THE CORD. 399 



pain is off, it re-enters the passage; and this continues for several 

 hours. 



The circumstance really takes place, but is altogether independent 

 of the umbilical cord; it is chiefly to be met with in young women 

 who are strong and robust, and at their first confinemeni. It de- 

 pends upon the elasticity of the perineum: this flooring of the pelvis-r 

 gives way while the womb, assisted by the abdominal muscles, urges 

 the head onwards and makes it project from the parts; but as soon as 

 the contraction ceases, its natural rpsistance returns the vertex into 

 the interior of the pelvis. 



However, it would be incorrect to assert, as Baudelocquef does, 

 that a cord's being too short cannot in any case interfere injuriously 

 with delivery; in such a case the placenta is liable to be prematurely 

 detached, wliich might facilitate the occurrence of inversion of the 

 womb, give rise to hemorrhagy, and bring the child's life into dan- 

 ger, should the labor be prolonged; the strain arising from it might 

 weaken, or even arrest, or at least disturb the contractions of the 

 womb, and suspend the labor; but in no case can the mere shorlness 

 of the cord mechanically hinder the expulsion of the child. 



911. Excessive length. When the cord is, on the contrary., too 

 long, it generally has a strong tendency to procidence, and particu- 

 larly to the formation of one or more loops around the limbs or 

 body of the fiEtus. These turns are frequendy met with in prac- 

 tice, and oftener round the neck than any where else; where there 

 are many of them, that portion of the cord that remains free may be 

 really too short, whence the same accidents as under the former 

 head might be feared. It has also been thought that they might 

 obstruct the passage of the blood in the jugular veins, and act like 

 ligatures, so as to produce a state of asphyxia. I have seen many 

 chddren born with turns of the cord about the neck, and it has never 

 seemed to me to be productive of danger in any case. Besides, in 

 strangulation, death is produced by the stoppage of respiration, and 

 death cannot take place in that way in the fostus: again, I do not 

 see how the cord can be drawn so tighdy as to obliterate the inter- 

 nal jugulars or the carotids; therefore, at most, only the umbilical 

 vessels are liable to be interrupted. It would appear, however, that 

 these turns of the cord may exist for several months before the pe- 

 riod of delivery, and thus give rise to some very curious anomalies. 

 A fact lately observed by M. Monod, a resident pupil at the Mater- 

 iiile, proves that they may, like a branch of ivy round a tree, leave 

 very deep grooves, and produce strangulations, &;c., from which 

 even the bones do not wholly escape. Moreover, it is fortunate 

 that these causes of dystocia either do not exist at all, or but very 



