ACTION OF THE FEMALE. 



hung down between the patient's thighs. A sound so much resembling this, 

 as to be scarcely distinguishable from it, may be occasioned, however, by a 

 cause of a very different nature, namely, an abdominal tumour, pressing 

 upon the aorta, iliac arteries, or enlarged vessels of its own ; and, in doubtful 

 cases, it is necessary to give full weight to the possibility of such an explana- 

 tion. The sound may be imitated at any time, by pressing the stethoscope 

 on the iliac arteries. The Placental bruit has been not unfrequently heard in 

 the llth week ; but it cannot generally be detected before the fourth month, 

 when the fundus uteri rises above the anterior wall of the pelvis. 



751. The amount of the peculiar tissue of the Uterus ( 375) greatly in- 

 creases during pregnancy ; and from the recent observations of Dr. R. Lee, 

 it appears that a corresponding increase takes place in the size of the Nervous 

 Ganglia. At the same time the Mammary gland and its appendages undergo 

 a fuller development ; and from this a valuable, but not unequivocal indication 

 of pregnancy may be drawn. Occasional shooting pains in the Mammae are 

 not unfrequently experienced within a short period after conception; and 

 more continued tenderness is also not unusual. A sense of distension is very 

 commonly experienced at about the end of the second month ; and from that 

 time a distinct " knottiness" usually begins to present itself, increasing with 

 the advance of Pregnancy. In many instances, however, these mammary 

 sympathies are entirely absent ; and they may be simulated by changes that 

 take place in consequence of various affections of the Uterus. A change of 

 colour in the areola is a very common, but not an invariable occurrence in 

 the early months of pregnancy ; but another sign is afforded by the areola and 

 nipple, which is of more value because more constant, namely, a puffy 

 turgescence, and an increased development of the little glandular follicles, 

 or tubercles, which commonly secrete a dewy moisture. The presence or 

 absence of kiestine in the Urine ( 690) also may probably be regarded as a 

 valuable diagnostic sign. This substance appears on the surface of the fluid, 

 after it has stood two or three days, in the form of a thin pellicle of a some- 

 what fatty aspect ; it is preceded by a sediment which has very much the 

 appearance of cotton wool ; and it disappears when the urine is decomposing, 

 at the same time emitting an odour like that of putrid cheese.* Many other 

 changes in the constitution take place during Pregnancy ; indicated by the 

 buffiness of the blood, the irritability of the stomach, and the increased excit- 

 ability of the mind. All these, however, are discussed with sufficient ampli- 

 fication, in works on Obstetric Medicine. 



752. The act of Conception, being one of a purely organic nature, is not 

 attended with any consciousness on the part of the mother ; but there are 

 some women, in whom it is attended with certain sympathetic affections, such 

 as faintness, vertigo, &c., that enable them to fix upon the particular time at 

 which it has taken place. From that period, however, the Mother has no 

 direct consciousness of the change going on in the Uterus (save by the effects 

 of its increasing pressure on other parts), until the occurrence of what is 

 termed " Quickening." This is generally described as a kind of fluttering 

 movement, attended with some degree of syncope or vertigo. After it has 

 once occurred, and has strongly excited attention, it is occasionally renewed 

 once or twice, and then gives place to the ordinary movements of the foetus. 

 Not unfrequently, however, no movement whatever is felt, until near the end 

 of the term of gestation, or even through the whole of it. As to the cause of 

 the sensation, Obstetricians are much divided; and no satisfactory account 

 has been given of it. It has been vulgarly supposed to be due to the first 



* [See an excellent paper on this subject in the American Journal of Medical Sciences, 

 No. vii. N. S.; by Dr. Elisha Kane. M. C.] 



51* 



I 



