' 399 



the ignorant think it so important to gratify. When the term of preg- 

 nancy draws near, respiration is oppressed, the diaphragm forced upward 

 by the abdominal viscera, descends with difficulty; accordingly, Nature 

 has, as much as possible, delayed this moment of oppression, by giving 

 the lower part of the abdomen a great capacity, at the expense of the 

 chest, which, in women, is much shorter than in men. 



If the growth of the foetus, its size, the quantity of liquor amnii, the 

 developement of the uterus, were always the same, we might settle the 

 height to which this last organ must rise, at each stage qf pregnancy; 

 but these conditions vary so much, in every individual, that the terms one 

 might assign would suit but a small number: let it suffice to have spoken 

 of the extremes. The uterus tends to rise directly upwards: while en- 

 closed within the pelvis, it preserves this direction ; but as soon as it has 

 passed the upper outlet of the pelvis, it is no longer supported, and in- 

 clines forwards, backwards, or to the sides. These inclinations, if they 

 go a certain length, constitute those vices of situation which accoucheurs 

 call obliquities of the uterus- Their direction is determined by the dis- 

 position of the parts: accordingly, they almost always lie forwards; 

 either because the upper outlet of the pelvis is naturally so inclined, and 

 forms, with the horizon, an angle of 45 degrees, or because the lumbar 

 column, being convex, pushes the uterus, which cannot depress it, upon 

 the anterior parietes, which yields the easier, the more frequent preg- 

 nancy has been. 



The dilatation of the uterus is not the effect of a simple distension of 

 its parietes, since these, far from stretching thinner, as the viscus grows 

 in size, thicken progressively, on the contrary, by the dilitation of ves- 

 sels of all sorts and the afflux of humours. In this sort of vegetation, the 

 uterus is really active, and does not give way to any efforts of the foetus. 

 The cervix of this viscus, which, from its greater consistency, had at 

 first resisted dilatation, ends by yielding to the efforts of the fibres of the 

 fundus, on the edges of the os tincae ; the edges of that opening are 

 attenuated, the cervix effaced, the orifice enlarged, and you may feel 

 through its parietes, the foetus plunged in the waters which its mem- 

 branes contain. 



Towards the term of gestation, the discharge of urine is more frequent, 

 because the bladder, under compression, cannot contain it in any quan- 

 tity; the lower extremities are oedematous ; the veins of the legs vari- 

 cose; women are also more exposed to haemorrhoids; and these effects 

 depend on the. compression of the vessels, which bring back the blood and 

 the lymph of the inferior parts, as the cramps, to which pregnant wo- 

 men are subject, depend on that of the sacral nerves. The groins are 

 alike painful, and there are felt in them, twitchings which must be as- 

 cribed to congestion in the round ligaments of the uterus*. Lastly, the 

 skin of the anterior parietes of the lower part of the abdomen, distended 

 beyond measure, cracks, when that of the neighbouring parts has yielded 

 as much as it could. 



Before explaining how the uterus expels the foetus and its coverings, at 



* These ligaments, as well as the uterus, manifest, during- grstation, their muscular 

 character: their vessels enlarge, and their iibres become more apparent, according to 

 the observations of M. Jules Cloquet, made on the bodies of s everal females who had 

 died soon after child-birth. 



See the Note (I I.) last referred to, in the APPENDIX, for the changes which the nerves 

 of the ute-us and its appendages undergo during pregnancy. Copland. 



