DISPLACEMENTS OF THE WOMB. 411 



the causes that most favor its obliquity. la touching, we feel, 

 sometimes almost at the bottom of the excavation, and at others 

 rather higher up, a tumor, generally very even, and which consists 

 of the child's head covered with the anterior wall of the distended 

 cervix of the uterus. This state of things has to me seemed to im- 

 press upon labor a peculiar character of tediousness, and often 

 coincides with what is called pains in the reins. The ablest wri- 

 ters, and Baudelocque himself, recommend, as a remedy, that we 

 should hook the os uteri with one or two fingers, draw it towards 

 the centre of the pelvis during the intervals between the paihs, and 

 keep it there during the contractions; or also, have recourse to 

 vaginal hysterotomy, the only means of avoiding gangrene or rupture 

 of the womb, &c. Were I to depend upon my own experience in 

 this matter, I should be led to think that the interference of art, in 

 this slate of things, is rarely necessary, and that in more than one 

 case there has been too great haste in acting, to the great detriment 

 both of the mother and child. I for a long time conformed to the 

 precepts laid down in the books, I pulled at the os uteri, and did 

 all I could to bring it back to the centre of the excavation; it is true 

 I succeeded, but pretty often not until I had remained several hours 

 with the woman. I was one day obliged to leave a student as my 

 substitute, who neglected the directions I gave him; after an ab- 

 sence of three hours I returned, found the os uteri completely 

 dilated, the membranes ruptured, and the head strongly engaged. 

 From that time I have never interfered in such cases, and tiie 

 organism has always succeeded in restoring things to their natural 

 state. My design is not to conclude from this, that we must never 

 do any thing but wait, but merely to observe, that, excepting in a 

 small number of cases, nature herself may suffice, and that a resort 

 to bloody operations ought not to be lightly resolved on. 



937. Gibbosities and acute diseases do not become a cause of 

 dystocia, excepting as they often do not allow the woman, without 

 danger, to give heiself up to the efforts needed for the delivery of a 

 child; but there is another very remarkable cause of difficult labor 

 which no author has mentioned. A strong, robust woman, pregnant 

 with her first child, in the forty-fifth year of her age, had been in 

 labor for forty hours, when M, Morisse sent for me to see her. 

 The presentation was good, the head had been in the excavation for 

 twelve hours without advancing, in spite of the energy of the uterine 

 contractions. The skin on the fore part of the thighs and abdomen 

 was all covered with old cicatrices, which were hard and fibrous, 

 and confined the lower part of the hypogastrium, so that the womb 

 was as if strangulated immediately above the pubis, and the child 



