P A R T U 
The child appeared lively. I loft no time in tying 
the umbilical cord, which was no thicker than ordinary, 
that I might remove it, to examine it more particularly 
and make farther obfervations. Having taken it into 
an adjoining room, I found it had all the powers of vo¬ 
luntary motion as perfedt as a natural fetus: the eyes 
of each head were opened and clofed occalionally; and 
the mufcles of each face contradled, as if to fquall, and 
one of them made a confiderable noife, which was the 
firft head protruded. On a clofer infpedlion, I found 
the other head never breathed, although it was equally 
lively with the firft. It continued gradually to weaken 
for about forty minutes, when it ceafed to breathe. For 
a confiderable time after refpiration bad ceafed, I could 
feel the heart palpitating, with a tremulous motion in 
the epigaftric region. 
Mr. Bailey, of Blackburn, a refpedlab'e furgeon and 
good anatomift, afiifted in examining the child, about 
twenty-four hours after its death ; when we made the 
following obfervations. The heads were well formed; 
the bones of which were as perfectly ofiified, as well as 
thofe of the limbs, as is found in the majority of infants. 
The neck of the left head appeared fomewhat longer than 
the other ; but I attributed that to the extending force 
I ufed in the extraction ; and the other would be forced 
in an oppofite direction upon the breaft, by the refiftance 
given from the foft parts of the mother. The weight of 
the child was 8 pounds 15 ounces and 6 drachms avoir- 
dupoife. The meafurement of the left and larger head, 
from the finus frontalis to the tubercle on the os occipitis, 
8| inches; round the head, 13 inches, at the fame re¬ 
lative points. The fmaller head meafuring 7! inches, 
and 12J inches. The circumference of the cheft imme¬ 
diately below the arms, 1+ inches. The fternum was 
broader than ufual, and the ribs appeared to make a 
greater curve than is generally obferved. The clavicular 
were three; two in their natural fituatioris; and the 
third, which was equally as large as the others, was at¬ 
tached to the top of the fternum, and proceeded back¬ 
wards between the two necks; where there was alfo a 
third fcapula, forming a protuberance, or fiioulder. On 
examining the back, there felt as if there were three 
vertebral columns: the middle one, on difl'eCHon, was 
found to be the cartilages of ribs, each about an inch in 
length, coming from the two fpines, which joined at 
obtufe angles, and gave to the touch externally the feel 
of fpinous procefles. 
On opening the thorax, the firft thing that attracted 
our attention was the fituation of the heart in its peri¬ 
cardium: it was fituated between the two lungs, and 
about as much inclined to the right fide as in a natural 
cafe it is to the left. The lungs were large, having two 
tracheae, each terminating feparately ; the one in the 
right, the other in the left, lung. Each lung had three 
lobes. Each head had a diftindl cefophagus, which pafled 
feparately through the diaphragm. The appearance of 
the lungs confirmed the obfervation I before made, that 
only the left head had breathed; the right lung having 
the appearance of liver, the colour of which, on being- 
inflated, was inftantly changed to that peculiar pul¬ 
monic mottled hue which characterizes this organ after 
refpiration. On opening the pericardium, the heart was 
found to be very large. The aorta, which was alfo very 
large, arofe from the left ventricle; as alfo did the pul¬ 
monary artery to the left lung. The contents of the 
abdomen appeared natural : the liver was large, but had 
nothing peculiar in its appearance. On turning back the 
liver, we found two ftomachs : the one to the left head 
occupied the natural fituation, the other was fituated 
under the right lobe of the liver. Each ftomach had its 
feparate duodenum, the right one about half an inch, 
and the left one about an inch and half in length ; when 
they united, forming one common duodenum. There 
were two gall-bladders, each having a feparate duCl, 
which terminated at the junction of the duodena. The 
Vol. XVIII. No. 1273. 
R I T I O N. 677 
fpleen, pancreas, and kidneys, were natural; as alfo 
were the inteftines ; the colon and reCtum were diftended 
with meconium. The contents of the pelvis were fimilar 
to thofe of a Angle child. On examining the vertebral 
columns, we found two, perfedt and entire, but which 
gradually approximated as they approached the facrum ; 
which was Angle, but much broader than natural. Cafes 
fimilar to the prefent very rarely occur: few fo Angular 
are on record; and, of thofe related, but a fmall lhare 
are well authenticated, or elfe, as before obferved, they 
were expelled before the full time of utero-geftation. 
With refpeCl to the mother, I may briefly ftate, that, 
whilft I was examining the child immediately after its 
birth in an adjoining room, one of the midwives, by of- 
ficioufly attempting to bring away the placenta, broke 
the umbilical cord ; fo that I w'as obliged to introduce 
my hand into the uterus, to detach and bring it away. 
Notwithftanding this circumftar.ce, added to the tedious 
and painful parturition, (he recovered as well as after an 
ordinary labour : no unpleafant fymptoms fupervened, 
except that the proftration of ftrength required a longer 
time to be re-eftablifhed. 
8 . The death of thefeetus is not neceflarily a caufe of 
lingering labour. Tliq affection of the mother, of what¬ 
ever nature it might be, which ocCafioned the death of 
the child, may poflibly retard the labour; otherwife it 
will terminate favourably, unlefs the fize of the fetus is 
increafed by putrefaClion ; and from this caufe very 
troublefome and dangerous labours have fometimes oc¬ 
curred. When a child, after death, becomes putrid, 
and thence enormoufly fwelled by the included and ra¬ 
refied air, the birth will be impeded ; but the difficulty 
will arife not from the death of the child, but from its 
increafed bulk. 
9. Shortnefs of the navel-firing will feldom be a caufe of . 
lingering labour, till the head is about to pafs through 
the external parts; it may then be an impediment to 
the birth by occafioning the head to be retraCled after 
each pain. We are not, however, always to conclude 
that the retraction of the head is produced by fnortnefs 
of the funis ; for the refilition of the parts, efpecially in 
firft labours, occafions a greater or lefs degree of retrac¬ 
tion of the head. The delay in the labour, which, fhort- 
nefs of the funis occafions, will generally be overcome 
by the unaided powers of Nature. Changing the petition 
of the woman fometimes facilitates the birth. 
It has been recommended, after the head is born, if 
the birth of the fhoulders is prevented by the navel-firing 
being twilled round the neck of the child, to introduce 
a pair of feiffors, divide it, and thus fet the parts at liberty. 
This operation may fometimes be expedient; great care 
being taken to guard . againft doing mifehief; but it is 
proper to remark, that Dr. Denman relates a cafe of the 
death of the infant from dividing the funis under thefe 
circu mftances. 
Befides the caufes of difficult parturition above enume¬ 
rated, it fometimes happens, that incautious praCli- 
tioners occafion lingering labours by mifmanaging the 
different llages, and thus interrupting the natural pro- 
grefs of the labour ; and this may be effected in various 
ways, particularly, by the injurious praCHce of giving 
cordials and ftrong drinks, under a falfe idea of fnpporc- 
ing the patient’s ftrength; by keeping the room too hot 
and dole ; by allowing too much company, who fatigue 
the patient, by their noife and talking, or by urging the 
woman to exert herfelf in bearing-down before the parts 
are well dilated. “ But this mull the mydsvyfe above all 
thynges take hede of, that file compell not the woman to 
labor before the byrt’n come forwarde and fhewe itfelfe. 
For before that tyme all labor is in vayne, labor as muche 
as ye lyft. And in this cafe many tymes it cometh to 
pafle, that the partie hath labored fo fore before the 
tyme, that when {he fhoulde labor in dede, her myght 
and ftrength is fpent before in vaine, fo that ftie is not 
nowe able to helpe herfelfe; and that is a perylouscafe.” 
8 K. Thefe 
