SYNCOPE. 403 



of the size of a three hvres piece; at each contraction her cries, an- 

 guish, and agitation restored an appearance of strength, the existence 

 of which was not suspected a few hours before; the poor woman 

 was urged to redouble her courage, and make the utmost of her ef- 

 forts; in fact the child was delivered at about eleven o'clock, but in 

 an hour afterwards she was no more. 



Consequently, as soon as the os uteri is sufficiently dilated where- 

 ever there is reason to fear too great a degree of exhaustion, prudence 

 requires us to have recourse to a forced delivery. The forceps should 

 be preferred in such cases, provided turning be not absolutely indi- 

 cated, inasmuch ^s it is less fatiguing for the woman. 



SECTION 2. 



Essential Dystocia. 



Labor is essentially difficult where the passage of the foetus requires 

 the interference of art, from its being rendered impossible, or greatly- 

 obstructed from some mechanical obstacle. Of these obstacles, some 

 depend upon the woman; others, on the contrary, depend upon the 

 foetus itself. 



§. I. Dystocia Occasioned l>y the State of the 

 Female Organs. 



The difficulties that arise in the organs of the female are some- 

 times referred to the soft parts, and at others to the hard parts of 

 her structure. The former alone will occupy our attention here, 

 for as much as the latter were treated of in the section on deformed 

 pelvis. 



920. Various tumors have been observed in the pelvic excava- 

 tion, and on more than one occasion, great difficulty has arisen from 

 them in regard to the birth of the child. 



They are pretty frequently found to occur in the perineum, or in 

 the recto-vaginal septum; being variable as to size, consistence, 

 nature, &c. they are far from always requiring the same kind of 

 treatment; when not very large or capable of being flattened by- 

 pressure, if other circumstances are favorable, they do not always 

 prevent the spontaneous delivery of the child; scirrhous or fibrous 

 masses connected with the ovary, the intestines or epiploon, when 

 sufficiently moveable to sink down and lodge betwixt the uterus and 

 sides of the pelvis, present a peculiar indication; they require to be 

 displaced and carried above the superior strait; for this purpose, the 

 woman must be placed upon her back or side, in such a way that 



