ARTIFICIAL ABORTION. 499 



if the delivery were to take place at term, and through a strait of 

 three inches and some lines. But how are we to learn accurately 

 whether the foetus is viable? If, for greater security, we should de- 

 fer the operation till two weeks latter, what assurance could we 

 have that the head is not already too large to pass through the straits? 

 And if it can clear them at eight months, it is not probable that it 

 will succeed equally well at the end of the ninth? 



I am far from thinking that the difficulty consists in penetrating 

 as far as the membranes so as to rupture them; nevertheless, wounds 

 of the uterus are so dangerous, that we should always dread to in- 

 troduce an instrument into its interior: and then it would be a 

 strange misconception to suppose that abortion brought on in this 

 way is not more dangerous, cseteris paribus, than a delivery at full 

 term: without mentioning the hemorrhagies, convulsions, or inflam- 

 mations of the peritoneum, that are but too frequently the results of 

 the operation, we ought also to expect the fcetus to perish either 

 before or soon after birth, in a large majority of cases. Being 

 scarcely viable, it is too feeble to bear the contractions of the uterus. 

 Although, after the membranes are perforated, the womb, some- 

 times, enters powerfully into action, it also happens that it remains 

 two, three, and even as much as fifteen days, before it begins to re- 

 act upon the product of conception; besides, its contractions are 

 generally slow, feeble, and too far apart to expel it when its size is 

 considerable. 



Unless a very slight value is attributed to the life of the fcetus, this 

 recourse is, then, of small advantage; at least, previously to making 

 a general precept of it, it deserves to be maturely considered by un- 

 prejudiced men, and in a more philosophical way than seems to have 

 been done hitherto in England and in Germany. 



1113. Signs of the death of the foetus. There is no doubt that 

 the fc3tus is still living if it moves, or if auscultation enables us to 

 hear the movement of the heart; there is, also, no doubt of its being 

 dead when portions evidently belonging to its structure, and in a state 

 of putrefaction, escape from the organs; but with the exception of 

 . these cases, which leave not the slightest uncertainty upon the sub- 

 ject, the question of life or death is, here, one of the most delicate 

 subjects in physiology, and one of the most difiicult of solution of 

 any in tokology. The same thing takes place in regard to the death 

 of the fcEtus as occurs in relation to the question of pregnancy; it is 

 announced by numerous signs, but they are extremely variable and 

 never certain. How could it be otherwise, inasmuch as it is some- 

 times impossible to pronounce upon the state of the fcetus that has 

 just been born, and that is before our eyes? 



