ile gauze or cotton, the dressing applied to the vulva and the
temporary bed removed, her night dress pulled down and the patient thus
lying in a clean, comfortable bedding. The woman may then have a cup of
weak tea, hot milk or broth and be left to rest; but during the first
sleep the womb should be carefully watched lest it relax and serious, if
not fatal, bleeding occur. In a normal confinement the dressings need not
be changed, as a rule, oftener than six times in twenty-four hours, for
the first few days. As soon as convenient after the first toilet is
finished the physician sterilizes his hands and with the patient on her
left side introduces one finger into the rectum and the thumb into the
vagina to discover the condition of the perineum. Washing out of the
vagina is not necessary as a rule.

[OBSTETRICS OR MIDWIFERY 537]

The binder is considered indispensable, and should be made of unbleached
muslin and wide enough to extend from the pubic (bone) to the breast-bone,
and long enough to go around the patient's body and slightly lap. The
binder should be pinned or sewed tightest in the middle, but it should not
be so tight as to press upon the womb and crowd it backward or to either
side. It acts as a splint to the muscles and assists in resting them to
their natural condition.

Rest.--Complete rest of the body and mind is essential to the well being
of the lying-in woman. She is better off without any company, and should
see no one except her family for the first week or two. Outside visitors
should be prohibited. The lying-in room should be kept free from noise and
confusion, and the patient should be protected from annoyances of every
kind. She should remain lying on her back for a few days and immediately
following delivery she should not have a pillow for her head. Sleep is
very necessary and desirable, and mild medicines should be given to
produce it, if necessary. It is best not to sit up in the bed until the
womb shall have had time to become smaller, and has resumed its natural
position behind the pubis. Among the upper classes, when it takes the womb
longer to regain its normal size, three weeks is a good rule to go by
before sitting up in the room, and she should remain in her room until the
end of the fourth week. Among healthy women of the laboring class, whose
muscular system has not been injured by "culture" and social excesses, the
womb and appendages regain their normal proportions more rapidly