52 OBSTETRICS. 



The irritability and restlessness is seen also in the lower animals, 

 and is therefore not peculiar to the human female. 

 • The symptoms indicative of the commencement of labour are, 

 pain, glairy discharge from the vagina, irritability of the bladder and 

 rectum, nausea and vomiting, and rigours or shivering, without the 

 accompaniment of chilliness. 



The pain felt in labour is due to the sensibility of the resisting, 

 rather than to that of the expelling organs. The sharp, cutting 

 pains of the commencement, which are technically called grinders, 

 are produced mainly by the stretching of the cervix uteri and the 

 vagina, and are generally referred to the lower part of the abdomen 

 and the back, in a situation corresponding to the position of the os 

 uteri. These generally accompany the dilatation of the os uteri, 

 and are indicated by the cries and gestures of the patient, the former 

 being of a moaning, complaining character, the latter, twisting and 

 writhing. 



When, however, the dilatation has gone to such an extent as to 

 allow some of the contents of the uterus to be propelled through the 

 opening, the pains become of a forcing, expulsive nature, and the 

 gestures attending them differ from those before mentioned. The 

 breath is held; she no longer cries out, but makes strong expulsive 

 efforts as if straining at stool ; she makes use of the muscles of 

 respiration to fix the thorax, and then contracts the abdominal mus- 

 cles upon the womb, at the same time pulling violently upon any- 

 thing within her reach. The gestures and cries are valuable indica- 

 tions of the character of the pains. The characteristic of the uterine 

 pains is, that they are dull, and not very acute in their character ; 

 are felt mainly in the back and loins; that under their action the 

 uterus becomes tight and hard; and particularly, that they are 

 regular and intermittent ; that is, coming on at tolerably equal in- 

 tervals, and succeeded by an entire relief from sufTering. 



At the commencement, the uterine pains are short, weak, and at 

 long intervals; as labour advances, the interval becomes less, and 

 the pains longer and stronger. It is well known that labour pains 

 may be suspended, by any sudden emotion, particularly those of a 

 depressing character, as well as by opiates, administered either by 

 the mouth, rectum, or rubbed upon the general surface. 



The mricous discharge which takes place from the vaginal surface, 

 is known commonly by the name o^ show. It is generally mixed with 

 the gelatinous mucus that blocked up the uterine cervix, and with 

 more or less blood. " The more albuminous it is, the better, and it 

 is always a good sign when lumps of albuminous matter come away 

 from time to time ; the thicker, softer, and more cushiony the os 

 uteri is, the more mucus does it secrete." It is useful noi only as 

 a lubricating agent, but also as a topical depletion, for by unloading 



