DELIVERY OF THE PLACENTA. 541 



thing rather than conclusive, and do not seem to have been properly 

 interpreted. 



I know that w^hen the cord has been pulled at an improper time, 

 it has been found to occasion the inversion of the womb; but, in the 

 first place, this accident is a very rare one; and next, it does not 

 prove that the union of the placenta and womb was maintained at 

 the time; for, if such tractions are performed while the womb is soft 

 and uncontracted, whether the adhesions of the placenta be continu- 

 ed or not, they occasion the woman to bear down, and it is very 

 natural that the womb should then be inverted. The cord has often 

 been pulled so as to break it off, so as to give pain to the woman, 

 and make her feel a dragging sensation within, and the placenta, 

 notwithstanding, has not been moved at all. All this is doubtless 

 true; but without speaking of the pretended uterine cristae which 

 have formerly been so much spoken of, does the womb never con- 

 tract, except in a regular manner, upon the secundines? Does it not, 

 on the contrary, mould itself, in some sort, upon the anfractuosilies 

 of the placenta, so as to make its extraction somewhat difficult? 

 and then, are we sure that the extracting force has been applied in 

 the best possible direction, and exactly to the proper extent; have 

 not the faults of the accoucheur been mos commonly attributed to 

 the adhesion of the placenta? In my amphitheatre I have many 

 times seen the students leave off pulling at the cord from a convic- 

 tion that the placenta was not detached, whereas I had only to pull 

 in a rather more methodical manner than they did, in order to termi- 

 nate the delivery at once, and without difficulty, in their presence. 

 In a woman who came to be delivered^at the Hospital de VEcole 

 and who had a flooding, the cord had already been pulled so as to 

 break it off. I introduced my hand into the womb and found no 

 adhesion at all. Being called to visit a woman, in the Rue de la 

 Montagne-Sainte Genevieve, whose child had been born six hours, I 

 learned that all imaginable efforts had been made to bring away the 

 placenta. The physician had asked for assistance only because he 

 was convinced that the hand must be introduced into the womb in 

 order to destroy the adhesions of the placenta. He repeated his at- 

 tempts in my presence, and I soon found he would not succeed. I 

 now took hold of the cord, and found that there was no particular 

 difficulty in bringing away the after-birth. I have so frequently met 

 with these cases of supposed adhesion; I have so often introduced 

 my hand into the uterine cavity with the design of destroying them, 

 when I was informed that they existed, and when in fact they had 

 no existence; and from reasoning it is so difficult to admit them, that 

 I do not hesitate to look upon their occurrence as very rare. How 



