384 OF LABOUR AND ITS SEQUELS. 



600. The phenomena of labour generally observe a 

 regular order of commencement and cessation,* whence 

 accoucheurs have divided them into stages, of which 

 the moderns enumerate four, although they define them 

 variously. 



601. In the first, the true pains occur, peculiar in 

 their nature, proceeding from the loins downwards in 

 the direction of the uterus (recurring, ^it intervals, in- 

 deed, during the whole of labour, with various degrees 

 of violence and frequency), mild in the beginning, at 

 which time they are called warning and the os uteri 

 begins evidently to dilate. The abdomen now falls 

 still more, the urine is urgent, and abundance of mucus 

 flows from the soft and tumid genitals. 



602. In the second, the pains, increasing, are called 

 preparing, and, by the compressing effect of the res- 

 piratory organs, a strong inspiration, &c. a segment of 

 the lower part of the membranes of the ovum is pro- 

 truded through the uterine orifice into the vagina. 



603. In the third, the pains, becoming more excru- 

 ciating, are called labour pains, and act with still more 

 violence upon the uterus, which is driven downwards 

 and compressed- against the foetus, so that the pro- 

 truded segment of membranes becomes extremely tense, 

 is burst asunder, and the greater part of the liquor 

 amnii escapes. 



604. Finally, in the fourth and last stage, the pains, 

 becoming dreadfully violent and agitating,^- are accom- 



* v. Smellie, Set of anatomical tables. Tab. xi. xv. 



f- Although, even among my own countrywomen, the symptoms described 

 under these four stages, vary greatly in violence and proportionate duration ; 

 nevertheless, however naturally they take place, they universally, (excepting 



