An Apparently Successful Case of Cardiac Massage

ago. Present confinement.?The membranes ruptured with the onset of labour and it was decided to apply forceps on account of primary uterine inertia which was contributed to by a cicatrical contraction in the vaginal canal about two inches above the vulva. Under chloroform ana;sthesia this was manually dilated and as forceps were being applied the patient suddenly stopped breathing. The forceps were removed, artificial respiration was immediately started and as the pulse was very feeble 1/30 grain of strj'chnine was injected. The patient failed to respond and the heart stopped beatingTen minims of adrenalin were injected into the heart and repeated after one minute. There was no response from the heart after a further minute. The baby at this point drew attention to itself by vigorous struggling and after it had been confirmed that there was no heart beat a hasty Cesarean section was performed and a living baby delivered. Before the placenta which was adherent was removed cardiac massage was done by compressing the heart between the right hand under the diaphragm and the left hand over the precordia. This was done easily but considerable upward pressure of the right hand was required as the heart tended to slip upwards out of reach. It began to beat after about four minutes' stoppage, at first feebly but after about half a minute forcibly. With the return of the heart beat the uterus started to bleed. The placenta was quickly removed and the uterus and abdomen sutured, 1 c.cm. of pituitrin having been given into the uterine muscle while the placenta was being removed. When the abdomen was closed the condition of the patient was fairly good, respirations though jerky with