PARTURITION. 
Thefe faXs, and many others that our limits oblige us 
to pal's over in lilence, feem to prove that fuperfcetation, 
although rare, is yet a real phenomenon. Thofe phyfi- 
ologifts who ftill deny its poffibility endeavour to account 
for births occurring at periods too remote to admit of 
their being referred to the fame period of conception, 
by aflerting that it can only be explained by the exiftence 
of a double uterus, or by a divifion of that organ into 
two cavities 5 circumftances which anatomical inveftiga- 
t-ion has fliown to take place. Thofe who believe that 
fuperfcetation may happen in the ordinary fate of the 
uterus, may fupport their opinon by the cafe of the wo¬ 
man at Arles, in which the two placenta were united to¬ 
gether by their broad furfaces, which could not have 
happened had they not been formed in the fame matrix. 
The ceffation of the lochias, which was obferved in this 
as well as in that related by Baudelocque, tends to prove 
that the two fcetufes were contained in the fame cavity. 
We refer our readers to the twenty-fecond, twenty-third, 
and twenty-fourth, volumes of the London Medical and 
Phylical Journal for fotne further obfervations and re¬ 
flexions on this fubjeX. 
II. Of PRETERNATURAL LABOURS. 
From the view we have given of human parturition 
under the moll favourable circumftances, it muft be ob¬ 
vious that many deviations from nature may occur. 
Thefe deviations may proceed ; firft, from the propelling 
powers concerned in parturition ; fecondly, from the 
ftate of the child itfelf; or, laftly, from the ftate of the 
paflages through which the child is forced. There may 
all'o be a combination of thefe caufes. 
I. The propelling pow’ers concerned in parturition con- 
fift of voluntary and involuntary mufcular aXion. The 
diaphragm and abdominal mufcles furnilh the former, 
and the uterus the latter. An excefs or diminution of 
the aXion of thofe powers muft interrupt the ordinary 
progrefs of labour. 
Impaired aflion of the uterus during the firft ftage of 
labour is in many inftances produXive of no other incon¬ 
venience than the protraXion of labour; and it has 
therefore been confidered under the preceding head of 
Natural Parturition. But, ifitexhaufts the ftrength of 
the patient, it influences materially the fubfequent pro- 
cefs, foas to require manual afliftance, and the ufe of in- 
ftruments. When it occurs during the fecond ftage, it 
occafions the mod dangerous fymptoms 5 if the head of 
the child continue to prefs for a confiderable time on the 
foft parts within the pelvis, thefe parts muft neceflarily, 
from the impeded circulation, become fwelled ; and con- 
fequently the aXion of the uterus, though it fhould re¬ 
turn, W'ould then be totally infuffleient for the expulfion 
of the child. This effeX of the protraXion of the fe¬ 
cond ftage was firft pointed out to the public in Dr. Ha¬ 
milton’s Letters to Dr. Ofborne. 
We have explained the effeX of the ergot of rye in bat¬ 
tening labour-pains; but, when that remedy is ineffec¬ 
tual, or when fome good reafon may prevent the exhibi¬ 
tion of it, and the child is detained fo long in the paflage 
as to endanger the health or life of the mother, it be¬ 
comes neceflary to extraX the infant by mechanical 
means. Two contrivances have been thought of for this 
purpofe, viz. the veBis or lever, and the forceps. 
Roonhuyfen, a Dutch praXitioner, who flourifhed 
about the beginning of the 18th century, contrived the 
veXis; and, from the great fuccefs which attended its ufe 
in his hands, an ediX was ifl’ued by the ftates-general, 
that no furgeon fhould praXife midwifery without being 
poflefled of the Roonhuyfen fecret, for the inftrument was 
not publicly known. In the year 1756, however, the 
fecret having been purchafed by two liberal-minded phy- 
ficians, Vifcher and Van de Poll, was publiflied by them 
for the benefit of mankind. Since that time the inftru¬ 
ment has undergone a variety of alterations in its form ; 
683 
for a particular account of which, the reader is referred to 
Mulder’s Hiltoria Forcipis. There can be no doubt that 
Roonhuyfen and his fucceffors employed the veftis as a 
lever of the firft fpecies, the head of the infant being the 
refiftance, the parts of the woman the fulcrum, and the 
hand of the operator forming the moving power. The 
injuries arifing from this praXice have been well explained 
by Dr. Ofborne in his Eflayson Laborious Labours. Al¬ 
though Dr. Bland and Dr. Denman ftill recommend the 
fame praXice, there can be no doubt that, whenever the 
ufe of the veXis proves fuccefsful according to their di- 
reXions, the fortunate termination is to be attributed to 
the aXion of the uterus being exerted by the p re flu re of 
the inftrument; or, in other words, the delivery might 
have been completed without any mechanical interfe¬ 
rence at all. The lever in its prefent ftate, called Lou- 
der’s lever, is reprefented on the annexed Plate, at fig. 1. 
but it has now nearly fallen into difufe, having given way 
to the for ceps y which is a double lever fo conltruXed that 
the fulcrum of each blade is in the handle of the other. 
The common fhort forceps is fuppofed to have been in¬ 
vented by Dr. Hugh Chamberlen, who was phyfician to 
king Charles II. but its fhape has been greatly altered 
fince his time. The raoft approved form is that repre¬ 
fented at fig 2. 
In order that this inftrument be applicable, it is necef- 
fary that the head be completely, or nearly fo, in the ca¬ 
vity of the pelvis ; but fometimes a lengthened pair is 
ufed for cafes where the head is fituated high. In what¬ 
ever fituation the head is, the inftrument is to be applied 
over the ears, otherwife there could be no fafe and fe- 
cure hold. In the procefs of extraXing the child with 
this inftrument too, it is to be obferved, that the con¬ 
vex edge of the blades is to be brought along the hollow 
of the facrum. The inftrument being applied fo cau- 
tioufly over the ears of the infant that no part of the wo¬ 
man be injured by their introduXion, the locking-parts 
are to be brought together, and fecured by a ligature; 
after which the operator, fupporting carefully the peri- 
nasum with one hand, is to draw gently in a direXion of 
from blade to blade during a pain, or now and then to 
imitate labour-throes, while he at the fame time favours 
the mechanifm of labour by accommodating the child’s 
head to the paflage fo as to make it take up the leaft pofli- 
ble room. If this be done with fuitable caution and gen- 
tlenefs, no part of the woman fhould be injured, and the 
parts of the infant on which the inftrument had refted 
fhould not even be marked. But, as there can be no 
doubt that, in the procefs of ufing the forceps, the parts 
of the woman are prefled upon by the blades, if much 
force be exerted, or if due attention be not paid to the 
adaptation of the head of the infant to the apertures 
through which it is to be brought, the moft dreadful ef- 
feXs refult from the operation. 
Violent a£lion of the diaphragm and abdominal mufcles, 
if exerted at the beginning of labour, tends to exhauft 
the patient and to retard delivery ; and, if induced when 
the head is within the vagina, may, provided proper pre¬ 
cautions be not taken, lacerate the perinaeum, and ren¬ 
der the future life of the patient miferable. The aXion 
of thefe mufcles, being quite voluntary', may be readily 
prevented by the patient fubmitting to proper advice. 
Violent aXion of the uterus at the beginning of labour, 
is frequently produXive of much mifehief. It exhaufts 
the patient, and renders the fubfequent procefs of deli¬ 
very exceedingly tedious and difficult. It alfo fome- 
times occafions an accident which generally proves al- 
moft immediately fatal, viz. rupture of the uterus, va¬ 
gina, or perinjeuin ; but, as thefe dreadful accidents hap¬ 
pen from other caufes alfo, they will be confidered, with 
the proper treatment, farther on. 
Violent aXion of the uterus during the latter ftage of 
labour, although not produXive of the fame dangers 
■Which enfue from it at the beginning, is by no means 
exempt from hazard j for, if the foft parts be rigid or 
6 not 
