STAGES OF LABOR. 269 



the courage returns, the sadness is dissipated; some women, op- 

 pressed with the want of rest, sleep quite soundly during the short 

 interval between the pains; I once attended a lady in labor, who, 

 having been three days and nights in the anguish of a most painful 

 travail, slept several times on the morning of the fourth, notwith- 

 standing that the contractions were carried to the highest degree of 

 intensity, and there was scarcely more than one or two minutes be- 

 tween them. A feeling of weight and bearing down, by some re- 

 ferred to the pressure experienced by the cervix, but which depends 

 rather upon that of the rectum and bladder, soon compels the woman 

 to second her pains; and almost in spite of herself, to contract 'the 

 abdominal muscles and make the most violent efforts. 



6H2. The bag of waters, the only portion of the ovum which is 

 not compressed externally, having no support whatever in the supe- 

 rior part of the vagina, bursts in the midst of one of the most vio- 

 lent pains; the foetus, forced downwards by the same contraction, 

 immediately takes the place occupied by the segment of the mem- 

 branes, and by engaging in the passage like a stopper or plug, pre- 

 vents the escape of the rest of the waters; and the head, if it be the 

 presenting part, is then said to be at the crowning (couronneraent); 

 the void thus produced in the womb is the reason why the labor 

 seems to slacken for a little while; but when this void disappears, and 

 the uterus is recovered from its astonishment, (I hope the expression 

 will be pardoned,) the pains recover all their energy, and succeed 

 each other with greater rapidity. Each one is ushered in with a gene- 

 ral shiver; the severest ones are often preceded by another which is 

 milder, and serves as a prelude to it; on other occasions we observe 

 one stronger and one weaker, alternately, regularly, and without 

 our being able to regard one as a sequel to the other. When they 

 come on, the woman lays hold of any thing solid in her reach, plants 

 her heels upon the mattrass, seizes with her hands the sides of the 

 bed or bolster, or the persons around her, to secure z point (Pappici; 

 she then throws her head back, draws a long breath, and all the le- 

 vers of her skeleton being thus fixed, contracts, with all her power, 

 the muscles of the belly, Avhile the diaphragm, and all the muscles of 

 her body act with the same energy; the neck and face swell, are en- 

 gorged with blood, and become purple or livid; the jugular veins ac- 

 quire an enormous size; the carotids beat violently; the thyroid gland 

 becomes engorged, the eyes sparkle, grow red, and seem to start 

 from their orbits; all the symptoms of cerebral congestion become 

 manifest; the general circulation is strongly excited; sweat some- 

 times pours from the skin, but only about the head, breast and ab- 

 domen, for the lower extremities, receiving less blood than common, 

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