240 THE FOETUS. 



period. But at a more advanced stage it can only give rise to the 

 ordinary phenomena of a natural labor; yet it is most commonly 

 preceded by lowness of spirits, a general depression, by lipolhymia, 

 syncope, a feeling of coldness in the epigastrium, palpitations, pale- 

 ness, fetid breath, flaccidity of the breasts, and a major part of the 

 rational signs indicative of the death of the fostus. Ordinarily, as 

 has been before remarked by Roderic a. Castro, MM. Fodere and 

 Desorraeaux, Madame Lachapelle and M. Diiges, the woman at first, 

 for one or more days, has rigors, horripilation, a hot skin, thirst, 

 want of appetite, increased movements of the heart and arteries, a 

 feeling of weight in the pelvis, about the fundament or loins, and a 

 general lassitude of the limbs, as if threatened with some severe dis- 

 ease; next appears hemorrhagy, accompanied with pain of greater or 

 less severity, and all the symptoms of real labor: but, amongst all 

 these signs, scarcely any, saving hemorrhage* and pain, afford any 

 certainty previously to the dilatation of the cervix, and the presence 

 of a portion of the ovum in the upper part of the vagina. 



619. Hemorrhage itself is not invariably followed by abortion, as 

 is proved by the observations of Mauriceau, Raymond, de Boer, 

 &c.; nevertheless, there is good reason to fear it when that symptom 

 once takes place. But before we accord to it any value, we should 

 know how to distinguish it from the menstrual discharge, which 

 sometimes continues throughout the whole of pregnancy. I have 

 already at another place (312) hinted that this discrimination is at 

 the beginning very difficult, and must here repeat that this kind of 

 abnormal menstruation, to which Madame Lachapelle appears not to 

 give much faith, is notwithstanding not of very rare occurrence; I 

 could add two instances to those related by Portal, Deventer, A.mand, 

 Baudelocque, &;c., and I can affirm that in these two women the 

 catameniae had never occurred with greater regularity. 



620. As to the pains, it is important that they should not be con- 

 founded with the colic, or with those uterine pains that are also 



* A patient under my care lost in the fourth month, by uterine hemorrhage, 

 more than twenty ounces of blood in the course of one day and a half, notwith- 

 standing which, she continued to the end of the ninth month in tolerable health, 

 and then gave birth to a very healthy child. It is certainly a very rare case, to 

 meet with a patient who does not miscarry after losing four or five ounces of 

 blood, as early as the end of the fourth month. 



I have now under my care a patient in the sixth month, who has had several 

 very considerable attacks of hemorrhage, and who has not been without more 

 or less of a show for two months past: the placenta is not near the cervix uteri, 

 and the child, as learned by auscultation, is in good health M. 



