CAUSES OF LABOR. 259 



on all sides, now efficaciously employs all its powers to expel the 

 foetus through the cervix, the only point which now offers no resist- 

 ance, and upon which all its efforts comes to operate.* 



657. This is the way in which the process takes place in a natural 

 state, but the organism is sometimes obliged to take another course; 

 the woman is not always capable of effecting this combination of ac- 

 tions. In certain cases the uterus, compelled to suffice for itself, 

 sometimes succeeds in producing the desirable result without any 

 difficulty; but in other cases, being too feeble, either in consequence 

 of over distension, which destroys its tone by reducing the thickness 

 of its walls, or of contractions too long continued or too frequently 

 repeated, or because its function is interfered with by some modifica- 

 tion of the natural state of its structure, it yields in importance to the 

 muscles, which, if directed with a vigorous and courageous will, are 

 sometimes able to expel the foetus with but a feeble co-operation on 

 the part of the womb. 



658. In this sense only may labor be regarded as in some cases a 

 partly voluntary function, like the excretion of stool, and the emis- 

 sion of urine. Doubtless, a woman who bears down, as it is called, 

 who enforces her pains, no matter how feeble soever they may be, 

 ■will get rid of the product of conception sooner; and that another 

 may, to a certain extent, protract its expulsion by preventing as much 

 as possible the contraction of her muscles. 



659. A woman presented herself at Baudelocque's amphitheatre, 

 to be delivered there; the labor at first went on very regularly; the 

 pupils were assembled; the dilatation of the orifice was suspended, 

 and a whole night passed away without its making any progress; 

 the spectators, who were fatigued, now dispersed; the pains soon re- 

 turned, and the dilatation went on; the young people being notified, 

 re-assembled; again the phenomena of the labor ceased. Baude- 

 locque, suspecting the cause of these irregularities, gave a hint to the 

 pupils, who all left the apartment with an injunction not to go far, 

 and to return upon the first signal; the woman immediately began to 

 bear down, and the child's head roon reached the vulva; the pupils 

 were then called, and the labor, which it was no longer in her power 

 to suspend, soon terminated. I witnessed a nearly similar case in 

 1825. One of the first women that came to lie in at my amphithe- 



* Hence it is that women, who are urged by the bystanders to bear down dur- 

 ing the grinding pains, find themselves unable to do so. The contraction of the 

 accessory or abdominal muscles, can be of no assistance until the child, and the 

 womb itself, have sunk so far down into the excavation, that those muscles be- 

 come able to act upon the fundus uteri, so as to fix it firmly, while the contrac- 

 tion of the uterus propels the head against the resisting points. — M. 



