372 DYSTOCIA. 



exist separately; that although the former almost always super-in- 

 duces the latter, it is not, however, impossible for it to exist alone, 

 and that the latter may pre-exist, or even exist to such an extent as 

 to give rise to the most imminent danger, without necessarily com- 

 bining with the other? Besides, it is well known, that blows, 

 shocks, vivid emotions, and all the othes causes of ordinary uterine 

 hemorrhage are equally fitted to produce it where the placenta is 

 inserted over the orifice; it therefore follows that both these kinds 

 of flooding depend on the same proximate cause, the hemorrhagic 

 molimen, and upon the same occasional causes; but that the presence 

 of the placenta upon the cervix constitutes a peculiar determining 

 cause, which rarely fails of being in itself sufficiendy powerful to 

 produce it. 



865. Vessels of the cord. It is at present pretty generally be- 

 lieved that the vessels of the umbilical cord may break during labor, 

 and give rise to one of the most serious kinds of hemorrhage. 

 Doubdess, it would not be wise to deny the possibility of such an 

 accident; but it must be confessed that the observations relied upon 

 to prove it are any thing but conclusive. The one mentioned by 

 Lamotte was evidendy only a case of ordinary hemorrhage: the 

 blood had begun to flow previously to the rupture of the mem- 

 branes; the woman rapidly grew weak, and the author believed that 

 the hemorrhage took place from the cord, because he found one of 

 its vessels to appear as if eroded to such a degree as to admit of the 

 transudation of blood. Levret's case, when carefully analysed, 

 proves nothing more in favor of the opinion of the surgeon of 

 Valogne; and the case by Baudelocque, who at first refused to coin- 

 cide with the opinion of Leviet, certainly ought not to have induced 

 him to change his views. Had the rupture of the cord been the 

 cause of the hemorrhage, the foetus would not have been born alive 

 in the cases reported by De la Motte and Baudelocque. In the 

 example cited by Levret, the foetus, it is true, was dead born, but 

 the forceps had been employed, and the meconium continued to 

 come away while blood was still flowing. In fine, in all three cases, 

 the mothers became so weak as to excite the serious alarm of the 

 accoucheur; which seems to me clearly to demonstrate that the 

 blood came from the uterus and not from the child. Did the nature 

 of this work admit of it, it would be an easy matter for me to show 

 that none of the reasons invoked by these authors are capable of 

 demonstrating the correctness of the opinion they desire to support: 

 let it suflflce me to say that in the actual state of our knowledge, the 

 hemorrhage from the cord, as understood by De la Motte, Levret, 

 and Baudelocque, can only be admitted as possible, and not as 



