PRESENTATIONS OF THE PELVIS. 331 



expose the neck of the uterus and the perineum, any more than the 

 head does, to the lacerations of which we have spoken. 



795. In presentations of the feel or knees, the bag of waters is in 

 general more elongated, tears more readily, and the os uteri has less 

 need of being so largely dilated. With the breech, on the contrary, 

 the amniotic sac is as large as in a head presentation, and does not 

 open until it has produced a considerable dilatation; the buttocks • 

 and hips, which have to open a passage, react without inconvenience 

 against the resistance of the neck; the belly and breast pass the straits 

 and vulva without the risk of a very violent pressure; for, excepting 

 the head, the hips exceed, as to dimensions and firmness, any other 

 part of the child. 



796. In breech cases it is true that the labor, in general, goes on 

 very slowly until they have passed through the cervix, and sometimes, 

 even until they have traversed the vulva; while in feet or knee pre- 

 sentations, it seems, at first, that the process of child-birth is going 

 to be extremely prompt. But these differences are all in favor of 

 breech positions; for in the second case, the phenomena then suc- 

 ceed each other, producing so much the less effect as the body is 

 nearer being completely expelled; while in the first case, where the 

 hips have once descended into the vagina, the rest of the body 

 emerges with much less difficulty. I dwell upon this idea because 

 it is well calculated to show how imprudent it may be, in a presen- 

 tation of the pelvic extremity, to bring down the feet artificially, with 

 the sole view of hindering the breech from engaging first before the 

 dilatation is completely effected. 



797. Baudelocque admits four positions for the breech, as he does 

 for the feet, and divides them in the same manner; M. Flamant 

 reckons eight of them, and MM. Maygrier and Capuron, four, as 

 for the head, &c. 



798. Without speaking of the cases where the fcetus engages 

 squatting, having the heels glued, as it were, against the ischia, cases 

 in which art is almost always required for the assistance of nature, 

 I must say that in women endowed with but little moral and mus- 

 cular energy, the softness and flexibility of the breech will absorb 

 the greater part of the motion communicated to the spine of the 

 child by the womb, which often ends by falling into a state of 

 inertia, and that the labor cannot then be always abandoned ta 

 itself without danger; besides, in the three anterior positions, the 

 external organs of generation of the male sex are exposed to fric- 

 tions more or less violent against the promontory; and it is also by 

 no means rare to find black and contused echymoses in new bora 

 children that come by the breech. 



