DIAGNOSIS. 335 



it be a first labor, the cervix does not begin to gape antecedently to 

 the appearance of the true pains, and if it feels like a tubercle, pier- 

 ced through its centre, we may be satisfied that there have been as 

 yet no uterine contractions; where, on the contrary, it is thin, hke 

 a sharp circle, the gestation is necessarily at its term, and if the par- 

 turition have not commenced, it is almost a matter of certainty that 

 the labor will not fail to show itself within a few days. 



To obtain a decisive proof on this point, we have, at most, only to 

 touch during a pain; if the finger feels, in such a way as to admit 

 of no doubt, that the membranes become tense, that they try to en- 

 gage in the os uteri, which manifestly becomes thinner, contracts, or 

 opens a little, to return immediately afterwards to its primitive con- 

 dition, nothing further is wanting, the labor has begun; if nothing 

 of all this is observed, we may be content, the moment for lying-in 

 has not arrived. 



804. However, I cannot quit this article without calling the at- 

 tention of young practitioners to a peculiarity in the diagnosis, that 

 is not sufficiently known, and which might lead them to deceive 

 themselves, after what has been above said. Modern accoucheurs 

 have with one accord rejected, as among apocryphal or ill-under- 

 stood facts, the very numerous cases tending to prove that labor 

 may begin, the contractions of the womb be brought into evident 

 play, and that, after having continued for several hours, the labor 

 may be suspended so that delivery shall not take place for a whole 

 month afterwards: such anomalies as these have been cited chiefly 

 on occasions of protracted gestation, and as proofs of superfoeta- 

 tion; it has been pretended that such powerless efforts as the above 

 had masked the natural term of gestation, and that the time that 

 elapsed betwixt their cessation, and the real labor, was an excess 

 over nine months. But I have acquired the conviction that this in- 

 complete labor, or, as Levret calls it, false labor, is not a mere 

 chimera. In March 1824, I was called to a woman in the rue 

 d'Orleans, in her second pregnancy, and who had been in pain for 

 about twenty-four hours; the pains were regular, weak, and sepa- 

 rated by pretty long intervals; the os uteri, which was very soft, 

 and wide enough to admit of the introduction of three fingers, was 

 not completely eff'aced; the point of the ovum had already begun 

 to engage within it, and when the pains came on, the membranes 

 were on a level with the top of the vagina, and became smooth and 

 tense, while, on the other hand, I felt the orifice and body of the 

 womb harden and contract with a certain degree of energy. It 

 was ten o'clock at night; I announced that the labor would not 

 terminate for several hours. I returned home after giving orders to 



