334 DIAGNOSIS. 



nounce a lesion of the stomach, the bowels the liver, the kidneys, 

 the bladder, or some other organ contained in the abdomen, and 

 have been called false because they are entirely unconnected with 

 parturition, appear in pregnant women as they do in those who are 

 not pregnant, or as they do even in persons of the other sex. No- 

 thing, therefore, but the greatest want of reflection, can cause them 

 to be confounded with the true pains — those which depend upon the 

 contractions of the womb. 



802. I, however, ought not to omit speaking of a state that might 

 render this discrimination very difllicult, and a mistake at the same 

 time highly dangerous: if an inflamed point be established in the 

 neighborhood of the womb, in that organ itself, in the bladder, rec- 

 tum, (fee, just as labor comes on, the pains of child-birth will pro- 

 gress just as those of the disease do, and if it were absolutely neces- 

 sary to decide from the testimony of the pains alone, the most skil- 

 ful person might be led into a mistake. But the science possesses 

 other means of ascertaining the existence of labor. If, when the 

 suffering is at the height, the hand, placed upon the hypogastrium, 

 feels the womb grow hard, contract, and become rounder, it is de- 

 cided that child-birth is about to take place, and, in this case, the true 

 pains may exist alone, as they may also be met with in conjunction 

 with false pains.* If the hand discovers the womb to be unmoved, 

 without action, and without connection with the cries uttered by the 

 patient, it may, to a certain extent, be affirmed that the labor has not 

 begun. 



803. In fine, we are by the touch enabled to solve the question 

 without any fear of being deceived. While ever the cervix is still 

 uneff'aced, while it retains some few lines of length as a canal, we 

 may, in general, assert that the woman is not at full term; only we 

 must avoid mistaking the lips of the os tincae for the cervix itself, 

 and remember that in persons who have had several lyings-in before, 

 it is now and then found to be extremely soft and very wide, several 

 days or even several weeks previously to the end of pregnancy; and 

 that in such women the orifice frequently forms a cushion or an 

 edge several lines in thickness at the commencement of labor. If 



* Let not the inexperienced practitioner be led by this statement into the mis- 

 take of supposing that where the abdomen, in these pains, grows hard, and then 

 relaxed, again to become hard upon the recurrence of the pain, the labor is actu- 

 ally begun. M. V.'s remark is true as applied to the hardening or contraction 

 of the womb itself; yet, in some cases of false pains, I have observed that they 

 were connected with a spasmodic constriction of the abdominal muscles, which 

 yielded to the touch a sensation closely resembling that of the womb under con- 

 traction. — M. 



