268 STAGES OF LABOR. 



val between the contractions is not calm; the woman is touchy, cross, 

 impatient, difficult to control; she cannot keep in one place, is dis- 

 contented with every body, and has an extreme susceptibility; every 

 pain in some degree resembles a paroxysm of fever; it is preceded 

 with a rigor and sometimes even with a tremor and rattling of the 

 teeth together; the quickness, frequency and hardness of the pulse 

 and temperature of the body augment; the skin is higher colored 

 and becomes moist; the mouth and tongue dry; the teeth and lips 

 are encrusted, become fuliginous, as in an adynamic fever; a great 

 thirst comes on; she has nausea, vomiting and cough; she wanders, 

 and the intellectual derangement is often carried to such an extent 

 as to resemble delirium. In irritable women, the anguish and rest- 

 lessness are sometimes carried to the highest degree; and the hardest 

 heart could scarcely resist a feeling of compassion and pity at the 

 sight of these unhappy beings, who with dishevelled hair, blackened 

 mouths, flushed countenance, burning skin and haggard eyes, can 

 only become mothers at the cost of so many sufferings and dangers. 

 When a contraction is over, every thing returns to its natural state; 

 the resdessness ceases; the pulse recovers its ordinary type; the 

 mouth becomes moist; the skin regains its natural color and habitual 

 temperature; if an examination be now made, the membranes, 

 having returned within the cavity of the womb, feel flaccid and 

 wrinkled, and the bag of waters cannot be felt; the edges of the os 

 uteri, which during the pain were hard, thin and sharp, are supple, 

 thick, and rounded immediately after it. The nausea, is suspended, 

 but the belly, particularly the epigastrium, most generally remains 

 very tender. Each pain reproduces the same series of phenomena 

 and is succeeded by a more and more complete remission, which also 

 grows shorter and shorter. The os uteri, which represents the re- 

 sistance to be overcome, gradually yields; its dilatation at length 

 becomes so complete, as that there is no contraction betwixt the 

 uterus and vagina. Thus is terminated the first stage of labor, the 

 longest and most fatiguing period of parturition, but not the most 

 dangerous or difficult. 



§. III. l§ieconcl 8ta^e, or Period of Expulsion. 



681. In the first stage the womb performs almost the whole duty 

 of the labor; it dilates the cervix, and forces the apex of the ovum 

 to engage itself therein; it either does not solicit at all, or but very 

 feebly, the contractions of the muscles, whose concurrence has not 

 as yet become indispensable. In the second stage, the contractions 

 in the first place become stronger, last for a longer period of time, 

 are not so far apart, and yet are followed, by a more decided calm; 



