OF TRUE PREGNANCY. 139 



softens, undergoes a major part of the changes that characterise real 

 pregnancy, its cavity becomes filled with a concrescible matter which 

 is amorphous, a kind of membrana caduca or anhisious layer, ob- 

 served by Berlrandi, Chaussier and others; the form of the belly and 

 the motions of the fostus exhibit nothing peculiar, and ballotteraent 

 itself is not always impossible. 



358. In general, the sexual organs depart but very little from 

 their natural state, when the foetal cyst is not within the tube, and 

 contracts no adhesions with the womb. On this subject, the case 

 noticed by M. de Bouillon should be regarded only as an uncommon 

 exception. In these cases the cervix rarely becomes much short- 

 ened, nor does its orifice dilate in any considerable degree ; it is 

 found to be much lower or higher, more forward or backward, or to 

 one side, than the presumed period of the pregnancy would seem to 

 indicate. 



359. After all, neither the rational nor sensible signs suffice, until 

 the end of the tliird month, to prove that pregnancy is extra-uterine. 

 After this period, it will in most cases be possible, by means of some 

 or all of them, to establisli an almost certain diagnosis; the evidence 

 derived from them will at least give rise to suspicions sufliciently 

 strong to fix the attention of the practitioner. 



360. As to the distinctive signs of the different species of extra- 

 uterine pregnancy, I do not think it would be useful to treat of them 

 in this place ; the knowledge of them could not be beneficially ap- 

 plied; besides, all those that have been mentioned are too uncertain 



to doeorvo the least COnfidBiico: eiiice, eveji on the dead body, we can 



scarcely decide, even by means of the scalpel, whether the ovum is 

 situated in the tube, the ovary, or the peritoneum, it would be in some 

 measure ridiculous to desire to obtain any certainty in relation there- 

 to, on the living subject. 



361. Extra-uterine pregnancy commonly terminates before the 

 fifth month; Baudelocque, MM. Arnault, Novara, Delisle and some 

 others have nevertheless seen it much more prolonged, and even to 

 the term of ordinary gestation. These authors, especially the for- 

 mer, mention a very remarkable circumstance; it is that in these 

 cases, at the close of a kind of labor, attended with intermittent 

 pains, that are sometimes pretty strong, a commencement of dilata- 

 tion of the neck, a discharge of mucus, of a bloody fluid, and what 

 seems still more surprising, very regular contractions of the womb 

 or of the foetal cyst are observed to take place. In foct we may 

 conceive of a part of these phenomena in tubal pregnancy; the tube 

 being composed of the same elements as the womb, it is quite na- 

 tural for it to enjoy the same properties; but, in abdominal preg- 



