138 OF TRUE PREGNANCY. 



the tube, &c. The assertions of Planchon, who affirms that the tubes 

 are slightly dilated in the first weeks of conception, a remarkably 

 curious case reported by Patune, in which it is said that the umbili- 

 cal cord of a foetus enclosed in the fimbriated extremity was inserted 

 into a globose placenta, situated in the very cavity of the womb, are 

 very rare facts, and ought to be met with anew before they can give 

 much weight to such conjectures. 



§. VI. Signs and Terminations of Preterna- 

 tural Pregnancy. 



356. The continuance of the menses, severe pains in the hypo- 

 gastrium, nausea, and frequent vomiting, as well as several other 

 distressing symptoms, considered as signs of extra-uterine pregnancy, 

 sometimes indeed do accompany it ; but as they also are oftener 

 wanting, and not at all uncommon in natural pregnancy, their pre- 

 sence is, on that account alone, of very little weight. Though the 

 breasts undergo no change, secrete no milky fluid; though the belly 

 is uneven, its growth more rapid, and its development chiefly on one 

 side; '.hough the motions of the foetus are earlier felt, and through 

 surfaces apparently very thin; though the womb remains quite small, 

 in some casfc« of extra-uterine pregnancy, the contrary happens in a 

 still greater nuiaber of cases, and one or more of these irregularities 

 is frequently met with even in simple pregnancy. 



However, though U is true that the womb sometimes increases in 

 size in such cases, it is equally true that the changes which it then 

 experiences are seldom sufSciently marked to make us believe in the 

 existence of a natural pregnaacy of four or five months' standing. 

 If, therefore, the abdominal tumor has risen early above the mar- 

 ginal strait, and is found in one of i\>e iliac fossae; if it appears to be 

 full of bumps, varicose, and if pulsaticns can be felt in it; if it be 

 easy to feel the protuberances and motions of the foetus, while the 

 parietes of the abdomen preserve nearly their natural thickness, and, 

 on the other hand, we can ascertain by the touch that the weight 

 and size of the womb are not at all, or but slightly increased; that 

 the cervix has not to any sensible degree diminished in length, al- 

 though it has altered in respect to its position, direction, density, and 

 even form, then it is evident that the pregnancy is preternatural. 



357. Still it may be conceived, that although the ovum has fixed 

 itself to some part in the pelvis, or to some point on the periphery 

 of the womb; or has been arrested very near the root of one of the 

 tubes, or even in the substance of the parietes of the uterus, all these 

 signs may in fact not exist, and the preternatural pregnancy be con- 

 founded with an ordinary gestation. In these cases the uterus swells, 



