274 LABOR-PAINS. 



of a person carrying a heavy burthen. The former are free and open, 

 and take place during the act of expiration; the latter are restrained 

 by the closure of the glottis, and can scarcely be heard except during 

 inspiration; the former are expressive of suffering, the latter of exer- 

 tion. 



688. When the labor approaches its termination, the pains, which 

 are sometimes of an extreme degree of violence, are pretty frequently 

 accompanied with a kind of convulsive trembling, during which it 

 seems as if the bones of the pelvis are about to separate or break, 

 and all the genital organs threatened with immediate laceration, have 

 been denominated dolores conquassantes, a barbarous and ill-sound- 

 ing term, but strongly expressive of the state of the case; their only 

 special character, however, is their high degree of intensity, for they 

 do not otherwise differ from the expulsive pains, properly so called. 



689. As has been already seen, the direction of the pains is not 

 the same in every stage of the labor; they most frequently follow 

 the great axis of the womb, or the occipito-coccygeal diameter of the 

 foetus, and consequently terminate at a point which is so much the 

 nearer to the centre of the vulva, in proportion as the foetus is nearer 

 its passage through the inferior strait; whence it follows that an an- 

 terior obliquity of the womb is one of the most evident causes of 

 those disagreeable pains that are called pains in the back, and to the 

 consideration of which I shall return in another page. 



Causes. The pains of labor are occasioned by the contractions of 

 the uterus: but what is the nature of their mechanism? At the time 

 of labor the womb is a muscle; but, in the natural order of things, 

 muscular contractions are not at all painful. The heart, the dia- 

 phragm, the stomach, the intestines, the rectum, and the bladder 

 give rise to pain by their contractions. The most violent contrac- 

 tions, even, of the muscles of the abdomen, in labor, are not painful; 

 we cannot therefore look to the fleshy structure of the womb for 

 the cause of the pain. Stein says that women would doubtless 

 bring forth their children without any pain, were it not for the power- 

 ful resistance offered to the passage of the foetus by the inferior seg- 

 ment of the womb and the neighboring parts, which by their antago- 

 nism give rise to pain. According to Levret, Asdrubali, &c., there 

 is not the least doubt that the seat of labor-pain is in the very orifice, 

 non vi cade guestione alcuna che in esso orijicio e il luogo positivo 

 ove si articolano i dolori del par to, &c., and not in the body and 

 fundus of the uterus, as supposed by most accoucheurs. Denman, 

 in speaking of labor-pains, does not attempt to define their seat; he 

 is satisfied with stating that, in labor, the degree of power can only 

 be estimated by the resistance, the resistance by the pain, and the 



