RETROVERSION OF THE UTERUS. 49 



a sure sign. The subsidence of the abdominal tumour, flaccidity of 

 the breasts, after having been tense, and the general deterioration of 

 the health, are all enumerated among the probable signs. The con- 

 currence of all these render the diagnosis nearly certain, though 

 separately they are of little value. 



The signs during labour are much more accessible and certain. 

 The loose, flabby scalp, the absence of swelling, occasional emphy- 

 sema of the cellular tissue beneath, the looseness and grating of the 

 cranial bones, and the sharpness of their edges, are enumerated by 

 Dr. Rigby among the certain signs. The absence of pulsations at 

 the great fontanelles, is admitted to be an important sign. 



In presentations o? the face, the lips of a dead child will be flaccid 

 and the tongue flabby and motionless, and the presenting part slightly 

 swelled. The contrary in a living child. 



In breech presentations, the sphincter ani, in a dead child is relaxed 

 and insensible to the finger. In a living child it is closed and resists 

 the finger. The presence of meconium is a sign of no value. 



In arm presentations, when the child is dead, the limb is cold, 

 livid, and flabby, there is no pulsation at the wrist, (the latter is not 

 of much value, as pressure may arrest it,) and the epidermis soon 

 begins to peel oflT. In a living child, the arm will swell and become 



livid. /. 1 • 



In prolapsion of the funis, the presence or absence of pulsation 

 will decide. There are exceptions to this rule, however, as in the 

 case related by Dr. Kennedy, in which the cord was prolapsed an 

 hour, and during a pain no pulsation was perceptible ; when the pain 

 subsided he drew the funis backward towards the sacro-iliac sym- 

 physis, and then detected a faint pulsation. The child was delivered 

 alive by the process. 



Fetid liquor amnii is not a certain sign of the child's death, 

 neither is the presence of meconium in it, especially in breech cases. 



RETROVERSION OF THE UTERUS. 



During the early months of pregnancy the uterus is liable to a pe- 

 culiar species of dis^yiacement, known by the above name. It is where 

 the fundus is pushed downwards and backwards into the hollow of the 

 sacrum between the rectum and posterior wall of the vagina, while the 

 OS tincse is tilted upwards and forwards behind the symphysis pubis. 



Most of the instances of retroversion are attributable to a distended 

 bladder ; for, as this organ fills, it rises, and pulls the lower portion 

 of the uterus upwards ; at the same time the fundus is pushed back- 

 wards, by the repletion of the bladder; the os uteri therefore presses 

 against the neck of the bladder and produces retention of the urme ; 

 the fundus presses against the rectum and prevents the passage of 

 faeces, which thus accumulate above the point of pressure, and not 

 only prohibit the ascent of the fundus to its normal position, but 



