EUTOCIA. 289 



of art produces evils more numerous and serious than the imperfec- 

 tions of nature." 



Such, doubtless, are the chief causes that render dystocia more 

 common in private than in hospital practice. 



720. However, it must be confessed that the proportions between 

 the different kinds of labor must of necessity vary from circum- 

 stances wholly accidental. Thus, of two practitioners who are 

 equally skilful and equally circumspect, one may attend several 

 hundred labors without being obliged to give any assistance to na- 

 ture; while the other may be several times obliged to have re- 

 course to the artificial means. Since I began carefully to notice the 

 facts that have fallen under my own observation in tokology, I have 

 found a very great difference between what has occurred at my 

 amphitheatre and in my private practice. Out of five hundred and 

 fifty labors that took place in the Hospital de Perfectionnement 

 while I had charge of it, and in my own amphitheatre, only eight 

 required 'any assistance; in my private practice, on the contrary, 

 out of less than three hundred cases, I had thirty cases of dystocia; 

 which gives for the former only one difficult labor in upwards of 

 sixty, and for the latter, so to speak, one for every eight labors. 

 Such a disproportion is, however, not difficult to account for; at 

 my public hall, and at the hospital, we received without distinction 

 all the women who presented themselves, without any of them, ex- 

 cept two, having previously undergone any examination; while the 

 cases of dystocia that fell under my notice elsewhere, were almost 

 all procured for me by my brethren, or by midwives, who, from ex- 

 cessive timidity, or for want of practice in the use of instruments, pre- 

 ferred calling on me rather than to attempt to deliver the women 

 themselves. 



SECTION 1. 



Of Natural Eutocia {simple or spontaneous labor, the head of the 

 child presenting). 



721. What I have said concerning the attitude and position of the 

 fostus in the womb, makes it sufficiently evident, that the child ought 

 properly to present its cephalic extremity to the straits of the pelvis, 

 and that the cases where it descends in any other way should be re- 

 garded only as anomalies. It was correct, therefore, in Hippocrates 

 and most of the ancient authors, not to give the tide of natural la- 

 bors except to those in which the head of the child came first, and 

 to call all labors where the feet, the breech, or knees presented, non- 



