SIGNS OF PREGNANCY. 



35 



the operator place the left hand upon the fundus uteri to steady it, 

 and introduce the index finger of the right hand to the cervix uteri, 

 then suddenly but gently jerking the finger upwards, he will feel a 

 sensation as if something had receded from it, and then settled down 

 upon it again. This test is most available about the fifth and sixth 

 months. (Fig. 11.) 



Auscultation, was applied to the detection of the presence of 

 2if(Btus in utero, first by M. Mayor, of Geneva. Three sounds have 

 been heard by different observers, 



viz. : that of the foetal heart, that Fig. 11.* 



of the placental circulation, and 

 that of the pulsation in the cord. 

 The first of these is the most cer- 

 tain ; the second may be imi- 

 tated by the pressure of a tumour 

 upon any great vessel, and the 

 last can only be heard under 

 very favourable circumstances, as 

 where the cord lies between the 

 child and the abdomen of the 

 mother. The situation in which 

 the foetal heart is most distinctly 

 heard, is about the middle point 

 between the scrobiculus cordis and symphysis pubis, generally to the 

 left. The frequency of the pulsation is about double that of the adult, 

 ranging from 120 to 140 per minute, and entirely independent of 

 the maternal circulation. The sound resembles very much the ticking 

 of a watch under a pillow. In breech presentations it is usually heard 

 a little higher. 



This is a most valuable diagnostic sign, and if once heard, une- 

 quivocally, the real nature of the case is established beyond doubt. 



The placental uterine souffle may usually be detected by the 

 stethoscope low on the sides of the abdomen after the fourth 

 month ; it is a peculiar blowing sound, corresponding to the pulse of 

 the mother. 



The movements of the child may frequently be detected by placing 

 a cold hand on the abdomen of the mother, after the sixth month, 

 but this is not a certain sign, as above stated, since it may be imi- 

 tated by movements of fiatus, &c. 



The following resume of the signs of pregnancy, is taken from 

 the " Elements of the Principles and Practice of Midwifery," by 

 Prof. Tucker :— 



* A, vertical section of sacrum ; B, rectum; C, uterus and ovum; D, bladder; E, finger in 

 the vagina with its extremity pressing up the uterus. 



