36 



OBSTETRICS. 



During the First mid Second Months, 



RATIONAL SIGNS. 



1. Suppression of the catamenial dis- 

 charge. 



2. Nausea, vomiting, ptyalism, ano- 

 rexia, &,€. 



3. Unnatural flatness over the hypo- 

 gastrium. 



4. Tumefaction and tenderness of the 

 raammsB. 



SENSIBLE SIGNS. 



1. Increase in the size and weight of 

 the uterus. 



2. Slight prolapsus of the uterus. 



3. Diminished mobility of the uterus. 



4. The cervix uteri is directed to- 

 wards the symphysis pubis. 



5. The OS uteri, round and regular in 

 primiparae, but in multiparas, irregular 

 in its circumference and more or less 

 open. 



6. Ramollissement of the mucous 

 membrane, covering the cervix uteri. 

 The fibres of the neck not yet softened. 



During the Third and Fourth Months. 



1. Suppression of the catamenia. 



2. Continuance of nausea, vomiting, 

 anorexia, ptyalism. 



3. Slight prominence over hypogas- 

 trium. 



4. Depression of the umbilicus. 



5. Tumefaction of the breasts in- 

 creased, with increase in the promi- 

 nence of the nipple, and a slight disco- 

 loration of the areola. 



6. Kiesteine in the urine. 



1. The fundus uteri elevated rather 

 above the pelvic brim, at the end of the 

 third month. At the termination of 

 tlie fourth month, it rises two inches 

 above the pubis. 



2. Fulness and dulness over the hy- 

 pogastrium. 



3. Existence of a small tumour in 

 hypogastric region. 



4. The direction of the long diameter 

 of the uterus is now changed, so as to 

 correspond with the axis of the pelvic 

 brim. The os uteri is considerably ele- 

 vated in the excavation. 



5. Ramollissement of the inferior 

 portion of the cervix is more marked ; 

 OS uteri more open in the multiparae, but 

 still closed in those who have not borne 

 children. 



During the Fifth and Sixth Months. 



1. Suppression of the catamenia. 



2. Cessation of nausea, vomiting, 

 &.C., now usually takes place, though 

 they may continue throughout preg- 

 nancy. 



3. Increased prominence of the um- 

 bilical region. 



4. The size of the abdominal tumour 

 is increased, it is round, elastic, and if 

 the abdominal walls be thin, the ine- 

 qualities of the foetus may be felt. 



5. The umbilical region more full. 



6. Discoloration of the areolae more 

 marked, with an enlargement of the 

 subcutaneous glands. 



1. At the end of the fiflh month, the 

 fundus uteri is within an inch of the 

 umbilicus. 



2. Movement of the foetus is now 

 active. 



3. The bruit de souffle and the foetal 

 pulsations may now be distinguished. 



4. Ballottement. 



5. Between the cervix and the pubis 

 a tumour may now be felt, either soft 

 and fluctuating, or round and hard. 



6. Ramollissement of one half of the 

 cervix uteri. 



7. In the primiparse, the os uteri is 

 still closed, but in the multiparce, it is 



