LABOR-PAINS. 273 



that the presence of strangers, or of persons displeasing to the wo- 

 man in labor, of whom she is afraid, or with whom 'She naturally 

 has no familarity, restrain her, and prevent her from giving free ex- 

 pression to the sensations she experiences. 



687. At the commencement, the pains are so weak and super- 

 ficial, that they have received the title of flies (mouches), doubtless 

 in allusion to the slight sensation produced by the bite of that insect, 

 or that occasioned by its creeping on the skin. They are then 

 called, also, preliminary pains, little pains: characterised by a sort 

 of shuddering of the body of the womb, they arise in the umbilical 

 region, and are lost therein, or spread, so to speak, over the whole 

 hypogastriuni and flanks. At a more advanced stage, when the 

 labor is fairly set in, the pains, which are longer, stronger, nearer 

 together, and more decided, are c2L[\ed preparative; never was epithet 

 better applied; their business is, in fact, to prepare for the expulsion 

 of the ovum, or preside over the dilatation of the cervix; from the 

 neighborhood of the umbilicus they generally extend towards the 

 sacro-vertebral angle, or to the centre of the strait; this is the period 

 during which the woman is most impatient, cross, sad, worried, 

 difficult to govern, and utters the sharpest cry, which perhaps de- 

 pends upon the womb acting alone, and leaving to the woman the 

 free exercise of her general sensibility. 



At the end of the first stage, and more particularly in the second, 

 the pains visibly change their character, assume the denomination 

 of bearing or expulsive pains, and in fact announce that nature is 

 employing all her resources for the expulsion of the fiBtus. These 

 pains, which are also designated as the great pains, are much 

 stronger, longer, and more complete than those of the first stage, 

 and are, besides, characterised by being separated by intervals more 

 perfect, better marked, and more calm, by giving rise to strangury 

 and tenesmus, or a sense of weight which brings the abdominal 

 muscles into play, force the woman to bear down, and make exertions 

 to assist the uterus. Notwithstanding their severity, they do not excite 

 her irritability so much, and are borne with more resignation and pa- 

 tience. The women who seem carefully to avoid every preparative 

 pain, are, on the contrary, anxious for the return of the expulsive 

 ones; they invite and solicit them; they converse, are tranquil, and 

 during the intervals between them, are even lively, and forget the 

 dangers, a sense of which had previously caused them to be so down- 

 cast. Their cries are difl'erent from those they uttered in the first or 

 second stages. The cries which accompany the first are sharp, and 

 resemble those occasioned by any other species of sufferino-. Those 

 of the second stage, on the contrary, seem to be suppressed like those 



24* 



