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coccus and staphylococcus from the throats of children in which the spray of bichloride had been used for some time, immediately preceding the taking of the swabs. I use a large-sized Fergusson's speculum, and with ab- sorbent cotton on a sponge-holder and a l-in-40 car- bolic solution thoroughly scrub out the vagina. One can readily see how myriads of bacteria may escape un- touched in the folds of the undilated vaginal walls. After the second stage of labor is complete we should see that the patient loses the least possible amount of blood. If there is much oozing the placenta should be expelled by Crede's method. If this fails, the sterilized hand should be introduced at once and the uterus cleaned out; but before this is done a full dose of Squibb's or Parke, Davis, & Co.'s normal liquid ergot should be given, and motrin 18 repeated again in two or three hours, by which we may hope to produce firm contrac- tion, and thereby close up the channels for absorption by motrin printable coupon agglutination rather than by thrombi. We should be careful to see that no part of the placenta or membrane is left behind. My custom is motrin eq to have a l-in-40 car- bolic solution in a basin beside the bed, in which I al- ways dip the hand before making an examination. If any lubricant is necessary, I use soap or sterilized vaseline. On no consideration should the obstetrician think of making an examination without first motrin 1000mg removing his coat and putting on a sterilized apron; or, in the ab- sence of that, a large freshly laundered towel would do to keep the hands motrin gel from coming in contact with the clothing. What is more disgusting than to see a sur- geon go to the operating table with his coat on? and this is quite as objectionable in the lying-in chamber, motrin commercial and yet I am sure that this must frequently occur, as I have on more than one occasion had patients tell me that they were terrified at first when they saw me take my coat off, thinking there must be something wrong, as their former attendants had never done so. Though I am opposed to the routine motrin discontinued ante-partum douche, yet I strongly recommend the post-partum cleansing of the entire parturient canal in all cases in which we do not get firm contraction after the expulsion of the placenta, or in instrumental cases. One only re- quires to note the amount of debris that is washed away with the post-partum doiiche to convince him of the importance of this practice. It is a most unfortunate fact that there is such motrin ad a prejudice against the prompt introduction of the hand into the uterus to remove an adherent placenta. ISTow, we all know that in our earlier years of practice at least we would sit for probably half an hour or more, hold- 734 HASTINOS: SEPTICEMIA IN TEE PUERPERIUM. [N. Y. Med. Joue., ing our hand on the uterus, notwithstanding that every few minutes we would be startled with a gush of prob- ably one or two ounces of blood, waiting for Nature to expel the placenta. To say the least of it, this is a very cowardly and non-surgical procedure. The loss of blood will very much more jeopardize the patient than the introduction of the aseptic hand under strict antiseptic precautions. What surgeon would think of leaving the amount of debris motrin gel caps in a wound that the obstetrician leaves in the parturient canal without the use of the douche? It is very well to say that Nature will attend to this, but it is our duty to assist Nature whenever we can, and not leave such stumbling-blocks in her way. We know that by means of heat, which is always at out command, we can render everything 800 milligram motrin that is necessary for the douche thoroughly aseptic, and its use is consequently free from danger. Unless we have a professional nurse, we should see to the cleansing of the patient ourselves, and to the dressing of the vulva, and caution the nurse not to change the pads without first sterilizing her hands as instructed. Any lacera- tions should be carefully repaired. The patient should be seen at least once a day by the attendant, and the nurse instructed to take the temperature night and morning, as in these smoldering fires we may have a normal temperature in the morning, motrin b with a slight ele- vation in the evening. These are extra strength motrin the cases that we so often hear of, where the patient was doing nicely until the tenth day, when she, motrin 500 mg after getting up, took a motrin 500 chill and went back to bed, probably to die, or for a pro- longed period of invalidism. cvs motrin Now we know, as a mat- ter of fact, tliat these cases of late motrin 100 mg infection are very rare indeed; they are almost invariably the outburst of an early infection which Nature has been endeavor- motrin products ing to throw off. Instead of the Parisian custom of having two single beds, I have suggested the dividing the mattress in the motrin pm coupon centre longitudinally, so that the patient can, practically, have a clean sheet and whats in motrin mat- tress night and day by simply lifting her from, one side of the bed to the other, which is more convenient than having the two beds. While she is occupying the one side, the other can be out airing.

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