548 COMPLICATED DELIVERY OF PLACENTA. 



and right side of the organ, where the remainder of the after-birth 

 was retained. In another woman who died at the Hospice de U 

 Ecoh, I found the uterus so moulded upon the placenta, that it was 

 divided, as it were, into five shallow cells, and which evidently de- 

 pended upon the protuberances formed by the corresponding cotyle- 

 dons of the after-birth. If the placenta were solid and even, like 

 the head, the womb in contracting would necessarily retain the form 

 of an ampulla; but the cotyledons in the process of the detachment 

 may separate from each other, and the placenta would then offer 

 more resistance in some parts than in others; so that the uterus soon 

 divides into several compartments or divisions more or less distinct 

 from each other, in the same way as it is found to accommodate 

 itself to the form of the head, of the shoulder, the breast, the pelvis, 

 and all the projecting or contracted parts of the fostus, after the 

 liquor amnii has been evacuated. Besides, what accoucheur of any 

 experience has not had an opportunity of observing, through the 

 abdominal parietes, the womb tuberculated, more or less uneven or 

 elongated, and not always globular or round, as it is too generally 

 said to be. 



1186. However it may be, the cyst may be formed by the fun- 

 dus of the uterus, as supposed by Simsou and Baudelocque, and 

 then the organ approaches more or less to the shape of a calabash; 

 sometimes, on the contrary, it is found to be upon one side, as was 

 observed by Levrct; and, again, in front or to the rear, and at 

 points of different height. Le Roux says that in one instance the 

 placenta was encased in the fundus of the womb like a watch-glass 

 in the lid. But as such a case has not been noticed since, and there 

 is every reason to believe that the author might have been deceived 

 by some peculiar circumstances. M. Herbin must have been mis- 

 taken also, when he thought the after-birth was encysted in the 

 Fallopian tube, in a woman whom he was obliged to deliver artifi- 

 cially. 



The placenta, moreover, may be enclosed wholly or only partially 

 within the accidental cell; it is sometimes strangulated by the circle 

 of the cyst; so that one portion of it may remain free in the cervix 

 while the rest of it is in some sort imprisoned above; in one or more 

 cells of the body or fundus of the womb. 



1187. To have understood what has now been said in relation io 

 encysted placenta is sufficient to enable one to guess at the signs of 

 it. The treatment demanded by the case differs accordingly as it is 

 or is not accompanied with some complications. If there be any 

 complication, the contractions of the womb alone suffice to make 

 them disappear; these are to be solicited by means of frictions upon 



