine contraction, by the exhibition of a full opiate. Dr. Lever considers this safer and more efficient than the use of small doses frequently repeated. 6. When Labour is complicated with Tumour, Opium will allay inordinate action, until we employ those manual or surgical means which are necessary to remove the obstructing cause to delivery. It is true that Opium cannot take away the mechanical obstacle, but it may and will lessen inordinate uterine action; for, in practice, we find that if there be any difficulty in the passage of the child, and the uterus is stimulated to undue action, or if such be not allayed or be overlooked, rupture of that viscus itself may take place. 7. In Ruptures of the Vagina and Uterus, Dr. Lever regards Opium in full doses, as capable of saving the patient. He mentions a case in which full doses of Opium, repeated at varying intervals for several days, brought about a successful termination.