292 NATURAL EUTOCIA. 



and lodges under the arch of the pubis; in the other, it is turned 

 backwards, and presses the anterior edge of the perineum forcibly 

 backwards. 



Agreeably to this observation I have thought that all the presenta- 

 tions of the vertex might without mconvenience be referred to two 

 fundamental positions: one, in which the occipital protuberance 

 answers to some one point of the anterior semi-circumference of the 

 superior strait; the other, where the same part is turned to the 

 opposite portions of the strait. This modification, although slight, 

 and in itself considered of very little importance, answers, notwith- 

 standing, all the wants of both theory and practice; it enjoys the 

 great advantage of not excluding the other classifications, and of 

 accommodating itself to all the various doctrines. 



The occipito-anterior position comprises the three first positions 

 of Baudelocque, or the two first of MM. Maygrier, Capuron 

 and Duges, and of Mesd. Boivin and Lachapelle. The occipito- 

 posterior position naturally includes the fourth, fifth and sixth of 

 Baudelocque, or the third and fourth of the authors just now men- 

 tioned. As to the lateral positions established by Madame Lachapelle 

 and M. Flamant, they are at least very rarely, if ever to be met with. 



It is evident that the first, second and third have one common 

 termination, and that their mechanism is in almost all respects 

 similar. It is also undeniable that the fourth, fifth and sixth do not 

 differ more than the others. I do not perceive, therefore, the utility 

 in any way, of admitting these varieties, otherwise than as so many 

 shades of the two fundamental positions, to which all others must 

 of necessity be at last reduced. As to these, I think that no one 

 ever attempted to confound them; their mechanism is so different, 

 that the English accoucheurs, such as Burns, Merriraan and Bland, 

 bestow the title of natural labor only upon the occipito-anterior 

 position, while, according to them, the occipito-posterior position be- 

 longs to the class of preternatural labor. 



1. Occipito-anterior Position. 

 1634 in 1800, Merrirnan; 19,370 in 20,517, Madame Boivin; 14,253 in 15,652 

 20,268, in 22,243, Madame Lachapelle; 60 in 67, M. Lovati. 



Many foreign practitioners think that the occipito-anterior position 

 is the only one we ought to abandon to the resources of nature. 

 The causes of its great frequency are wholly physical and easy to 

 be understood. The head is the heaviest part of the foetus; the 

 plane of the neck of the womb is always lower than that of the 

 fundus; the head therefore ought to incline constantly towards the 



