DIAGNOSIS. 337 



sutures; by adding their direction to the notions we derive from the 

 particular situation of the fontanels, it is commonly easy to avoid 

 confounding the anterior with the posterior varieties, and to attach 

 to each shade of one and the same position, those characters by 

 which it is separated from all the others. 



806. The face is so different from every other part, that, at a first 

 glance, it seems impossible to mistake such a presentation: this is an 

 error; the proof of the contrary is contained in all the collections of 

 cases, and is daily met with in practice; ihe chin may be mistook for 

 the elbow, the shoulder for the heel, or the knee; the mouth for the 

 anus, the nose for the sexual organs, and the cheeks for the tube- 

 rosities of the ischia. Lest the testimony of an infinite number of 

 learned observers should not suffice to demonstrate the possibility of 

 such mistakes, I will relate a well known anecdote of a former pro- 

 fessor of midwifery at the Ecole de Paris: being a man of a rather 

 decided character, he had just touched a woman in labor, and sup- 

 posing he had found a face presentation, he asserted with great ges- 

 ticulation that such a position could in no case be confounded with 

 one of the breech, not perceiving that his finger, which was covered 

 with meconium, was giving him the lie, in the faces of the students, 

 who could not help bursting into loud laughter. 



It is chiefly in cases where the soft parts of the face have had time 

 to swell and puff up, that we may be readily deceived, especially 

 when the mind, pre-occupied with such or such a position, receives, 

 with a sort of avidity, the most equivocal signs as certain proof of 

 what we had predicted. With proper attention, however, we shall 

 be enabled, without difficulty, except in a few very rare cases, to 

 recognise the face whenever it presents, and the rupture of the 

 membranes, allows us to examine it naked; the eyes and eye lids, 

 the nose and lips, the alveolar arches and tongue, the chin and ears, 

 which are found near at hand, possess characters too decided for the 

 positions of the face not to be always clearly ascertained. 



807. The feet cannot deceive the accoucheur when they pre- 

 sent: the heel, to be sure, has some resemblance to the elbow, and 

 the toes some similarity to the fingers; but when we remember the 

 difference of length between the latter named parts — that the one 

 are arranged upon the same line and short, that the others are of 

 unequal lengths and much flexed; when we reflect on the form of 

 the ancles and legs, one must be very careless to compare it with the 

 fist and fore-arm, and not to distinguish the feet from the hands, ex- 

 cepting when these parts are still above the superior strait. 



808. The knees might indeed be mistaken for the elbows or 

 shoulders, although rounder than ihe former and smaller than the 



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