Hasmorrhage during or after labour is one of
the most trying accidents connected with the subject of
Obstetrics; whether it occurs before the birth of the
Child, or after, when its sudden onset, just as labour
seems to be happily terminated, and its alarming effect
on the patient, tax the resources of the Obstetrician
to the utmost and necessitate the possession by him of
the military qualities, calmness and coolness in danger.
Some idea of the importance of this subject
may be gathered from the Registrar-General's report.
Thus in five years, 1871-1875, $524 deaths were return¬
ed as due to "flooding" .■*■' In the year 1871 there was
a population in England and Wales of 22,712,266 and in
London of 3,254,260 ot* a total of 25,966, 526.2) The
death rate during this time was 22 per 1000 per annum,®'
or a total death-rate for the five years of (roughly) 2,856,260. By Calculations we can now see that one
death in every 800 odd is due to flooding. Similarly,
taking the birth-rate as 35 per 1000 per annum1' we get
a total birth-rate of 4,544,050 and a proportion of One
death due to flooding in every 1,289 labours.
It must be remembered that these figures show
only the actual deaths due to this complication, and it
is probable that only post partum haemorrhage is includ¬
ed under the term"flooding"; cases of Placenta Praevia
etc. being returned under other heads. I know of no
statistics that show the number of people who actually
suffer from haemorrhage , not of so severe a degree as to
cause death, nor the amount of illness and misery caused
by this complication.
The difficulty a student or young practitioner
has in treating cases of severe haemorrhage is much in¬
creased by the habit obstetrical books have of looking
on Uterine Haemorrhage as a different thing from ordin¬
ary surgical haemorrhage and entailing a special treat¬
ment. But I don't think this is the case at all. The
treatment of Uteris haemorrhage rests on the same broad
principles as that of ordinary surgical haemorrhage , and
differing only in being applied to a special place.