690 PARTURITION. 
fhould there be any circumftances in the cafe, rendering 
it very improbable that the child could be preferved, 
even if it were turned, it would be injudicious praftice 
to attempt the operation. For, as turning the child in 
utero is an operation always more or lefs hazardous to 
the mother, it is not judifiable to put her to this hazard, 
unlefs there be a well-grounded expectation of faving 
the child. 
What has been laid hitherto, applies chiefly to the 
prefentation of the funis along with the head : when it 
prefents together with any other part, the accoucheur 
will be guided in his practice by the peculiarities of the 
cafe. If the arm and funis fhould prefent together, 
turning mud of courfe be had recourfe to; for this ope¬ 
ration will then become neceflary, not becaufe the funis 
prefents, but becaufe the arm has funk into the vagina. 
3. Monstrosity of the Fcetus. 
Ith as been feen, at p. 676, that monflrofity does not 
neceflarily take the cafe out of the clafs of Natural La¬ 
bours. Mod frequently, however, it does. In the fol¬ 
lowing molt extraordinary cafe, the fufferings of the 
mother were fo great, that (lie furvived the birth only 
two days. But we have no particulars of the nature of 
the pregnancy, nor whether the birth was premature, 
nor in what manner the delivery was efrefted ; fo that 
perhaps what we fiiall relate may rather be conf.dered as 
a fupplement to our account of Monsters, vol. xv. than 
as ftriftly appertaining to the prefent article. The ac¬ 
count was tranfmitted by Mr. John Livingftone, furgeon 
to the Britifh factory, China. 
“A-ke was born fixteeen years ago, in the didrift of 
Yun-lang-yuen, with another male child of nearly the 
fame fize united to the pit of his ftomach by the neck, as 
if his brother had plunged its head into his bread:;” pre¬ 
fer, ting an appearance, as we fhould fuppofe, fomething 
like fig. 9. on the engraving which accompanies the arti¬ 
cle referred to. “The fkin of the principal here joins 
that of the upper part of the neck of the parafite, quite 
regularly and fmoothly, excepting the fuperficial blood- 
velfels, which appear fomewhat turgid. A careful ad- 
meafurement of the parafite was made: the trunk and 
neck meafured about eleven inches, and the longed 
limb thirteen inches, making the extreme length two feet; 
but, as the modellers in China do not work by any fcale, 
it would be ufelefs to deduce any exact meafurement of 
the whole figure ; 7 knowing a part. 
“Since that ti : a the parafite has not much increafed 
in fize, and at prefent is not much larger than new-born 
infants ufually are ■. but the bones are completely formed. 
The fhoulder-bones are remarkably prominent. But all 
this plumpnefs has difappeared from the original, whofe 
bones feem only to be covered with fkin. The attach¬ 
ment of the neck of the parafite to the ched of the prin¬ 
cipal, admits of a femi-rotatory motion. The natural 
pofition of the bellies is towards each other ; but 
A-ke can turn his brother fo far round, that he can 
bring either fide towards his own belly. Fie alfo fltows 
that his brother's arms can be moved freely. The thighs 
and legs remain ftiffly bent; the thigh being anchylofed 
with the offa innominata above, and the tibiae below. 
Infeiagraphia, genitalianimis perfeffa apparent; quoniam 
in archetypo, tedium vedigium nullum, ferotique exi- 
guum tantum, videndum fit. At penis proportionaliter 
craffus eft; et prseputium glandem feinivelat. Tentigo 
interdum obfervatur; quo tempore fiuidum vifeidum ex 
urethra ftillat, quapropter Sinenfes femen copiofe fecerni 
credunt. Renes odicia rite perficiunt ; anus deed. 
“A-ke is now about four feet ten inches high, of a 
feeble frame and fickly appearance; but, excepting the 
incumbrance above deferibed, he is in all refpefts per¬ 
fectly formed. He appears to be fufficiently convertible 
and intelligent; and fays that he has the fame feeling of 
pain, if any part of his brother’s body is hurt, as if it 
was the dime part of his own body: even the flighted: 
touch, which would be perceptible if applied to his own 
perfon, is equally perceptible if applied to his brother. 
This fiatement was mod fatisfaCtorily confirmed by an 
ingenious medical gentleman ; who, obferving A-ke’s 
attention to be fully employed, and his head turned away 
in a contrary direction, pinched quickly the hip of the 
parafite: A-ke indantly druck the dame part of his own 
perfon, juft as if that had been the pinched place. 
“ Formerly he had reafon to imagine, from certain ob» 
feure motions which he perceived within his brother 
when he was himfelf in pain, that all their feelings were 
reciprocal; but for fame time pad he has not been fen- 
fible of this, nifi miCturis fit. Frater ejus nunquam 
eodem tempore, feu urgente natura, feu curiofitati ad- 
dantium fatisfaciendi caufa, urinam reddere deficit. 
“ A-ke’s refpiration is never perfectly free : on the 
contrary, it is commonly laborious ; and, on the dighted 
exertion, fuch as walking to a little didance, attending 
a flight of deps, or the like, he breathes quickly, and 
with difficulty. To relieve this, he fupports the parafite 
with his hands; but, to obtain any confiderable degree 
of eafe, a recumbent podure is neceflary. His pulfe is 
commonly quick and fmall. Mr. Gomez felt didinCtly 
the pulfation of the carotids in the neck of the parafite ; 
it was feeble. He alfo examined carefully the pulfe at 
the wrids ; it was very flow. The ufual temperature of 
both is natural. A-ke wears an unufual quantity of 
clothes, yet he never appears to perfpire, even in the 
warmed weather. His ufual gait is undeady and feeble : 
'when he walks up or down dairs, he fupports himfelf 
with one hand, and his brother with the other, and 
brings both his feet upon the fame dep before he at¬ 
tempts to advance another foot. 
“ When in his bed date of health, he informed Mr. 
Gomez his appetite was fo good that he could take as 
much food as any three of his age; at prefent, his health 
in general is much impaired. He complains of weaknefs 
of domach, lofs of appetite, defective and painful di- 
gedion; fo it is commonly thought that he cannot live 
long.” London Med. Journal, Aug. 1821. 
III. The third clafs, or order, of impediments to 
natural labour, confids alfo of various fpecies. The 
chief of thefe are 
Deformities of the Pelvis. 
1. When the apertures of the pelvis are too large, the 
mother incurs much danger, and the child is not totally 
exempt from hazard. 
The danger incurred by the mother arifes from there 
being no refidance to the palfage of the child, fo that, 
when the aCHon of the uterus begins, the child may be 
pudied by the force of the pains through the pafl’age be¬ 
fore the loft parts are dilated ; hence the uterus may be 
ruptured, or the foft parts lacerated. If, on the other 
hand, the external parts be foft and yielding, a confider¬ 
able portion of the uterus may be excluded without the 
parts. There is a very wonderful hidory of a cafe of 
this kind alluded to by Saxtorph in the following words: 
“ Memorabilius adhuc exemplum ed illud a cel. Wolfg. 
Mullnero ailatum, ubi iotus uterus una cum feetu extra 
genitalia dilapfus, fcetufque vivus extra pelvim verdone 
extraftus fuit, matre pod reduCtionem uteri fuperdite.” 
Did. de Diverfo Partu ; Nuremb. 1771. 
The hazard which the child undergoes is that of being 
fuddenly expelled, included within the entire ovum, fo 
that it may be lod before proper aflidance can be afforded. 
Another danger is, that, the membranes having given 
way, it may be dallied with violence upon the door on 
which the patient walks. Whenever, from the great 
width of the hips, there is reafon to fufpeCt that the pel¬ 
vis is too large, the practitioner Ihould continue in con- 
dant attendance from the very commencement of labour, 
and Ihould carefully adopt the appropriate and obvious 
means to prevent the hazards juft enumerated. 
a. But 
