M I D W I F E R Y. 



241 



conception. In *n instance where the conception 

 could not be less than five weeks, the membranes were 

 of the size of a sm til chetnut, and the foetus scarcely 

 to Urge as an ant. In the sixth week it is curved, 

 farming a bulk like a split pea. In the seventh as 

 large as a bee. In the eighth, about the fize of an or. 

 dinary bean. At first the embryo consists merely of 

 two oval bodies joined together, which are the rirli- 

 ments of the bead and trunk ; then the extremities 

 sprout out like buds, and the different organs became 

 gradually developed. At the full time a male child 

 measures about 20 inches, and the average weight is 

 even pounds. 



At first, from the increased weight, the uterus tub- 

 side* in the pelvis, at the same time tlvt the os uteri 

 becomes more circular, instead of transverse, as for- 

 merly. In course of time, however, it become* to 

 Urge that it can no longer remain sunk in this situa- 

 tion, but rises above the brim of the pelvis. The time 

 at which this happens mast depend to a certain degree 

 on the capacity of the pelvis, and the enlargement of 

 toe uterus. It usually happens in the end of the 

 fourth month, that is, alter Hi weeks from conception, 

 but it may be earlier, and is often somewhat later. 

 This elevation take* place in general rather suddenly, 

 and in many cases the sensation occasioned by the ris- 

 ing of the uterus is very well marked, and sometimes 

 accompanied with fainting, or hysterical symptoms. 

 This is confounded by many with the motion of the 

 child it.ielf, which it felt about this time, and the per- 

 son is said now to quicken. It is quite absurd to sup- 

 pose, that before thu the child is not alive, and do-a 

 not move. The motions are now felt, because the 

 child is stronger and larger, compared to the quantity 

 of liquor amnii, and the uterus is in a more sensible 

 situation. Lawyers, however, who are in general bad 

 physiologists, have decided that it is murder to pro- 

 cure abortion after the time of quickening, but a mi- 

 nor offence to do so earlier. If any doubts have ex- 

 isted respecting the triatrnce of pregnancy, they are 

 at this period cleared up ; for the patient herself is 

 sensible of the notion, and the accoucheur, by exami- 

 nation per vatinam, feeU the uterus to be heavy, and 

 when pressed op with the finger, there is perceived 

 the motnfment de ballotemenl . and by gently striking 

 the under pan of the uterus once or twice, the foetus 

 is perceived distinctly to more or flutter within. 



It requires nine months to bring the human foetus 

 to perfection, and experience teaches many women, 

 from particular feelings, how to judge pretty accurate- 

 ly with regard to the time when they are to be con- 

 fined. N\ hen there is no particular circumstance to 

 guide them, the general way is to calculate forty- 

 two weeks from the last period of menstruation, forty 

 werks being the terra of gestation. This determines 

 within a fortnight, and farther assistance is derived 

 from attending to the time of quickening. Many 

 bring forth before the full time, but it if rare to go 

 beyond the ordinary term ; but it is certainly possible 

 to do so. 



Children bom in and after the seventh month may 

 live, but the nearer they approach to perfection 

 more likely are they to thrive. If they have no hair 

 nor nails, and the skin be not red alx>tit the palms of 

 the han<U, breast, end scrotum, and if they can neither 

 ery nor suck, there is no chance of their living. In- 

 stances, howevrr, have occurred, where children in 

 the sixth month have been kept alive by being fed and 

 ept warm. 



VOL. XIV. PART I. 



CHAP. II. 



Of the Sign of Pregnancy. 



ALTIIOCOII some women very eavly begin to have 

 complaints, or to experience certain sensations which 

 apprize them of conception having taken place, yet 

 in general the first indication of pregnancy is the 

 interruption of the menstrual action. It has been a 

 question for discussion amongst medical men, whether 

 the menses have ever continued to appear regularly 

 during pregnancy, and notwithstanding the different 

 instances which have been brought forward to the au- 

 thor, he is still convinced that the two conditions are 

 t.o incompatible with each other, that regular menstru- 

 ation is inconsistent with pregnancy. It is placed be- 

 yond all doubt, that many women have had periodical 

 discharges during part or the whole of pregnancy ; but 

 these, from the attendant circumstances, are rather to 

 be viewed as hemorrhages than as a continuation of 

 the natural secretion. Yet Baudeloque, Chambon, 

 and other respectable men, have told us of instances 

 where women did not menstruate except during ges- 

 tation. 



The breasts very early sympathise with the uterus. 

 It is not unusual for them at first to become a little 

 smaller, but by the third month there is an evident 

 enlargement, and the nipple presently becomes sur- 

 rounded with a brown areola. The augmentation of 

 siae is slower of taking place in those who are delicate, 

 or who have sanguineous evacuations from the uterus 

 during the early months of pregnancy. A serous or 

 milky fluid also is secreted, and either flows from the 

 nipples or can be pressed out. 



It is not unusual for the abdomen, soon after con- 

 ception, to become flatter than formerly, and continue 

 so for a month or two, after which it enlarges. In 

 othrr instances it very early increases in size, chiefly 

 from a distended state of the bowels. In pregnancy 

 tin- tumour is most manifest below the umbilicus, which 

 generally becomes prominent towards the sixth month, 

 if not sooner. 



It is possible, but not usual, for all these symptoms 

 to appear in the virgin state, in consequence of ute- 

 rine irritation ; but much more frequently they arise, 

 if not from true pregnancy, at least from a blighted 

 ovum, or what has been called a false conception. 

 Many women, who have had a Urge family, when they 

 advance in life, are liable to inflation of the abdo- 

 men, and irregularity of the menstrual discharge, oc- 

 casionally accompanied with slight changes in the ap- 

 pearance of the breasts. They are willing to believe 

 themselvex not p*st the age of childbearing, and fancy 

 they feel the motion of the child ; but it is only wind 

 pawing along the bowelo, and i* known to be so by 

 shifting its place, and generally being perceived higher 

 than the uterus. 



These signs, with the existence of what have been 

 called the disorders of pregnant women, do, in the 

 married state, justly warrant the belief of the existence 

 of pregnancy ; but we cannot arrive at certainty until 

 the time of quickening, or by examination per vagi- 

 nam, about that period. Earlier, even this mode can- 

 not iK),itively decide the question, for the womb may 

 be enlarged by other causes. Still it afford* in the 

 third month strong presumptive evidence. 



it 



Or the 



Pregnant 



Slate. 

 i _i 



Of the 

 ''P 18 r 



P rc S nal 



