,transcrib]'s ,note3 ,italic text is d5ot$ by und]scores & bold text by equal signs4 ,illu/ration3 ,& ,adam knew ,eve 8 wife1 & %e conceiv$1 & b>e ,ca94 ,*apt] ,,iv ,,g5esis4 #a/ v]se ,,! ,,matron',s ,,manual ,,( ,,midwif]y1 ,,& ,,! ,,diseases ,,( ,,wom5 ,,dur+ ,,pregnancy ,,& ,,9 ,,*ildb$1 ,,be+ ,a ,,famili> ,,& ,,practical ,,treatise1 ,,m ,,especially ,,int5d$ ,,= ,,! ,,in/ruction ,,( ,,females ,,!mselves1 ,,b ,,adapt$ ,,also ,,= ,,popul> ,,use ,,among ,,/ud5ts ,,& ,,practition]s ,,( ,,m$ic9e4 ,by ,,fr$]ick ,,hollick1 ,m4 ,d41 ,,lectur] ,,on ,,physiology ,,& ,,female ,,diseases1--,,& ,,au?or ,,( ,,! ,,diseases ,,( ,,woman1--,,outl9es ,,( ,,anatomy ,,& ,,physiology ,,= ,,popul> ,,use1--,,neuropa?y1--,,& ,,! ,,orig9 ,,( ,,life4 ,,illu/rat$ ,,by ,,ov] #ej ,,spl5did ,,engrav+s4 ,,new ,,york3 ,,publi%$ ,,by ,t4 ,w4 ,,/rong1 ,,no4 #ih ,,nassau ,,/reet4 ,,bo/on3--,,no4 #fd ,,cornhill4 #ahdi4 ,ent]$ accord+ to ,act ( ,congress1 9 ! ye> #ahdh1 ,by ,,fr$]ick ,,hollick1 ,m4 ,d41 9 ! ,cl]k's (fice ( ! ,di/rict ,c\rt ( ! ,unit$ ,/ates = ! ,s\!rn ,di/rict ( ,new ,york4 ,! price ( ?is ,book is ,"o ,doll>4--,x may be obta9$ ( all ,booksell]s1 or ( ,t4 ,w4 ,,/rong1 #ih ,nassau-/41 ,n4 ,y41 :o w also s5d x by ,po/ to any "p ( ! c\ntry1 on receiv+ ,"o ,doll> & ! ,address4--,n4 ,b4 ,all ,dr4 ,hollick's o!r ,books w be s5t by ,t4 ,w4 ,/rong 9 ! same way4 ,,preface4 ,a %ort "t ago ,i publi%$ a popul> treatise on ,! ,diseases ( ,woman1 9 ! non pregnant /ate1 & 9 t "w ,i ann\nc$ my int5tion ( %ortly publi%+ a simil> "o on ,pregnancy & its diseases4 ,?is book is ! fulfilm5t ( t promise4 ,be+ ! fir/ popul>1 & yet /rictly sci5tific & practical book on ,midwif]y ev] publi%$1 its prep>ation has necess>ily be5 a "w ( great lab\r & difficulty4 ,ev]y?+ _h to be simplifi$2 famili> explanations _h to be giv5 ( complicat$ processes1 & illu/rations _h to be design$ t c\ld be und]/ood by my read]s4 ,little or no assi/ance c\ld be obta9$ f o!r works on ! subject1 because !y 7 ei!r design$ = pr(essional m52 & !re=e too te*nical1 or else 7 too g5]al 9 _! explanations1 & too unsy/ematical1 to be ( any practical use4 ,i !re=e _h to write e "p afre% myself1 & plan a new arrangem5t2 & s difficult 0 ?is to d1 satisfactorily1 t ,i h twice be=e complet$ ! :ole "w1 & !n comm5c$ at ! beg9n+ aga91 be=e ,i 0 satisfi$ ) my own production4 ,z x n[ /&s1 ,i tru/ ?is treatise answ]s ! purposes = :i* x 0 int5d$4 ,i h tak5 c>e to make x s complete1 & sci5tific1 t a m$ical /ud5t may take x = 8 text book2 & at ! same "t ,i h endeav\r$ to s simplify x t any female1 ( ord9>y capacity1 c fully und]/& bo? its explanations & practical directions4 ,all purely te*nical words h be5 avoid$1 or1 :5 absolutely necess>y1 !y h be5 c>efully expla9$4 ,e topic connect$ ) ! ma9 subjects has be5 discuss$1 & ! late/ in=mation giv5 on e po9t1 & f e s\rce4 ,su* a "w z ?is has long be5 ne$$4 ,females h be5 kept 9 %ameful ignorance1 ( ev]y?+ connect$ ) _! own sy/ems1 & ( ! wond]ful ph5om5a 9 :i* !y play s important a "p4 ,t ignorance has l$ to untold evils1 :i* c nev] be correct$ till !y become m enlight5$ respect+ !mselves4 ,=tunately _m ( !m beg9 to see ?is1 & !y reque/1 9 behalf ( !mselves & _! si/]s1 t su* k be no long] )held4 ,i h be5 n[1 = a long "t1 engag$ 9 ?is pleas+ task ( female in/ruction1 bo? by my ,lectures & books1 & 9 my daily communion ) !m z pati5ts2 ,i am !re=e aw>e bo? ( _! great lack ( prop] in=mation1 & ( _! /rong desire = x1 & ,i flatt] myself ,i also "k1 f exp]i5ce & c>eful obs]vation1 ! be/ mode ( imp>t+ x to !m4 ,9 fact1 ,i h made x a matt] ( c>eful /udy1 n only to r5d] my subject pla91 b also pleas+ & unobjectionable2 s t ! mo/ unreflect+ %all feel an int]e/ 9 x1 & ! mo/ s5sitive be able to /udy x )\t pa9 or repugnance4 ,! object ( ?is book is n to make e woman a pr(essional ,midwife1 nor to induce h] to disp5se ) prop] assi/ance 9 h] h\r ( difficulty1 b simply to expla9 to h] ! nature & mann] ( *ild-bir?1 & ! means by :i* %e is to be assi/$4 ,?is w disabuse h] m9d ( _m p]nici\s errors--make h] m pati5t "u h] unavoidable difficulties & pa9s--m docile to :at is requir$ ( h]1 s9ce %e w see ! reason = x--& x w also enable h] to avoid mu* positive suff]+1 & to r5d] great help1 9 _m cases1 to h] att5dant4--,9 a case ( em]g5cy also1 :5 o!r assi/ance _c be procur$ "t en\gh1 or n at all1 x w tea* "o female h[ to assi/ ano!r 9 deliv]y1 :i* e "o ( !m ought to be able to d4 ,v (t5 x happ5s t a case ( ?is k9d occurs1 & ! ,females ar\nd1 in/ead ( kn[+ h[ to help ! suff]]1 are utt]ly useless1 & ev5 make h] worse by _! evid5t t]ror & ignorance4 ,i h kn[n wom5 die 9 *ild-b$1 = want ( ! mo/ trivial assi/ance1 :i* ev5 a *ild c\ld und]/& h[ to give1 ?\gh !re 7 eld]ly females1 mo!rs !mselves1 ar\nd h]2 b !y knew n :at to d4 ,su* a /ate ( ?+s is disgraceful to ! boa/$ intellig5ce ( ! age1 & %\ld be rem$i$ z spe$ily z possible4 ,e ,adult female1 or at lea/ e m>ri$ "o1 %\ld be in/ruct$ 9 ^! ?+s1 s t %e may "k h[ to regulate h] own conduct & h[ to r5d] useful assi/ance to o!rs 9 case ( ne$4 ,ill in=m$ wom5 are g5]ally z appreh5sive ( dang] z !y are incapable ( avoid+ x2 & z reg>dless ( prop] advice z !y are ignorant ( ! reason = x4 ,! "t1 ,i tru/1 is fa/ com+1 :5 e female w be taught1 z ( p>am\nt importance1 ev]y?+ :i* conc]ns h] own welf>e2 & :5 ignorance w no long] be consid]$ necess>y to propriety & virtue1 nor useful k incompatible ) ! mo/ ref9$ delicacy & ! /ricte/ morality4 ,i consid] x my duty to assi/ 9 ha/5+ t "t1 & ,i feel mu* pleas$ t my previ\s ef=ts h be5 s mu* comm5d$4 ,?is book ,i hope w be equally acceptable1 &1 if possible1 m useful1 ?an ^? :i* h prec$$ x4 ,f4 ,,hollick1 ,m4 ,d41 ,new ,york ,,introduction4 ,p>turition1 or ! expulsion ( ! p]fectly =m$ human be+ f ! body ( its "m1 is a mo/ wond]ful natural function1 = ! complete & safe p]=mance ( :i* at ! prop] "t1 e requisite is f\nd to exi/4 ,not)/&+ ! contr>y exp]i5ce ( society1 z x n[ exi/s1 x is well kn[n t extreme suff]+1 & dang] to life1 are n necess>y nor ev5 probable accompanim5ts to *ild-bir?2 = x is inv>iably f\nd1 :5 females live "u circum/ances fav\rable to _! full physical developm5t & heal?1 t x occurs spe$ily1 & ) little or no difficulty or pa94 ,num]\s pro(s ( ?is c\ld be giv5 9 acc\nts ( ! ,indians1 & o!r unciviliz$ females1 among :om p>turition is reg>d$ z an ord9>y occurr5ce1 = :i* no prep>ation ne$ be made1 & ab\t :i* no appreh5sion ne$ be felt2 su* facts1 h[ev]1 are s well kn[n t !y only ne$ be ref]r$ to "h4 ,z ! organization & requirem5ts ( society *anges1 by ! adoption ( :at is call$ civilization1 ! condition ( woman becomes v diff]5t to :at x 0 orig9ally4 ,9 _m respects h] lot is mu* meliorat$1 & %e has great reason to be pleas$ ) ! *ange1 b 9 o!r respects %e has n be5 s =tunate4 ,"o great evil result+ f h] alt]$ position is1 a neglect ( prop] physical education :ile "y1 & ( ! v>i\s requirem5ts = bodily heal? 9 aft] life4 ,9 consequ5ce ( :i* %e becomes con/itutionally weak]1 & m s5sitive to v>i\s injuri\s influ5ces1 :i* %e possesses dim9i%$ p[]s to )/&4 ,?is evil increases 9 proportion z civilization advances1 until at la/ females become s imp]fectly organiz$1 & s en]vat$1 t !y are utt]ly unable to fulfil ! duties assign$ !m1 & !y ei!r die prematurely1 or pass _! :ole lives 9 suff]+ & compla9t4 ,s univ]sally is ?is ! case at ! pres5t "t1 p>ticul>ly 9 cities1 t ! exempt are v r>e exceptions to a rule mo/ lam5tably g5]al4 ,un=tunately1 cu/om & false notions h giv5 ?is melan*oly /ate ! /amp ( propriety1 & ?r[n ar\nd x ! *>m ( fa%ion4 ,! suff]+ invalid is call$ int]e/+1 & ! pale fac$ debilitat$ creature1 sc>cely able to crawl ab\t1 is /yl$ g5teel1 :ile robu/ heal? & physical capability is t]m$ co>s5ess & vulg>ity4 ,s infatuat$1 & weak m9d$1 h females be5 made on ?is po9t1 t ,i h actually kn[n "s ( !m q *agr9$ because p c\ld see !y 7 well & /rong2 & ,i h kn[n o!rs q al>m$ = fe> t !y %\ld look s4 ,a %ort "t ago ,i knew a lady :o1 by ! adoption ( a prop] c\rse ( tra9+ & treatm5t1 pass$ ?r\gh h] conf9em5t s quickly1 & ) s little exhau/ion1 t %e 0 up & travell+ ab\t 9 ?ree days aft]1 n only )\t inconv5i5ce b ) pleasure & advantage4 ,b :at 0 ! impression made on h] female fri5ds by su* a spe$y recov]y8 did !y feel q pleas$ at x1 & desir\s t all o!rs %\ld be equally =tunate8 ,no2 b q ! contr>y6 ,%e 0 actually ?\ght des]v+ ( repreh5sion1 & 0 /igmatiz$ z vulg> 9 ! extreme4 ,"o p]son ev5 made ! rem>k1 t %e mu/ be a v common p]son1 & no ,lady6 ,n[ :at a pitiable /ate ( ignorance1 & m5tal imbecility1 ^! females mu/ be 91 to be actually pr\d ( _! infirmities2 & yet !y are b l ! majority ( _! sex4 ,if !y 7 n s un=tunate 9 n kn[+ _! true int]e/s1 !y w\ld be highly culpable1 b z x is !y are truly des]v+ ( our pity4 ,x mu/ be admitt$1 h[ev]1 t ?\gh civilization has1 s f>1 entail$ ^! evils on wom51 x has also done mu* to alleviate !m4 ,_m diseases are b5eficially modifi$1 & "s are ev5 cur$1 by m$ical treatm5t2 surgical sci5ce has also atta9$ a high po9t ( p]fection2 & ! difficulties att5dant on *ild bir? are ov]come to a great ext5t by ob/etrical skill4 ,b not)/&+ all ?is alleviation1 ^! evils are /ill deplorably great4 ,! utmo/ sci5tific skill to :i* society c ev] atta91 w d b little t[>ds effectually reliev+ human suff]+1 & remov+ disease1 s long z x is entirely devot$ to ! m]e art ( cur+ & palliat+ z x *iefly is n[4 ,our k ( ! human sy/em1 & ( ! causes :i* produce 9 x disease & det]ioration1 mu/ be univ]sally dissem9at$1 s t ! :ole p may see h[ ^! evils arise1 & h[ !y %\ld live1 & conduct !mselves1 s z to avoid !m altoge!r6 or1 9 o!r words1 sci5ce %\ld tea* u h[ to prev5t disease & suff]+1 in/ead ( m]ely h[ to alleviate !m4 ,ev5tually ?is w be done1 & our females w !n pass ?r\gh _! travail z easily z _! savage si/]s d n[4 ,let u hope t "t w soon come2 & let e "o e/eem x 8 duty1 :o possesses ! ability1 to ha/5 its com+1 by do+ all he c to spread ! necess>y in=mation to ^? :o ne$ x4 ,! happy exemption f difficulty & suff]+ :i* females enjoy 9 m uncultivat$ /ates ( society1 & :i* we believe !y w ultimately enjoy univ]sally1 does n h[ev] obviate ! necessity = assi/ance n[1 9 our /ate ( society1 & we h !re=e to expla9 h[ x c be/ be r5d]$4 ,x has (t5 be5 a matt] ( dispute1 bo? ) m$ical m5 & ) morali/s1 :e!r ,m5 or ,wom5 ought to assi/ 9 *ild-bir?4 ,! discussion has call$ =? a great deal ( declamation1 b v little has be5 said to ! po9t on ei!r side4 ,x appe>s to me1 h[ev]1 t ! "q may be v easily settl$1 if x be rightly consid]$4 ,! fir/ requisite1 & ! mo/ indisp5sable1 9 ^? :o are to assi/ 9 *ild bir? is1 t !y %\ld "k h[ to assi/4 ,?is is p>am\nt to e ?+ else4 ,n[1 if females really did "k :at to d 9 su* cases1 & 7 fully compet5t to d x1 ,i ?9k !re is no "q b !y w\ld be ! be/ assi/ants1 to say no?+ ( _! be+ ! mo/ prop]4 ,!re are _m ?+s exp]i5c$ by females 9 su* situations1 :i* c nev] be und]/ood by a man at all1 ?\gh !y are readily appreciat$ by "o ( _! own sex1 p>ticul>ly if %e has be5 a "m h]self4 ,) ea* o!r also !re w\ld be less disposition & less occasion = res]ve 9 delicate communications1 & less repugnance to necess>y exam9ation or manipulation1 :i* c\ld !re=e be m effici5tly practis$4 ,9 %ort1 if wom5 7 und\bt$ly equally compet5t ) m5 9 ?is art1 & full confid5ce 0 felt 9 !m by _! own sex1 ,i ?9k x is evid5t !y w\ld1 9 e respect1 be ! mo/ fitt+ practition]s1 & ,i h no d\bt b !y w\ld be pref]r$4 ,! "q simply arises !n1 :e!r !y are s compet5t8 ,& e "o able to judge1 :o speaks hone/ly1 mu/ admit t v few1 if any ( !m really are s4 ,x has n be5 possible = !m to acquire ! requisite in=mation1 nor to pursue ! necess>y inve/igations1 & !re=e we _c expect t !y c be equal to ^? :o h4 ,!re are "s wom5 ,i "k1 :o h be5 c>eful obs]v]s1 & :o h _h great exp]i5ce1 t c r5d] all ne$ful help 9 mo/ cases1 b ev5 !y are apt to meet ) difficulties1 :i* require m skill ?an !y possess to ov]come2 !re=e v few l to dep5d ^u !m altoge!r4 ,x is naturally argu$ t1 z a physician may be ne$$1 x is bett] to h him at fir/1 & s be ready = e cont+5cy4 ,t females c make compet5t ,acc\*eurs is prov$ by num]\s well kn[n in/ances1 among :i* ,i ne$ only ref] to ,,madame ,,boiv91 & ,,madame ,,la*apelle1 bo? ( :om1 z practition]s & z au?ors1 /& 9 ! v highe/ rank4 ,^! ladies are ref]r$ to z au?orities1 & _! works are quot$ by ! mo/ em95t ,pr(essors ( ! day2 9 fact1 on _m po9ts1 !y h surpass$ all competitors4 ,fur!r on 9 our "w we %all h occasion to ref] to _! lab\rs1 ! value ( :i* w !n be se54 ,x is !re=e evid5t t females c (ficiate1 if !y are prop]ly in/ruct$1 :i* ,i ?9k !y ought to be1 indep5d5t ( ! reasons already giv54 ,t !y w ev5tually be compet5t ,i h no d\bt1 & ,i am pr\d to ?r[ my mite ( in/ruction 9 _! way to assi/ 9 mak+ !m s4 ,9 reg>d to ! all$g$ immorality result+ f ! pres5t sy/em ( m5 act+ z ,midwives1 !re is mu* exagg]ation1 & mu* unnecess>y al>m4 ,t x is1 9 "s respects1 indelicate1 & only to be ju/ifi$ by necessity is true1 b !re is no f\ndation = say+1 z "s d1 t x leads to wide spread ,pr(ligacy & ,adult]y4 ,i %\ld pref] to see females always able to assi/ ea* o!r2 b ,i _c nev]!less consid] ! pres5t sy/em a necess>y cause ( lic5ti\sness4 ,t females 7 always dep5d$ ^u 9 old times1 & are n[ 9 c]ta9 rude communities1 is true1 b t is no reason :y !y %\ld be dep5d$ ^u "u all circum/ances4 ,9 our pres5t highly artificial /ate !re are num]\s causes at "w1 & num]\s difficulties exp]i5c$1 unkn[n to m primitive times & conditions1 & we !re=e require great] skill & m ext5sive res\rces4 ,females h 9 fact become m 9 want ( help1 & less able to assi/4 ,at :at "t1 & 9 :at c\ntry1 m5 fir/ began to assi/ 9 cases ( lab\r is n record$4 ,!y h done s h[ev] = a long "t1 mu* long] ?an mo/ p suppose4 ,9 ! "t ( ,hippocrates1 call$ ! ,fa!r ( ,m$ic9e1 :o liv$ m ?an f\r hundr$ ye>s be=e ,*ri/1 x appe>s t physicians 7 commonly resort$ to4 ,9 8 writ+s we f9d cases describ$1 :i* %[ t he 0 well acqua9t$ ) ! process ( p>turition1 & ev5 ) "s ( ! mo/ difficult op]ations n[ practis$4 ,! ,israelites appe> to h employ$ wom51 z mo/ ea/]n nations 9 fact d at ! pres5t day4 ,midwif]y1 h[ev]1 did n attract mu* att5tion1 nor make mu* progress1 till ab\t ! middle ( ! sixte5? c5tury1 s9ce :5 x has be5 /udi$ & practis$ by ! mo/ em95t ,physicians & ,surgeons1 & has arriv$ at great p]fection4 ,_m new discov]ies h be5 made lately1 :i* enable u to facilitate deliv]y & ease its pa9s1 s t x is n[ robb$ ( _m ( its =m] t]rors & dang]s4 ,"s ( ^! discov]ies are ( easy application1 & promise mu* future good2 ,i %all c>efully describe !m all1 9 ! foll[+ pages4 ,f4 ,h4 ,,illu/rations4 ,,frontispiece1 ,eve 9 ! ,g>d5 ( ,ed54 ,,plate ,i4--,lat]al ,section1 ( ! ,female ,pelvis1 to %[ ! position ( ! ,organs 9 _! natural /ate1 #e4 ,,plate ,,ii4--,front ,view ( ! ,female ,pelvis1 ) ! ,ext]nal ,walls remov$1 #i4 ,,plate ,,iii4--,! ,ut]us & its ,app5dages1 #ac4 ,,plate ,,iv4--,v]tical ,section ( ! ,womb & ,vag9a1 natural size1 #ah4 ,,plate ,v4--,! ,muscul> ,fibres ( ! ,womb1 #bc4 ,,plate ,,vi4--,muscul> ,fibres ( ! ,womb1 #bg4 ,,plate ,,vii4--,bones ( ! ,pelvis1 #cc4 ,,plate ,,vii4-a4--,male ,pelvis1 to %[ ! diff]5ce 9 /ructure1 #ce4 ,,plate ,,viii4--,section ( ! ,pelvis1 #cg4 ,,plate ,,ix4--,diamet]s ( ! ,upp] ,/rait1 #da4 ,,plate ,x4--,! ,bones ( ! ,pelvis view$ f bel[1 #de4 ,,plate ,,xi4--,! ,direction ( ! ,pelvis1 #di4 ,,plate ,,xii4--,section ( ! ,ut]us1 ) ! ,ovum & app5dages1 at ab\t "o mon?1 #fe4 ,,plate ,,xii4-a4--,female ,brea/1 #gg4 ,,plate ,,xiii4--,brea/ ab\t ! ,f\r? ,mon?1 #ij4 ,,plate ,,xiv4--,womb1 at ab\t ! ?ird1 sev5? & n9? mon?s1 #ii4 ,,plate ,,xv4--,primip>a1 or ! ,fir/ ,pregnancy4--,woman :o has borne *ildr5 be=e1 #aja4 ,,plate ,,xvi4--,mode ( p]=m+ ! ,ballotm5t1 to detect ,pregnancy1 #ajg4 ,,plate ,,xvii4--,at ! end ( ! ,fif? ,mon?1 #aaa4 ,,plate ,,xviii4--,! neck ( ! ,womb 9 a fir/ pregnancy1 & 9 a female :o has borne *ildr5 be=e1 at ! end ( ! sev5? mon?1 #aaf4 ,,plate ,,xix4--,ftus 9 ! mo/ usual position1 #aba4 ,,plate ,,xx4--,ftus 9 ! next mo/ frequ5t position1 #abe4 ,,plate ,,xxi4--,pres5tation ( ! ,pelvis1 or bree*1 #abi4 ,,plate ,,xxii4--,! position ( ,tw9s1 z mo/ usually obs]v$1 #acc4 ,,plate ,,xxiii4--,end ( ! ,n9? ,mon?1 #ace4 ,,plate ,,xxiv4--,! ,ftal head1 #adg4 ,,plate ,,xxv4--,diamet]s ( ! ,head1 #aea4 ,,plate ,,xxvi4--,attitude ( ! ,ftus1 #aec4 ,,plate ,,xxvii4--,head j ent]+ ! upp] /rait1 #agc4 ,,plate ,,xxviii4--,head l[] 9 ! ,pelvis1 #agg4 ,,plate ,,xxix4--,head beg9n+ to ,rotate1 #aha4 ,,plate ,,xxx4--,rotation ( ! ,head1 #ahc4 ,,plate ,,xxxi4--,head 9 ! "r ant]ior occipito iliac position1 #ahg4 ,,plate ,,xxxii4--,deliv]y 9 a bree* pres5tation1 #aid4 ,,plate ,,xxxiii4--,ant]ior po/]ior position ( ! head1 #aie4 ,,plate ,,xxxiv4--,! *9 j pass$ 9 pres5tation ( ! face1 #bjj4 ,,plate ,,xxxv4--,pres5tation ( "r %\ld]1 #bje4 ,,plate ,,xxxvi4--,desc5t ( %\ld]1 #bjf4 ,,plate ,,xxxvii4--,desc5t ( %\ld]1 #bjg4 ,,plate ,,xxxviii4--,trunk desc5d$1 #bjh4 ,,plate ,,xxxviii4-a4--,/ate ( ! p>ts at beg9n+ ( labor1 #bae4 ,,plate ,,xxxix4--,mann] ( support+ ! p]9eum1 #bcc4 ,,plate ,,xl4--,/&>d =m ( ,pelvis1 #bga4 ,,plate ,,xli4--,mascul9e ,pelvis1 #bga4 ,,plates ,,xlii1 ,,xliii1 ,,xliv1 ,,xlv4--,de=m$ ,pelves1 #bge-bgi4 ,,plate ,,xlvi4--,head fix$ 9 a n>r[ pelvis1 #bhb4 ,,plate ,,xlvii4--,case ( ,tumor1 #bhi4 ,,plate ,,xlviii4--,case ( ,polypus1 #bic4 ,,plate ,,xlix4--,limbs cut (f by ! ,cord1 #cja4 ,,plate ,l4--,=ceps1 #cdf4 ,,plate ,,li4--,head extract$ by ,=ceps1 #cec4 ,,table ,,( ,,cont5ts4 ,,"p ,i4--,,midwif]y4 ,section ,i4 ,,position ,,& ,,uses ,,( ,,! ,,female ,,organs4 ,page ,,*apt] ,i4--,position ( ! ,organs & ,p>ts1 #ac ,int]nal ,organs1 #ad ,ext]nal ,organs1 #af ,,*apt] ,,ii4--,/ructure ( ! ,pr9cipal ,organs & ,p>ts1 #ah ,! ,womb1 #ai ,! ,vag9a4--,vulva4--,p]9eum1 #bi ,! ,pelvis1 #cj ,,*apt] ,,iii4--,functions ( ! ,pr9cipal ,female ,organs1 #ej ,! ,womb1 #ej ,! ,ov>ies4--,m5/ruation1 #ea ,conception1 #ed ,,*apt] ,,iv4--,ftal ,developm5t1 #eg ,ftal ,nutrition1 #fg ,peculi>ities ( ! ,ftal ,circulation1 #gj ,! ,brea/1 #gd ,section ,,ii4 ,,signs ,,( ,,pregnancy1 ,,& ,,! ,,means ,,( ,,detect+ ,,x2 ,,its ,,duration1 ,,& ,,! ,,p]iod ,,at ,,:i* ,,! ,f,,tus ,,c ,,live4 ,,*apt] ,v4--,presumptive ,signs1 #hc ,probable ,signs1 #id ,,*apt] ,,vi4--,duration ( ,pregnancy1 #acg ,,*apt] ,,vii4--,p]iod :5 ! ,*ild c live1 #adb ,section ,,iii4 ,,! ,,=m1 ,,size ,,& ,,position ,,( ,,! ,f,,tus1 ,,& ,,its ,,app5dages1 ,,at ,,full ,,t]m4 ,,*apt] ,,viii4--,=m & ,size ( ! ,body1 #add ,size & ,=m ( ! ,head1 #add ,attitude ( ! ,ftus at ,full t]m1 #aeb ,,*apt] ,,ix4--,! ,app5dages ( ! ,ftus at t]m1 #aee ,,*apt] ,,ix4--,! ,membranes1 #aee ,! ,plac5ta1 #aef ,! ,umbilical ,cord1 #aeg ,section ,,iv4 ,,! ,,me*anism ,,( ,,deliv]y ,,9 ,,all ,,! ,,diff]5t ,,pres5tations ,,& ,,positions ,,( ,,! ,f,,tus4 ,,*apt] ,x4--,pres5tations1 #afj ,positions1 #afa ,mode ( asc]ta9+ ! ,pres5tation & ,position1 #afd ,,*apt] ,,xi4--,! ,me*anism ( ,deliv]y1 9 a ,pres5tation ( ! ,head1 #agj ,! ,left ,ant]ior ,occipito ,iliac ,position1 #agj ,me*anism ( ,deliv]y 9 all o!r ,positions ( ! ,head1 #ahe ,g5]al ,rem>ks on ! ,diff]5t ,positions ( ! ,head1 #ahi ,,*apt] ,,xii4--,me*anism ( ,deliv]y 9 ,pres5tations ( ! ,l[] ,extremities1 #aia ,deliv]y 9 a ,bree* ,pres5tation 9 ! left ,ant]ior ,sacro-,iliac ,position1 #aib ,deliv]y by ! ,bree* 9 ! ,"r ,po/]ior ,sacro ,iliac ,position1 #aif ,deliv]y by ! ,bree* 9 ! ,full ,po/]ior1 or ,sacro ,sacral ,position1 #aif ,g5]al ,rem>ks on ! ,pres5tation ( ! ,l[] ,extremities1 #aig ,,*apt] ,,xiii4--,me*anism ( ,deliv]y 9 ,pres5tations ( ! ,face1 #aii ,deliv]y 9 ! ,"r ,po/]ior ,m5to ,iliac ,position ( ! ,face1 #aii ,deliv]y 9 o!r positions ( ! face1 #bjj ,,*apt] ,,xiv4--,me*anism ( ,deliv]y 9 ,pres5tations ( ! ,trunk1 #bjc ,me*anism ( ,deliv]y 9 ,pres5tations ( ! ,trunk by ,spontane\s ,evolution1 #bjd ,section ,v4 ,,! ,,physiology ,,( ,,spontane\s ,,deliv]y1 ,,or ,,*ildbir?1 ,,& ,,! ,,mann] ,,( ,,conduct+ ,a ,,natural ,,labor4 ,,*apt] ,,xv4--,( ,deliv]y 9 ,g5]al4--,diff]5t ,k9ds ( ,deliv]y4--,causes ( ,labor1 #baa ,signs ( ,deliv]y1 #bab ,,*apt] ,,xvi4--,! ,progress1 ,ph5om5a1 & ,duration ( ,natural ,labor4--,fir/ ,p]iod1 #bad ,second ,p]iod1 #baf ,duration ( ,natural ,labor1 #bbj ,,*apt] ,,xvii4--,! ,conduct or ,managem5t ( a ,natural ,labor4--,prelim9>y ,requisites1 #bbb ,prelim9>y ,proce$+s1 #bbc ,prep>ations = ! ,deliv]y1 #bbf ,att5dance aft] ! ,prep>ations are made1 & dur+ ! ,deliv]y1 #bbi ,,*apt] ,,xvii4--,deliv]y ( ! ,aft] ,bir?1 or ,plac5ta & ,membranes1 #bci ,att5tions to ! ,female aft] ! ,deliv]y ( ! ,aft] ,bir?1 #bdb ,att5tions to ! ,*ild1 #bdc ,accid5ts :i* may happ51 #bdf ,subsequ5t ,att5tions to ,"m & ,*ild1 #bdi ,conclud+ ,rem>ks1 #bee ,section ,,vi4 ,,protract$ ,,& ,,difficult ,,labors4 ,,*apt] ,,xviii4--,! ,causes & ,consequ5ces ( ,prolong$ ,labor to bo? ,"m & ,*ild1 #bei ,! ,consequ5ces ( ,prolong$ ,labor1 #bei ,,*apt] ,,xix4--,causes connect$ ) ! ,"m :i* may imp$e labor1 or make x difficult1 #bfj ,in]tia1 or ,want ( suffici5tly ,p[]ful ,contraction 9 ! ,womb1 #bfj ,rigidity ( ! ,m\? ( ! ,womb1 ,vag9a & ,vulva1 #bfd ,obliquities ( ! ,womb1 #bff ,prolapsus ,ut]i4--,smallness or ,de=mity ( ! ,pelvis1 #bfg ,tumors 9 ! ,pelvis1 #bhf ,tumors ext]nally4--,ob/ructions 9 ! ,vag9a1 #bie ,,*apt] ,,xx4--,causes connect$ ) ! *ild1 or *ildr51 :i* may imp$e deliv]y4 #big ,procid5tia ( ! ,umbilical ,cord1 #big ,%ortness ( ! ,cord1 #cjj ,desc5t ( o!r p>ts ) ! head1 #cja ,tw9s & ,triplets1 #cjb ,excessive size ( ! ,ftus1 or ! diseas$ developm5t ( c]ta9 p>ts1 #cjd ,ossification ( ! ,head1 #cje ,v>i\s pres5tations & positions ( ! ,ftus1 #cjf ,pres5tations ( ! ,l[] ,extremities1 #cjg ,pres5tations ( ! ,%\ld]1 #caa ,section ,,vii4 ,,accid5ts ,,dur+ ,,labor ,,:i* ,,may ,,compromise ,,! ,,"m',s ,,life4 ,,*apt] ,,xxi4--,ut]9e ,hemorrhage1 or ,flood+1 dur+ ,labor1 #cae ,,*apt] ,,xxii4--,eclampsia1 or ,convulsions dur+ ,labor1 #ccf ,,*apt] ,,xxiii4--,rupture ( ! ,womb or ,vag9a1 #cda ,section ,,viii4 ,,op]ations ,,) ,,! ,,h& ,,& ,,) ,,in/rum5ts4 ,,*apt] ,,xxiv4--,op]ations ) ,in/rum5ts4--,! ,=ceps1 #cde ,o!r ,in/rum5ts1 #cee ,,*apt] ,,xxv4--,op]ations ) ! ,h&4--,turn+1 #ceg ,,"p ,,ii4 ,,! ,,diseases ,,( ,,wom5 ,,dur+ ,,pregnancy1 ,,& ,,9 ,,*ildb$4 ,section ,,ix4 ,,! ,,diseases ,,( ,,pregnancy4 ,,*apt] ,,xxvi4--,sympa!tic ,diseases occurr+ dur+ ,pregnancy4--,sickness & ,vomit+1 #cff ,ptyalism1 or ,excessive ,salivation1 #cfi ,odontalgia1 or ,too?a*e1 #cfi ,d]angem5ts ( ! ,appetite1 #cga ,pyrosis4--,dysphagia1 #cgd ,ga/ralgia1 #cge ,con/ipation1 #cgg ,dys5t]y & ,di>rha1 #cgh ,dyspna1 or ,difficulty ( ,brea?+1 #chj ,c\gh1 #cha ,palpitation ( ! ,he>t1 #chc ,syncope1 or ,fa9t+1 #chd ,heada*e & ,dizz9ess 9 ! ,head1 #chf ,insomnia1 or ,sleeplessness1 #chh ,tempor>y ,affection ( ! ,sight1 ,he>+1 & ,smell1 #chi ,disord]$ ,judgm5t1 ,incl9ations1 & ,prop5sities1 #cia ,hmoptysis1 ,hmatemesis & ,epi/axis1 #cic ,v>icose ,ve9s1 #cie ,hmorrhoids1 or ,piles1 #cig dema1 or ,wat]y ,swell+s1 #cii ,hydrorrhea1 or ,pr(use ,dis*>ge ( ,wat]1 #djj ,pu/ules1 & ,muc\s ,dis*>ges1 #djj ,d]angem5ts ( ! ,ur9>y ,organs1 #dja ,cramps4--,pruritus1 or ,it*+ ( ! ,ext]nal ,p>ts1 #djc ,,*apt] ,,xxvii4--,idiopa?ic1 or ,prim>y ,diseases ,incid5t to ,pregnancy4--,flood+1 #djf ,abortion1 or ,misc>riage1 #dji ,section ,x4 ,,! ,,diseases ,,( ,,wom5 ,,9 ,,*ildb$1 ,,aft] ,,ly+ ,,94 ,,*apt] ,,xxviii4--,diseases ( ,*ildb$4--,pu]p]al ,fev]1 or ,*ildb$ ,fev]1 #dbj ,affections ( ! ,brea/ occurr+ aft] ,pregnancy1 #dcj ,bron*ocele1 or swell+ 9 ! ,?roat1 #dch ,phlegmasia ,alba ,dol5s1 or ,milk ,leg1 #dci ,tr\ble ) ! ,ur9e1 #dda ,,app5dix4 ,,on ,,prev5t+ ,,pa9 ,,9 ,,*ildbir?1 #ddc ,,"p ,i4 ,,midwif]y4 ,,plate ,i4 ,lat]al ,section1 or side view ( ! ,female ,pelvis1 to %[ ! position ( ! ,organs4 ,a4 ,! ,bladd]4 ,b4 ,! ,womb4 ,c4 ,! ,vag9a4 ,d4 ,! ,rectum4 e4 ,! ,"r ,ov>y4 f4 ,! ,"r ,fallopian ,tube4 g4 ,! ,os ,t9c1 or ,m\? ( ! ,womb4 h4 ,! ,meatus ,ur9>ius1 or ,m\? ( ! ,bladd]4 i4 i4 ,! ,small ,inte/9es4 j4 j4 ,! ,back ,bone4 k4 ,! ,pubic or ,front ,bone4 l4 ,! ,"r ,ext]nal ,lip1 or ,labium4 m4 ,! ,"r ,int]nal ,lip1 or ,nymph4 n4 ,! ,hym54 o4 ,! ,op5+ ?r\gh ! ,hym54 q4 ,! ,p]9eum4 p4 ,! ,clitoris4 7,?is ( c\rse %[s ! half ( all ! s+le ,organs & ! "r "o only ( ^? t are d\ble47 ,illu/ration3 ,plate ,i4 ,lat]al ,section1 or side view ( ! ,female ,pelvis1 to %[ ! position ( ! ,organs 9 _! natural /ate4 ,,plate ,,ii4 ,front ,view ( ! ,female ,pelvis1 ) ! ,ext]nal ,walls remov$4 ,a4 ,! ,bladd]4 ,b4 ,! ,womb4 ,d4 ,! ,rectum4 e4 e4 ,! ,ov>ies4 f4 f4 ,! ,fallopian ,tubes4 i4 i4 ,! ,small ,inte/9es4 r4 r4 ,! ,r\nd ,ligam5ts4 ,illu/ration3 ,plate ,,ii4 ,front ,view ( ! ,female ,pelvis1 ) ! ,ext]nal ,walls remov$4 ,,midwif]y4 ,,section ,i4 ,,position1 ,,/ructure1 ,,& ,,functions ,,( ,,! ,,organs ,,& ,,p>ts ,,( ,,! ,,female ,,body ,,conc]n$ ,,9 ,,g5]ation ,,& ,,p>turition4 ,to und]/& ! subjects treat$ ^u 9 ! pres5t "w1 x is necess>y to h at lea/ a g5]al acqua9tance ) ! /ructure1 position1 & special uses ( ! pr9cipal organs & p>ts ( ! female sy/em4 ,a complete acqua9tance1 s f> z our k ext5ds1 w\ld be advisable1 b is n absolutely requir$1 & c\ld n ) conv5i5ce be giv5 "h4 ,! foll[+ explanations !re=e1 *iefly tak5 f my book on ! ,diseases ( ,woman1 are m]ely suffici5t = ! pres5t occasion1 & = ref]5ce--full details be+ res]v$ = a sep>ate & complete "w1 n[ prep>+1 on ! ,philosophy & ,physiology ( ! ,reproductive ,functions4 ,,*apt] ,i4 ,,position ,,( ,,! ,,organs ,,& ,,p>ts4 ,plate ,i1 repres5ts "o half ( ! ,female body1 suppos+ x to be cut d[n ! middle1 & gives an accurate repres5tation ( ! relative position ( ! diff]5t organs4 ,plate ,,ii1 repres5ts a front view ( ! ,female body1 ) ! ext]nal walls remov$1 to %[ ! relative position ( ! organs4 ,plate ,,iii1 repres5ts ! ut]us & its app5dages remov$ f ! body1 s t _! connections ) ea* o!r may be se54 ,illu/ration3 ,,plate ,,iii4 ,b4 ,! ,womb4--,c4 ,! ,vag9a4--e4 e4 ,! ,ov>ies4--f4 f4 ,! ,fallopian ,tubes4--s4 ,! left broad ,ligam5t1 ! "r "o be+ remov$4--r4 r4 ,! ,r\nd ,ligam5ts4--g4 ,! ,os ,t9c1 or ,m\? ( ! ,womb4 ,,int]nal ,,organs4 ,! ,ov>ies4--7e4 e4 ,plates ,i1 ,,ii & ,,iii47--,^! are two oval %ap$ bodies1 ab\t ! size ( an almond nut1 plac$ "o on ea* side1 ne>ly 9 ! gro94 ,!y conta9 a numb] ( small r\nd gra9s1 or granules1 call$ ! ov1 or eggs1 :i* are ! g]ms ( human be+s1 z ! eggs ( birds are ( _! p>ticul> k9d4 ,!y are connect$ ) ! ut]us by two %ort arms1 or prolongations1 & are enclos$ 9 ! folds ( ! broad ligam5ts4 ,! ,fallopian ,tubes4--7f4 f4 ,plates ,i & ,,ii47--,^! are two ,tubes1 "o on ea* side1 b5ea? ! ,ov>ies1 & ext5d+ f>!r4 ,ea* ( !m has a small passage :i* op5s into ! ut]us at "o end1 & opposite ! ,ov>ies at ! o!r4 ,_! use is to convey ! impregnat+ pr9ciple to ! ,ov>ies1 at ! "t ( conception1 & to convey ! ,ov1 :5 impregnat$1 to ! int]ior ( ! ,womb4 ,! ,ut]us1 or ,womb4--7,b4 ,plates ,i1 ,,ii47--,?is is a holl[ organ1 plac$ betwe5 ! ,bladd]1 :i* is 9 front1 & ! ,rectum1 :i* is beh9d4 ,x is connect$ ) ! ,vag9a1 & op5s into x by ! small orifice call$ ! m\? ( ! womb4--7g4 ,plate ,i47--,! ,ut]us is ! organ :i* receives ! impregnat$ ovum1 & 9 :i* x is develop$ into ! human be+4 ,x is connect$ ) ! ,ov>ies by ! ,fallopian ,tubes1 & ) ! ,vag9a by ! ,os ,t9c1 & is reta9$ 9 its situation p>tly by its connections ) o!r organs1 & p>tly by ! r\nd & broad ligam5ts4 ,! ,vag9a4--7,c4 ,plate ,i47--,?is is ! passage :i* leads to ! ,womb f ! ext]nal op5+4 ,! ,os ,t9c1 or ,m\? ( ! ,womb4--7g4 ,plates ,i & ,,ii47--,?is is ! small orifice1 op5+ into ! ,vag9a1 by :i* communication is e/abli%$ ) ! ,ut]us f )\t4 ,! ,bladd]4--7,a4 ,plates ,i & ,,ii47--,! ,receptacle ( ! ,ur9e4 ,x is plac$ imm$iately 9 front1 on ! pubic bone1 ! ,ut]us ly+ ne>ly on ! top ( x4 ,! ,rectum1 or ,t]m9ation ( ! l>ge ,inte/9e4 7,d4 ,plates ,i & ,,ii47--,?is is situat$ beh9d ! ,vag9a1 & betwe5 x & ! back bone4 ,! ,broad ,ligam5ts4--7s4 ,plate ,,iii47--,^! are two broad folds ( membrane1 :i* s]ve p>tly to enclose ! ,fallopian ,tubes & ,ov>ies1 & p>tly to su/a9 ! ,womb 9 its place4 ,!y adh]e to ! ,ut]us & to ! walls ( ! ,pelvis4 ,! ,r\nd ,ligam5ts4--7r4 r4 ,plates ,,ii & ,,iii47 ,^! two cords arise f ea* upp] corn] ( ! ,ut]us1 & curv+ d[nw>ds are fix$ by _! o!r extremities to ! pubic bone4 ,!y are p>tly enclos$ 9 ! ,broad ,ligam5ts4 ,!y assi/ 9 su/a9+ ! ,ut]us 9 its position1 & probably also !y /r5g!n ! ,broad ,ligam5ts & prev5t _! rupture :5 ! /ra9 ^u !m is too great4 ,fimbri ( ! ,fallopian ,tubes4--7t4 t4 ,plate ,,iii47 ,^! ,fimbri are l ,t5tacul1 or f+]s1 spr++ f ! extreme ends ( ! ,tubes1 & float+ loosely 9 ! cavity ( ! pelvis4 ,_! use is to clasp hold ( ! ov>ies at ! "t ( conception1 s t ! fecundat+ pr9ciple c rea* !m1 & also to take up ! ov :5 impregnat$1 & convey !m into ! ,tube1 d[n :i* !y pass into ! ,womb4 ,,ext]nal ,,organs4 ,! ,ext]nal ,lips4--7l4 ,plate ,i47--,^! are commonly t]m$ ! ,labi ext]na4 ,!y are two broad folds ( membran\s & adipose sub/ance1 =m+ ! portals to ! ,vulva1 or entrance to ! ,vag9a4 ,! ,int]nal ,lips4--7m4 ,plate ,i47--,^! are two small] labi1 sometimes call$ ! ,nymph1 )9 ! fir/1 ! *ief use ( :i* appe>s to be to direct ! fl[ ( ! ur9e f ! ure?ra4 ,! ,hym54--7n4 ,plate ,i47--,?is is a membrane g5]ally f\nd 9 virg9s1 :i* gr[s ov] & closes m or less completely ! entrance to ! ,vag9a4 ,use unkn[n4 ,:5 x exi/s !re is g5]ally a small orifice ?r\gh x1 by :i* ! m5ses escape at ea* mon?ly p]iod4--7o4 ,plate ,i47 ,! ,clitoris4--7p4 ,plate ,i47--,?is is a small prom95t organ1 ab\t ! size ( a l>ge pea1 plac$ 9 ! upp] "p ( ! op5+ betwe5 ! ext]nal lips1 & imm$iately above ! ,meatus ,ur9>ius4 ,x is ! pr9cipal seat ( v5]eal excitem5t1 & is subject to _m annoy+ diseases4 ,! ,p]9eum4--7q4 ,plate ,i47--,! "p betwe5 ! ,vulva1 or entrance to ! ,vag9a1 & ! fundam5t4 ,x is *iefly compos$ ( ! muscles belong+ to ! neighbor+ p>ts1 & assi/s v mu* 9 support+ ! womb4 ,! ,meatus ,ur9>ius1 or ,m\? ( ! ,bladd]1 7h4 ,plate ,i47--,a small op5+ by :i* ! ur9e escapes1 plac$ betwe5 ! lips1 & imm$iately above ! ,vulva1 or entrance to ! ,vag9a4 ,^! organs are all plac$ )91 or 9 contact )1 ! l[] "p ( ! ,trunk1 call$ ! pelvis4 ,!y are all intimately connect$ ) ea* o!r1 & "s ( !m h mo/ ext5sive & /rong sympa?ies ) almo/ e o!r "p ( ! sy/em4 ,s mu* s is ?is ! case 9 fact1 t probably ! great majority ( diseases to :i* females are liable arise1 directly or indirectly1 f ,ut]9e or ,ov>ian d]angem5t4 ,v (t5 ! he>t1 ! /oma*1 or "s o!r organ1 ?\gh p]fectly heal?y1 is ?\ght to be diseas$1 & appe>s to be s1 m]ely f its sympa?y ) ! diseas$ womb4 ,,*apt] ,,ii4 ,,/ructure ,,( ,,! ,,pr9cipal ,,organs ,,& ,,p>ts4 ,illu/ration3 ,,plate ,,iv4 ,v]tical ,section ( ! ,womb & ,vag9a1 natural size4 a4 a4 a4 ,! solid walls ( ! ,womb cut ?r\gh4 b4 ,t "p ( ! cavity1 or holl[ ( ! ,womb1 :i* is 9 ! fundus1 or top4 c4 ,t "p ( ! cavity :i* is 9 ! l[] "p1 or neck1 ( ! ,womb4 d4 ,! ,vag9a4 e4 e4 ,! cut edges ( ! ,vag9a4 f4 f4 ,! positions ( ! ,fallopian ,tubes1 :i* are cut (f1 & d[n ! passages ( :i* two ne$les are pass$4 g4 ,! ,os ,t9c1 or ,m\? ( ! ,womb4 ,9 addition to ! g5]al explanation already giv51 !re are "s ( ! ,female organs ^: peculi> /ructure requires to be m fully notic$1 on acc\nt ( its important influ5ce on "s ( ! processes h]eaft] to be describ$4 ,,! ,,womb4 ,! ext]nal appe>ance ( ! womb1 view$ 9 front1 & 9 connection ) its app5dages1 is %[n 9 ,plate ,,iii4 ,x is plac$ 9 ! ,pelvis1 betwe5 ! bladd] & ! ,rectum1 & at ! top ( ! ,vag9a1 z se5 9 ,plates ,i & ,,ii4 ,its int]nal /ructure is repres5t$ 9 ,plate ,,iv4 ,! l5g? ( ! ,womb1 aft] pub]ty1 is ab\t ?ree in*es2 its bread? at ! upp] "p1 or fundus1 ab\t two in*es2 & at ! c]vix1 or neck1 ab\t "o in*4 ,! cavity 9 ! int]ior is small1 ow+ to ! ?ickness ( ! walls1 & its =m is triangul>4 ,! %ape ( ! ,womb resembles a pe>1 some:at flatt5$1 f be=e backw>d4 ,previ\s to pub]ty its size is mu* small]1 & ) ^? :o h _h *ildr5 x (t5 exce$s ! dim5sions we h giv54 ,! ,neck1 or n>r[ "p1 7c4 ,plate ,,iv47 is mu* *ang$ by pregnancy4 ,9 virg9s x is long & po9t$1 & some:at enl>g$ 9 ! middle4 ,9 ^? :o h borne *ildr5 x is consid]ably %ort]1 m obtuse1 & less regul> 9 its =m4 ,! cavity 9 ! ,neck is l>g] 9 ! middle ?an at ei!r end1 z w be se5 9 ,plate ,,iv4 ,! ,os ,t9c1 or m\? ( ! ,womb1 also und]goes consid]able *ange f ! same cause4 ,9 ! "y p]son x is m]ely l a small slit1 sc>cely to be felt1 b aft] pregnancy x mu* enl>ges1 & rema9s m or less p]man5tly op54 ,! ant]ior lip1 or ! "o 9 front1 is some:at l>g] ?an ! po/]ior "o4 ,! body ( ! ,ut]us is =m$ ( a v d5se1 gray color$1 muscul> sub/ance1 possess+ a/oni%+ contractile p[]4 ,! int]ior is l9$1 l ! ,vag9a1 ) a mucus membrane1 & ! :ole organ is pl5tifully suppli$ ) art]ies1 ve9s1 & n]ves4 ,"o ( ! mo/ rem>kable prop]ties ( ! ,womb is t ( be+ able to di/5d to an extraord9>y degree1 & !n retract aga9 to ne>ly its orig9al size4 ,! =ce :i* x sometimes exhibits dur+ its contraction is v great1 be+ suffici5t to sep>ate1 & ev5 break1 ! bones ( ! "m's pelvis1 & p>alyze ! h& ( ! op]ator :5 introduc$4 ,! ,muscul> ,fibres on :i* ?is contractile =ce dep5ds are mo/ obvi\s dur+ ge/ation2 !y !n appe> v num]\s1 & v curi\sly dispos$1 "s ( !m ramify+ 9 almo/ e direction1 z w be se5 by ,plates ,v1 ,,vi4 ,x is ow+ to ?is t ! ,womb contracts 9 e conceivable direction1 & ?us presses1 dur+ labor1 on e "p ( ! *ild's body4 ,,plate ,v4 ,figures #a & #b4 ,fig4 #a4 ,9 ?is plate repres5ts ! ,muscul> ,fibres a little exagg]at$1 s t !y c be m di/9ctly se54--a4 a4 are ! orifices ( ! ,fallopian ,tubes4 ,fig4 #b4 ,repres5ts ! natural appe>ance1 ! fibres n be+ q s di/9ct1 ?\gh suffici5tly obvi\s4--a4 a4 ,! orifices ( ! ,fallopian ,tubes4 ,9 bo? ,figures ! ,womb is suppos$ to be turn$ inside out1 its peculi> /ructure be+ m readily se5 int]iorly ?an ext]iorly4 ,illu/ration3 ,plate ,v4 ,! ,muscul> ,fibres ( ! ,womb4 ,,plate ,,vi4 ,figures #a & #b4 ,fig #a4 ,?is repres5ts ! appe>ance ( ! ,fibres ext]nally1 & %[s h[ !y t]m9ate 9 ! r\nd ligam5t a4 b4 ,fig4 #b4 ,! l9es a4 b4 repres5t ! direction ( ! =ce ( ! ,fundul ,fibres2 c4 d4 ,t ( ! ,circul> ,muscles ( ! body ( ! ,ut]us2 d4 e4 ,! comb9$ =ce ( ! ,muscles4 ,! dott$ l9es repres5t ! =ce reflect$ by ! liquor amnii4 ,! dott$ curv$ l9es ! direction ( ! circul> fibres ( ! body ( ! ,ut]us4 ,illu/ration3 ,plate ,,vi4 ,! ,muscul> ,fibres ( ! ,womb4 ,,! ,,vag9a4 ,! ,vag9a 7c4 ,plate ,i47 is a membran\s canal1 l9$ ) a mucus membrane l ! ,ut]us4 ,by its upp] "p x is atta*$ to ! neck ( ! ,womb1 at ab\t two-?irds ( its height--s t two-?irds ( ! neck hang )9 ! ,vag9a4 ,bel[1 x t]m9ates 9 ! ,vulva1 or ext]nal m\?4 ,! upp] "p ( ! ,vag9a is mu* l>g] ?an ! l[] "p1 p>ticul>ly 9 ^? :o h borne *ildr54 ,x is capable ( consid]able di/5sion1 & aft] retraction1 to all[ ( ! *ild pass+ d[n x f ! ,womb4 ,! ext]nal m\? is call$ ! ,vulva1 & is usually p>tly clos$1 9 ! virg9 /ate1 by ! membrane call$ ! ,hym51 7n4 ,plate ,i47 ,! l5g? ( ! ,vag9a is f ?ree to five in*es1 & its diamet] f "o in* to "o & a half1 or ev5 two in*es 9 ^? :o h borne _m *ildr54 ,,! ,,vulva4 ,?is is ! ext]nal op5+1 or m\? ( ! ,vag9a1 ?r\gh :i* ! *ild has to pass at ! t]m9ation ( deliv]y4 ,! ext]nal & int]nal lips1 ) ! muscul> & membran\s tissue surr\nd+ x1 are all capable ( great di/5sion1 )\t injury1 to all[ ( ! passage ( ! *ild4 ,,! ,,p]9eum4 ,?is is ! "p situat$ betwe5 ! ,vulva & ! ,rectum4 7p4 ,plate ,i47 ,x is compos$ ( a some:at d5se & firm sub/ance1 *iefly muscul>1 &1 l all ! o!r p>ts m5tion$1 is capable ( great di/5sion4 ,x is important1 9 _m ( ! manipulations dur+ labor1 to be well acqua9t$ ) x2 & :5 ! *ild's head is pass+ ! p]9eum requires support+1 to prev5t its be+ lac]at$ or brok5 ?r\gh1 an accid5t :i* (t5 happ5s f want ( due att5tion1 & :i* leads to ! mo/ s]i\s consequ5ces4 ,,! ,,pelvis4 ,! ,pelvis is t "p ( ! bony /ructure1 or skeleton1 ( ! female1 9 :i* ! g5]ative organs are plac$1 & ?r\gh :i* ! process ( p>turition is effect$4 ,an acqua9tance ) its natural /ructure1 & ) ! *anges :i* may be produc$ 9 its =m & size1 by disease & o!r accid5ts1 is indisp5sable to ^? :o wi% to practise or und]/& midwif]y4 ,9 e>ly life ! ,pelvis is compos$ ( sev]al bones1 _m ( :i*1 aft] pub]ty1 gr[ toge!r4 ,9 ! adult female x is cu/om>y to speak ( b f\r bones1 ! sacrum1 ! coccygis1 & ! two innom9ata1 or hip bones1 7see ,plates ,,vii1 ,,viii47 ,9 ! "y female ^! are divid$ into sev]al di/9ct p>ts4 ,,plate ,,vii4 ,bones ( ! ,pelvis4 ,! f\r pr9cipal bones1 z f\nd 9 ,mature life4--,a4 ,a4 ,! ,ossa ,ilii1 or ,ossa ,innom9ata1 commonly call$ ! haun*1 or hip bones4--,b4 ,! ,os ,sacrum1 or l[] "p ( ! back bone4--,c4 ,! extreme t]m9ation ( ! back bone1 call$ ! ,os ,coccygis4 ,! divisions into p>ts1 z 9 ,e>ly life4--,! ,ilium1 ,a1 on ea* side1 is 9 ?ree p>ts2 ! ,ilium1 prop]ly s call$1 m>k$ a4 a42 ! ,pubis1 m>k$ b4 b42 & ! ,is*ium1 m>k$ c4 c4 ,! ,sacrum is 9 five p>ts1 m>k$ #a1 #b1 #c1 #d1 #e4 d4 ,is ! la/ bone ( ! sp9e1 :i* jo9s ! ,sacrum4--e4 e4 ,are ! ,sockets 9 :i* ! upp] p>ts ( ! ?igh bones fit1 =m+ ! hip jo9ts4--g4 g4 ,! two r+s1 =m$ by ! bones ( ! ,pubis & ,is*ium1 ea* call$ ! ,=am5 ,magnum4 ,illu/ration3 ,plate ,,vii4 ,bones ( ! ,pelvis4 ,illu/ration3 ,,plate ,,vii4--a4 ,?is repres5ts ! ,male ,pelvis1 to %[ ! diff]5ce 9 /ructure4 ,! lett]s correspond ) ^? 9 ,plate ,,vii4 ,illu/ration3 ,,plate ,,viii4 ,section ( ! ,pelvis1 to %[ ! %ape & connection ( ^? p>ts n di/9ctly visible 9 ! full view4 ,! section is made d[n ! middle ( ! back bone1 & ?r\gh ! symphysis pubes1 9 front4 ,! lett]s correspond ) ^? 9 ,plate ,,vii4 ,a4 ,! "r ,ilium4--,b4 ,! ,sacrum4--,c4 ,! ,coccygis4--b4 ,! ,os ,pubis4--c4 ,! ,os ,is*9um4--g4 ,! ,=am5 ,magnum4--o4 %[s ! mann] 9 :i* ! coccygis is b5t back ?r\gh labor4 ,^! bones are all firmly b\nd toge!r by a c>tilag9\s sub/ance1 :i* is plac$ betwe5 :]e !y t\*1 & is firmly atta*$ to ea* "o4 ,?is union is call$ a symphysis4 ,! "o at front :i* jo9s ! pubic bones is call$ ! symphysis pubis2 ! two :i* jo9 ! ,ossa ,illii to ! ,sacrum are call$ ! sacro iliac symphyses2 & t :i* jo9s ! ,coccygis to ! ,sacrum1 is call$ ! ,sacro coccygeal symphysis4 ,! two pubic bones are sep>at$ a little 9 ,plate ,,viii1 simply to %[ !m bett]4 ,! read] w be> 9 m9d t !y are naturally connect$ by ! c>tilag9\s sub/ance :i* =ms ! symphysis4 ,^! articulations1 or jo9+s1 become mu* s(t5$ dur+ labor1 & give way a little1 b n to any ext5t suffici5t to assi/ deliv]y4 ,x is a mi/ake to suppose t ! bones sep>ate at t "t4 ,! only "p :i* gives way is ! sacro coccygeal symphysis1 :i* does relax1 & all[s ! ,os ,coccygis to be pu%$ back by ! *ild's head a full in* or m1 ?us enl>g+ ! inf]ior /rait4--7,see c4 & o4 ,plate ,,viii47 ,sometimes ?is little bone w be ev5 brok5 (f1 :5 !re is great disproportion betwe5 ! head & ! /rait4 ,i h he>d x snap l a /ick break+4 ,!re is no?+ s]i\s nor al>m+ 9 ?is1 h[ev]1 unless x be a fir/ deliv]y late 9 life1 ?\gh x may cause "s pa9 at ! "t1 & a little difficulty 9 sitt+ = "s "t aft]4 ,9 "y p]sons ! symphysis is s(t1 & gives way easily1 s t !y h little difficulty dur+ deliv]y f ?is cause2 b if a female m>ry late 9 life1 aft] x becomes h>d5$1 %e may suff] consid]ably4 ,9 ?is case ! coccygis is usually curv$ inw>ds consid]ably1 & be+ firmly fix$ ! head _c pu% x back1 & on t acc\nt _c pass1 )\t great difficulty1 & ) ! risk ( ruptur+ "s ( ! s(t p>ts1 or break+ ! coccygis completely (f4 ,!re is 9 fact great difficulty1 & "s dang]1 if ! fir/ pregnancy takes place late 9 life4 ,! ,pelvis is usually divid$ into two p>ts1--! great pelvis1 or upp] "p1 enclos$ betwe5 ! wide flanges ( ! ,ossa illii & ! upp] "p ( ! sacrum2 & ! small pelvis1 or bas91 :i* is enclos$ betwe5 ! l[] "p ( ! sacrum & coccygis beh9d1 & ! ossa is*ii & ossa pubes 9 front4 ,! bas9 is ne>ly cyl9drical1 l>g] 9 ! middle1 & curv$ t[>ds ! front4 ,! ,/raits ( ! ,pelvis4--,! bones ( ! ,pelvis1 x w be se51 =m a k9d ( broad r+1 or cyl9d]1 p>ticul>ly 9 ! bas92 & ! /raits are two passages1 "o by :i* ! *ild passes into ! bas9 f ! upp] ,pelvis1 & ! o!r by :i* x passes out f ! bas9 into ! _w4 ,9 ,plate ,,viii4 ! l9e m>k$ is ! ant]o po/]ior diamet] ( ! upp] /rait1 ?r\gh :i* ! *ild fir/ passes1 call$ also ! brim1 or entrance to ! ,pelvis4 ,! l9e m>k$ is ! diamet] ( ! l[] /rait1 ?r\gh :i* ! *ild passes into ! _w1 call$ also ! outlet ( ! ,pelvis4 ,9 ,plate ,,vii4 ! l9e m>k$ crosses ! upp] /rait1 or brim ( ! ,pelvis4 ,! diamet]s ( ! ,pelvis are ! di/ances betwe5 ! prom95t po9ts ( ea* /rait1 & are f\r 9 numb] = ea*1 ^? = ! upp] /rait be+ repres5t$ bel[4 ,,plate ,,ix4 ,diamet]s ( ! ,upp] ,/rait4 ,a ,b1 :i* ext5ds f ! mo/ prom95t po9t ( ! ,sacrum1 to ! top ( ! ,symphysis pubes1 is call$ ! ant]o po/]ior diamet]1 or t f be=e to beh9d4--,c ,d1 & ,e ,f1 are call$ ! two oblique diamet]s2 !y ext5d f ea* sacro iliac symphysis1 to ! mo/ prom95t po9t ( ! ,os ,ilium on ! opposite side4--,g ,h1 is call$ ! ,transv]se1 or bis iliac diamet]1 x crosses ! ,pelvis ne>ly f "o hip jo9t to ! o!r4 ,! ,sacro ,ant]o po/]ior diamet] measures f\r in*es4 ,! two oblique diamet]s f\r in*es & a half ea*4 ,! bis iliac diamet] measures five in*es4 7,by comp>+ ?is ) ,plate ,,vii4 ! v>i\s po9ts w be /ill m app>5t47 ,! inf]ior /rait has also f\r diamet]s1 repres5t$ 9 ,plate ,x4 ,illu/ration3 ,plate ,,ix4 ,diamet]s ( ! ,upp] ,/rait4 ,,plate ,x4 ,! ,bones ( ! ,pelvis view$ f bel[1 look+ ?r\gh ! inf]ior /rait1 to %[ its diamet]s4 ,a ,b1 :i* ext5ds f ! end ( ! ,coccygis to ! l[] "p ( ! ,symphysis ,pubis1 is call$ ! ant]o po/]ior diamet]2 x measures f\r in*es1 l t ( ! upp] /rait1 b is increas$ a little by ! b5d+ back ( ! ,coccygis4--,c ,d1 & ,e ,f1 are ! two oblique diamet]s1 also correspond+ to ^? 9 ! upp] /rait2 !y measure f\r in*es1 b are increas$ a little by ! giv+ way ( ! s(t p>ts4--,g ,h1 is ! transv]se1 or bis-is*iatic diamet]2 x measures f\r in*es4 ,illu/ration3 ,plate ,x4 ,! ,bones ( ! ,pelvis view$ f bel[1 look+ ?r\gh ! inf]ior /rait1 to %[ its diamet]s4 ,x w ?us be se5 t ! diamet]s only av]age f f\r to five in*es1 b x mu/ be rememb]$ t ! s(t p>ts1 & ev5 "o ( ! bones1 v readily give way1 & ?us !y are slightly increas$4 ,:5 we come to describe ! =m & size ( ! ftal *ild's head1 x w be f\nd t its diamet]s correspond v ne>ly ) ^? ( ! pelvic /raits ?r\gh :i* x has to pass1 s t ord9>ily labor pres5ts no s]i\s difficulty4 ,if ! head be l>g] ?an natural1 f any cause1 or if ! ,pelvis be too small1 or de=m$1 ?is mutual adaptation does n exi/1 & deliv]y ( c\rse becomes difficult1 or dang]\s1 & sometimes impossible4 ,! only ob/acle !re=e1 :i* c s]i\sly imp$e ! expulsion ( ! ftus1 or prev5t x altoge!r1 is ?is want ( con=mity1 9 size & %ape1 betwe5 its head & ! bones ( ! ,pelvis4 ,! s(t p>ts may ret>d labor consid]ably1 by be+ contract$ or rigid1 b c g5]ally be made to give way1 ei!r by ! ef=ts ( nature or by manual assi/ance2 & ! ftal head c be r$uc$ 9 size if necess>y2 b insuffici5t size1 or faulty =m1 9 ! bones1 is irrem$iable4 ,! v>i\s causes :i* produce de=mity1 or imp]fect developm5t1 9 ! ,pelvis1 & unnatural gr[? ( ! *ild's head1 w be /at$ 9 a subsequ5t section4 ,= ! pres5t1 we h only to d ) bo? 9 ! normal /ate4 ,! importance ( an accurate k ( ! /ructure ( ! ,pelvis1 & ( ! *anges :i* may be induc$ 9 x1 w n[ be obvi\s2 nei!r ! !ory nor ! practice ( ,midwif]y c 9 fact be und]/ood )\t su* k4 ,x is also frequ5tly ( ! fir/ importance to "k1 previ\s to m>riage1 :e!r ! pelvis ( a "y p]son is s =m$ t deliv]y c be safely effect$6 ,inatt5tion to ?is has sacrific$ ! lives ( _m1 & caus$ o!rs to live = ye>s suff]+ & helpless4 ,9 ano!r place we %all give "s pla9 rules & directions by :i* ?is important po9t may be det]m9$4 ,! floor ( ! ,pelvis4--,! s(t p>ts at ! bottom ( ! bas9 ( ! ,pelvis1 consi/+ ( ! p]9eum & v>i\s muscles1 are call$ ! floor ( ! ,pelvis--! only passage ?r\gh :i* is by ! ,vulva1 or m\? ( ! ,vag9a4 ,z ! head ( ! *ild desc5ds to ! bottom ( ! bas91 x presses ^u ?is floor1 & gradually di/5ds x1 until ! ,vulva is suffici5tly enl>g$4 ,?is delay is advantage\s1 = if ! passage 0 always l>ge en\gh1 or increas$ 9 size )\t any difficulty1 ! *ild w\ld pass too sudd5ly1 & mu* mis*ief might (t5 result f its sudd5 expulsion--su* z pull+ d[n ( ! womb1 flood+1 & ! fall+ ( ! *ild ^u ! gr\nd4 ,direction ( ! passage ( ! ,pelvis4--,9 mo/ ( ! l[] animals ! passage ( ! ,pelvis is /raight1 & on a l9e ) ! body1 ! two /raits be+ opposite ea* o!r1 :i* makes deliv]y mu* m easy ) !m4 ,ev5 9 ! negroes1 & o!r inf]ior races1 ! passage is mu* /raight] ?an 9 ! :ites4 ,! m p]fect ! organization !re=e1 ! m difficult is p>turition2 & ! m imp]fect or simple ! organization1 ! m easy is p>turition4 ,! dott$ l9e 9 ,plate ,,xi4 %[s ! direction ( ! passage ( ! ,pelvis1 9 ! human female1 to be a curve1 s t ! *ild has to move1 dur+ its passage1 9 a circle4 ,illu/ration3 ,,plate ,,xi4 ,! axis1 or direction1 ( ! upp] /rait is d5ot$ by ! l9e ,a1 t ( ! l[] /rait by ! l9e ,b1 & t ( ! ,vulva by ! l9e ,c4 ,! =ce ( expulsion t5d+ to pu% ! *ild 9 ea* direction1 x has to trav]se a pa? int]m$iate ) !m all1 or comp\nd$ ( !m all1 n be+ able to move 9 ei!r alone4 ,?is aggregate direction is d5ot$ by ! dott$ curv$ l9e1 :i* %[s ! direction 9 :i* ! *ild passes1 & 9 :i* ! h& mu/ be pass$ :5 introduc$4 ,i is ! ,p]9eum4--,! dott$ l9e :i* crosses ,a d5otes ! upp] /rait1 & ! l9e ,i ! l[] /rait4 ,,*apt] ,,iii4 ,,functions ,,( ,,! ,,pr9cipal ,,female ,,organs4 ,! great object = :i* ! :ole ( ! ,female organs p]=m _! sev]al functions is1 t ( br++ into exi/5ce a new be+6 ,= ?is purpose !y act bo? sep>ately & conjo9tly1 ea* "o hav+ its specific "p to play 9 ! gr& ph5om5on4 ,z already rem>k$1 x w\ld n be 9 place "h to give all ! details ( ?is wond]ful ev5t1 b m]ely su* a description ( its pr9cipal /ages1 z w suffice = an und]/&+ ( ! ma9 subject ( ! pres5t treatise4 ,i %all !re=e1 fir/ give ! uses ( ! pr9cipal organs sep>ately1 & !n expla9 ! processes ( conception1 & ftal developm5t4 ,,! ,,womb4 ,! ,womb is no?+ m ?an ! receptacle 9 :i* ! impregnat$ egg is plac$1 & 9 :i* x und]goes all ! wond]ful *anges by :i* x ev5tually is develop$ into a p]fect human be+4 ,! womb is n !re=e absolutely ne$$ 9 conception1 & inde$ sev]al cases h be5 kn[n :]e ! new be+ 0 =m$ )\t ! womb altoge!r1 ?\gh n p]fectly4 ,its pr9cipal use is 9 ftal developm5t1 :i* _c take place p]fectly 9 any o!r "p ( ! body4 ,,! ,,ov>ies4 ,! ,ov>ies1 z already rem>k$1 are two oval-%ap$ bodies1 plac$ "o on ea* side ( ! womb1 & connect$ ) x1 ^: use is to =m ! g]m or rudim5t1 call$ ! ovum1 or egg1 f :i* ! new be+ is develop$4 ,! /ructure ( ! ,ov>ies is v simple1 & ! mann] 9 :i* !y produce ! ovum is n v well und]/ood4 ,x is c]ta9 h[ev]1 t !y are indisp5sable to conception1 be+ 9 fact ! mo/ ess5tial p>ts ( ! female g5]ative sy/em4 ,,m5/ruation4 ,m5/ruation appe>s to be a process result+ f ! developm5t & heal?y action ( ! ,female organs1 & is ess5tial to _! well be+4 ,! foll[+ brief acc\nt ( its nature & orig9 is extract$ f my ,diseases ( ,woman1 page #aeb to #aee3 ,until v rec5tly b little 0 kn[n1 ) any c]ta9ty1 respect+ ?is rem>kable & important ph5om5on ( ! female sy/em4 ,! mo/ crude & vision>y !ories h be5 advanc$ to expla9 x1 & our works on m$ic9e & physiology d no?+ m ?an repeat !m1 "o aft] ! o!r4 ,! inve/igations ( sev]al di/+ui%$ physiologi/s h[ev]1 )9 ! la/ few ye>s1 h ?r[n a new light on ?is hi!rto obscure subject1 & expla9$ mu* t 0 previ\sly unkn[n1 or1 at be/1 m]ely conjectur$ ^u4 ,a brief /atem5t ( ! result ( ^? inve/igations w n only be highly int]e/+ 9 itself1 b w mat]ially assi/ 9 expla9+ :at we %all aft]w>ds speak ^u4 ,x is well kn[n t ! female organs are liable1 at regul> p]iods1 to assume a peculi> action1 :i* results 9 ! dis*>ge ( a fluid t]m$ ! m5ses4 ,! secretion & excretion ( :i* are highly ess5tial1 bo? to ! prop] p]=mance ( _m o!r functions1 & to ! ma9t5ance ( ! g5]al heal?4 ,:5ce comes ?is fluid1 & :at causes x to fl[8 ,^! 7 que/ions unansw]$1 except by m]e supposition1 previ\s to ! discov]ies ref]r$ to1 :i* we n[ proce$ to make kn[n4 ,9 ! fir/ *apt] x 0 /at$ t ! ,ov1 or eggs1 conta9$ ! rudim5ts or g]ms1 f :i*1 :5 impregnat$ by ! male pr9ciple1 new human be+s 7 develop$4 ,^! ov1 h[ev]1 are n prep>$ to und]go ?is developm5t be=e ! age ( pub]ty1 nor aft] ! *ange ( life1 nor are ! :ole ( !m fit = conception ev5 dur+ ! prolific p]iod4 ,x appe>s t !y become fit = fecundation 9 succession1 dur+ ! m5/rual p]iod1 "o ovum1 or m1 be+ rip5$ e mon?6 ,:5 fully p]fect$ x sep>ates f ! ov>y & is lo/1 unless conception occurs1 9 :i* case x passes along ! fallopian tube into ! ,womb1 & !n develops into ! ftus4 ,"h !n we see ! cause ( ! m5ses2 ! rip5+ ( ! ovum causes a local excitem5t1 & conge/ion1 9 ! ov>y & womb1 :i* increases till ! p]iod :5 x is ?r[n (f1 & !n ! accumulat$ fluid is dis*>g$1 ! excitem5t subsides1 & a new developm5t comm5ces4 ,?is curi\s process is t]m$ by "s physiologi/s ! mon?ly ponte1 or lay+ ( eggs1 & by o!rs ! ,ov>ian labor1 or bir?6 ,a small sc> is left on ! ov>y at ! po9t :]e ! ovum sep>ates1 :i* fades away aft] a "t1 b a numb] ( !m may always be obs]v$ on ! ov>ies ( ^? :o h long m5/ruat$4 ,9 ^? :o die dur+ m5/ruation ! ov>ies are f\nd v r$1 & full ( blood1 & sometimes "o ( ! ov w be f\nd swell$1 & j ready to bur/ ?r\gh1 or ! ruptur$ op5+ may be se5 ?r\gh :i* x has actually escap$4 ,precisely ! same ph5om5on occurs 9 ! l[] animals1 except+ t _! p]iods are m ext5d$2 "s ( !m occurr+ annually1 & o!rs at /ill long] int]vals4 ,"s ( ! monkeys ev5 h a species ( real m5/ruation4 ,^! important facts1 by enabl+ u to und]/& :at causes m5/ruation1 give u an insight also into ! nature ( its d]angem5ts1 & ! conditions requir$ = _! regulation4 ,:5 we call to m9d also ! close sympa?y betwe5 ! ut]9e organs & e o!r "p ( ! sy/em1 x %[s u h[ important a prop] m5/ruation is to ! g5]al heal?1 because )\t x ^? organs mu/ be diseas$1 & consequ5tly e o!r "p ( ! sy/em liable to suff] ) !m4 ,=m]ly _m absurd notions prevail$ respect+ m5/ruation1 :i* 9 fact are n q remov$ ev5 n[4 ,?us "s au?ors ass]t$ t a female1 :ile unwell1 c\ld cause v>i\s diseases1 by m]ely t\*+ p]sons6 ,o!rs suppos$ !y w\ld curdle milk1 & ne>ly all believ$ t ! m5/rual fluid itself 0 highly poison\s1 s t females1 at ^? times1 7 compell$ to live ap>t & approa* no "o4 ,9 ! ,old ,te/am5t !re are _m regulations giv51 = females :ile m5/ruat+1 :i* %[ ! preval5ce ( su* notions 9 old5 times4 ,x is sc>cely necess>y to say t !re is no f\ndation :atev] = all ?is1 z ! fluid itself diff]s b little f ord9>y blood1 & is equally innocu\s4 ,9 l mann] x 0 suppos$1 t m5/ruation 0 influ5c$ by ! ,moon1 & only occurr$ at a c]ta9 p]iod ( h] age4 ,we "k1 h[ev]1 t females are unwell almo/ e h\r ( e day 9 ! ye>4 ,! due e/abli%m5t ( ! m5/rual function is absolutely necess>y1 to ! p]fection bo? ( m9d & body1 & its regul> p]=mance is q z ess5tial to ! cont9uance ( heal?1 = !re is sc>cely a s+le disease t its d]angem5t w n ei!r cause1 or at lea/ s]i\sly aggravate4 ,x is !re=e vitally important to att5d to ?is matt]1 p>ticul>ly 9 "y p]sons approa*+ pub]ty6 ,a little c>e at t "t1 prop]ly be/[$1 may prev5t ye>s ( disease & suff]+1 if n untimely dea?6 ,,conception4 ,conception is ! union ( ! male pr9ciple ) ! female ovum1 or egg1 aft] t is p]fect$ 9 ! mann] describ$ 9 ! article on ,m5/ruation4 ,! precise mann] 9 :i* ?is union is effect$ is unkn[n1 ?\gh our in=mation 9 reg>d to x is mu* m ext5sive1 & precise1 ?an =m]ly4 ,z ne>ly z c be /at$ x occurs 9 ! foll[+ way3 ,at ! "t ( a fruitful connection1 :i* c only occur1 x mu/ be rememb]$1 :5 ! ovum is ripe1 ! male pr9ciple is c>ri$ into ! ,womb1 7,b1 ,plates ,i4 & ,,iii47 & is !n suppos$1 by "s1 to meet ) ! ovum :i* has desc5d$ d[n ! ,fallopian ,tube 7f1 ,plates ,i4 & ,,iii47 f ! ,ov>y1 s t ! union ( ! two takes place1 accord+ to ?is view1 ei!r 9 ! ,fallopian ,tube or 9 ! ,womb4 ,o!rs1 h[ev]1 suppose t ! ovum does n leave ! ,ov>y be=e conception1 b t ! male pr9ciple passes d[n ! ,fallopian ,tube & meets x !re1 & t x is sev]al days aft] be=e x rea*es ! ,womb4 ,!re are _m facts & argum5ts br\ght =w>d 9 support ( ea* view1 all ( :i* w be set =? 9 my =?com+ "w on ! reproductive functions4 ,all t is kn[n = c]ta9 is1 t ! two pr9ciples mu/ unite 9 "o place or ! o!r1 & t ! ovum mu/ pass d[n ! ,tube into ! ,womb1 ei!r be=e impregnation1 or aft]4 ,! union ( ! two pr9ciples 9 ! ,womb appe>s s likely an ev5t t x is sc>cely possible to avoid ?9k+ t x really does !n take place1 b at ! same "t !re are v /rong reasons = adopt+ ! op9ion t x takes place 9 ! ,ov>y4 ,among o!rs may be m5tion$ ! ph5om5on ( extra ut]9e conception1 :i* w be m fully allud$ to 9 ano!r place4 ,9 ^! cases ! ftus is f\nd outside ( ! ,womb1 9 ! ,tube1 or ! ,ov>y1 or ev5 9 ! ,abdom51 among ! inte/9es4 ,su* an occurr5ce seems to r5d] x almo/ c]ta9 t ! ovum mu/ h be5 fecundat$ 9 ! ,ov>y1 because we _c well conceive1 if x 7 n s1 h[ x c\ld rea* ! outside ( ! ,womb4 ,?is difficulty is n1 h[ev]1 reg>d$ z insup]able1 by ! advocates ( ! opposite !ory4 ,possibly conception may occur 9 bo? ways4 ,!re are _m causes :i* prev5t conception1 or1 9 o!r words1 :i* produce b>r5ness & /]ility4 ,^! v>i\s causes _c be all expla9$1 except 9 connection ) a full explanation ( ! process ( reproduction1 & ( ! nature ( _m female diseases4 ,9 my "w on ,! ,diseases ( ,woman1 ,i h giv5 a *apt] on ?is subject1 & h also ref]r$ to ! pres5t "w z "o 9 :i* x w\ld be m fully treat$4 ,?is ref]5ce1 h[ev]1 0 made 9 mi/ake2 ! subject is n ne$$ "h1 b w be 9 ! o!r "w1 on ! reproductive functions 9 :i* x w be discuss$ at l5g?4 ,,*apt] ,,iv4 ,f,,tal ,,developm5t4 ,! la/ ,*apt] br\ght u up to ! po9t ( conception1 or ! fir/ comm5cem5t ( ! new be+4 ,! next /ep is to exhibit its v>i\s /ages ( developm5t1 & to %[ h[ x is n\ri%$ & ma9ta9$ 9 its prop] position4 ,?is is requisite 9 ord] to und]/& ! orig9 ( _m diseases & accid5ts :i* occur dur+ ge/ation1 & also to expla9 ! v>i\s signs by :i* x is det]m9$ :e!r a female is pregnant or n4 ,f,,tal ,,developm5t4 ,! developm5t ( a p]fectly =m$ human be+ f ! egg 9 :i* x orig9ates1 is "o ( ! mo/ a/oni%+ ph5om5a t c come "u our obs]vation1 & is em95tly des]v+ ! /udy ( e rational be+4 ,! pres5t explanation ( x mu/ necess>ily be brief1 be+ m]ely int5d$ to make ! ma9 subject m cle>4 ,x has already be5 rem>k$ t x is unc]ta9 :e!r ! ovum is impregnat$ be=e x is br\ght into ! ,ut]us1 or aft] x arrives !re2 b be t z x may1 no?+ has yet be5 discov]$ 9 ! ,womb till sev]al days aft] conception4 ,"s physiologi/s tell u t ! rudim5t ( ! new be+ may be f\nd !re ab\t ! six? day2 b o!rs aga9 assure u t x _c be f\nd be=e ! twelf?1 at :i* p]iod our explanation ( its developm5t w comm5ce4 ,at ! twelf? day ! ovum is ab\t ! size ( a l>ge pea1 x is compos$ ( a vesicle conta9+ a ?ick fluid1 call$ ! g]m1 :i* corresponds to ! opaque sub/ance se5 9 ! :ite ( a fecundat$ bird's egg1 & ( a yell[i% sub/ance1 9 :i* x floats1 call$ ! vitellus1 :i* answ]s to ! yelk4 ,! :ole be+ surr\nd$ by two membran\s cov]+s1 ! out] "o call$ ! *orion1 & ! inn] "o ! amnion4 ,betwe5 ^! is a gelat9\s sub/ance1 & )9 ! amnion is a fluid1 call$ ! liquor amnii4 ,! two membranes1 ! liquor amnii1 & ! inclos$ ovum1 are call$ ! ovulum6 ,imm$iately aft] conception ! ut]us beg9s to secrete1 f its inn] walls1 ano!r membrane1 v delicate1 call$ ! decidua4 ,?is l9es ! :ole cavity1 s t :5 ! ovulum passes out ( ! tube x is met by ?is l9+ :i* seems to prev5t its entrance into ! womb4 ,! ovulum1 h[ev]1 presses ^u x & s makes a depression1 l a ne/1 9 :i* x lies4 ,?is prev5ts its mov+ ab\t1 or fall+ to ! bottom ( ! womb4 ,! weight ( ! entire ovulum is ab\t "o gra94 ,! embryo comm5ces 9 ! g]m1 & may n[ be se5 ab\t ! size ( a p9's po9t4 ,! vitellus removes away f x1 b rema9s connect$ by a small p$icel or ?read-l tube1 d[n :i* x is gradually absorb$ z nutrim5t4 ,a small :ite ?read1 sc>cely p]ceptible1 may be se5 sometimes z e>ly z ?is p]iod1 be+ ! comm5cem5t ( ! bra9 & sp9al m>r[4 ,! m\? is visible also f ! twelf? to ! tw5tie? day1 & frequ5tly ! eyes4 ,^! are plac$ at fir/ on ! side ( ! head1 l ^? ( quadrup$s1 & move r\nd to ! front aft]w>ds4 ,at tw5ty-five days1 ! embryo is ab\t ! size ( a l>ge ant1 :i* x also resembles 9 =m4 ,x beg9s to h a little m consi/5ce1 & ! future bones beg9 to resemble c>tilage1 or gri/le4 ,a small groove may be se5 d5ot+ ! neck1 :i* ?us indicates ! sep>ation ( ! head f ! trunk4 ,! weight is ?ree or f\r gra9s4 ,! fir/ mon?1 x is ab\t ! size ( a ,bee1 & is some:at l a small worm b5t toge!r4 ,! arms may be se5 l two little w>ts4 ,!y are fir/ =m$ "u ! sk91 & %oot out l buds1 gr[+ /raight f ! body2 aft]w>ds !y become fold$ toge!r1 9 a curi\s mann]1 ^u ! brea/4 ,! head is z l>ge z ! re/ ( ! body1 & ^u x we c n[ see di/9ctly ! eyes1 l two black dots1 ! m\?1 l a l9e1 & also ! nose4 ,! l[] extremity is l5g!n$ out l a tail4 ,weight ab\t t5 gra9s4 ,! second mon?4 ,e "p has n[ become mu* m develop$1 & ! g5]al =m is t ( a human be+4 ,! sup]ior memb]s are mu* m elongat$1 & ! inf]ior ones beg9 to be di/+ui%$1 =m+ 9 ! same mann] z ! o!rs4 ,! f+]s are unit$ toge!r by a membrane1 l ! web on a ,frog's foot4 ,9 ! ribs1 clavicles1 & jaw bones1 a few po9ts c be se5 ossifi$1 ! c>tilage beg9n+2 to h>d5 into bone4 ,! rudim5ts ( ! fir/ tee? are also visible4 ,! weight is ab\t "o dra*m1 & ! l5g? "o in*4 ,at ab\t sev5ty days ! eyelids are visible1 ! nose becomes prom95t1 ! m\? enl>ges1 & ! ext]nal e> may be se54 ,! neck is well def9$4 ,! bra9 is s(t & pulpy1 & ! he>t is p]fectly develop$4 ,e organ is orig9ally =m$ )\t ei!r blood or blood vessels4 ,! circulation :i* aft]w>ds takes place 9 !m is m]ely = _! subsequ5t developm5t4 ,! he>t is p]fect 9 all its p>ts1 & ev5 has a slight motion1 be=e ! blood is f\nd 9 x4 ,?ree mon?s4 ,all ! ess5tial p>ts are well def9$4 ,! eyelids di/9ct1 b firmly clos$4 ,! lips p]fect1 b drawn tightly toge!r4 ,! he>t beats =cibly1 & 9 ! l>g] vessels r$ blood is se54 ,! f+]s & toes are def9$1 & ! muscles beg9 to be app>5t4 ,! organs ( g5]ation are rem>kably prom95t1 b /ill x is some:at difficult1 at fir/1 to di/+ui% ! sex by ^! organs1 not)/&+ _! developm5t1 z ! pr9cipal p>ts 9 bo? are ne>ly id5tical 9 =m4 ,x c1 h[ev]1 be asc]ta9$ by o!r circum/ances1 z ! =m ( ! head1 dorsal sp9e1 ?orax1 & abdom54 ,x n[ weighs ab\t two ounces & a half1 & measures f\r or five in*es 9 l5g?4 ,f\r mon?s4 ,! developm5t is rem>kably increas$4 ,! bra9 & sp9al m>r[ becomes firm]1 ! muscles di/9ct1 & a little cellul> tissue is =m$4 ,! abdom5 is fully cov]$ 9 & ! inte/9es are no long] visible4 ,a little ( ! sub/ance call$ meconium ev5 collects 9 ! inte/9es1 ! same z is f\nd 9 at bir?4 ,x n[ weighs sev5 or eight ounces1 & measures six or sev5 in*es4 ,! bones are ossifi$ 9 a great "p ( _! ext5t1 & ! rudim5ts ( ! second set ( tee? are visible1 "u ! fir/4 ,! ut]us n[ is s l>ge t x c no long] rema9 9 ! l[] "p ( ! pelvis1 b is compell$ to rise up into ! abdom5 = m room4 ,?is *ange ( position is improp]ly call$ quick5+6 ,sometimes x takes place v gradually1 s t x is sc>cely notic$1 b m frequ5tly x rises sudd5ly1 di/urb+ all ! int]nal organs1 & caus+ 9 !m consid]able d]angem5t till !y accommodate !mselves to ! *ange4 ,?is occurr5ce (t5 causes unnecess>y al>m1 ?\gh ! sickness1 & o!r unpleasant s5sations1 are always suffici5tly annoy+4 ,?is /age corresponds ) t 9 :i* ! "y ( ovip>\s animals breaks ! %ell & escapes4 ,! human be+ h[ev]1 und]goes a rem>kable *ange1 & rema9s 9 ! womb = a p]iod long] ?an t already pa/1 9 ord] to become m p]fect$4 ,f f\r to n9e mon?s ! developm5t is proportionally mu* m rapid ?an dur+ ! fir/ f\r mon?s1 ow+ to ! circulation ( p]fect r$ blood1 :i* is n[ f\nd ! same z 9 ! adult1 & is probably d]iv$ f ! "m's blood vessels4 ,five mon?s4 ,e "p is consid]ably increas$ 9 size1 & become m p]fect4 ,! lungs enl>ge1 & are ev5 capable ( be+1 to a c]ta9 ext5t1 dilat$4 ,! sk9 becomes mu* /rong]4 ,! situation ( ! nails c be disc]n$4 ,! meconium is m abundant1 & l[] d[n 9 ! inte/9es4 ,! l5g? is n[ eight or t5 in*es1 & ! weight fifte5 or sixte5 ounces4 ,six mon?s4 ,! nails are m>k$4 ,! head becomes d[ny1 f ! fir/ developm5t ( ! hair4 ,a little fat is =m$4 ,l5g? twelve in*es1 weight f "o & a half to two p\nds4 ,no indications ( intellectual faculties4 ,sev5 mon?s4 ,! :ole be+ has rapidly progress$4 ,! nails are =m$1 ! hair is p]fect1 9 ! male ! te/icles desc5d to ! scrotum1 & 9 ! female ! ov>ies rea* ! brim ( ! pelvis4 ,! bones are tol]ably firm1 & ! meconium collects 9 ! l>ge inte/9es4 ,l5g? f\rte5 in*es1 weight ab\t ?ree p\nds4 ,intellectual functions n yet ex]cis$4 ,! two rema9+ mon?s are m]ely devot$ to fur!r increase 9 size & weight4 ,no new ph5om5a pres5t !mselves4 ,n9e mon?s4 ,e function has become active4 ,! sk9 becomes color$1 & p]spiration occurs4 ,!re are no indications ( ! intellectual functions1 b ! animal functions are rem>kably active1 p>ticul>ly t ( ta/e1 :i* no d\bt leads to ! act ( suck+1 f ! natural desire = its gratification4 ,! *ild c n[ exp]i5ce all ! ord9>y s5sations ( pa91 hung]1 heat1 & cold1 & is capable ( pres]v+ an indep5d5t exi/5ce if br\ght into ! _w4 ,plate ,,xii4 repres5ts a section ( ! ,ut]us at ab\t "o mon? ( ge/ation1 s z to %[ all ! p>ts 9 _! prop] situation4 ,,plate ,,xii4 ,section ( ! ,ut]us1 ) ! ,ovum & app5dages1 at ab\t "o mon? ( ge/ation4--a4 a4 a4 ,! sub/ance ( ! walls ( ! ,womb4--b4 b4 ,! ,embryo4--c4 ,! diff]5t vessels by :i* x is connect$ ) ! ,plac5ta4--d4 d4 ,! ,plac5ta4--e4 ,! ,vitellus4--f4 f4 f4 ,! ,membrane l9+ ! ,ut]us1 call$ ! ,decidua2 x is se5 to be b5t d\ble1 or reflect$1 ! ,embryo be+ on ! outside ( x4--g4 g4 ,! ,*orion1 or ,middle ,membrane1 :i* is /udd$ ov] ) villosities1 or small blood vessels4--h4 h4 ,! ,amnion1 or inn] membrane1 :i* conta9s ! fluid call$ ! liquor amnii1 9 :i* ! ,embryo floats4--i4 i4 ,! blood vessels :i* connect ! ,plac5ta ) ! ,womb4--j4 ,is a plug ( ,mucus1 by :i* ! m\? ( ! ,womb is n[ block$ up4--k4 k4 ,! ends ( ! ,fallopian ,tubes1 :i* are cut (f2 ^! are also block$ up ) mucus1 ! same z ! ,os ,t9c4--l4 ,! ,os ,t9c1 or m\? ( ! ,womb4--m4 ,! ,vag9a4 ,illu/ration3 ,plate ,,xii4 ,section ( ! ,ut]us1 ) ! ,ovum & app5dages1 at ab\t "o mon? ( ge/ation4 ,f,,tal ,,nutrition4 ,! mann] 9 :i* ! new be+ d]ives its nutrim5t1 or ! mat]ial by :i* x gr[s1 is1 9 a great measure1 unkn[n to u1 ?\gh we c]ta9ly obta9 "s little in=mation ab\t x by a /udy ( ! app>atus employ$ 9 ! process4 ,= ! fir/ fifte5 or tw5ty days ! sub/ance call$ ! ,vitellus1 7e4 ,plate ,,xii47 :i* is analag\s to ! yelk ( ! ord9>y egg1 appe>s to supply mo/1 if n all ( ! mat]ial t is requir$ 9 ! =mation ( ! new be+2 & inde$ ?is sub/ance does n totally disappe> till aft] ! ?ird mon?1 ?\gh we _c suppose x to be ! sole s\rce ( nutrim5t !n4 ,x is also suppos$1 by "s1 t ! amniotic liquor1 9 :i* ! ftus floats1 may af=d "s nutrim5t1 ei!r by be+ swall[$1 or by be+ absorb$ ?r\gh ! sk94 ,x is c]ta9 t ?is fluid is nutritive1 & !re is no?+ impossible 9 its absorption1 ?\gh x is n v likely to occur to a suffici5t ext5t4 ,! idea t x c be swall[$ h[ev]1 is errone\s1 because ! m\? ( ! ,ftus is firmly clos$ :ile 9 ! ,womb2 & besides1 *ildr5 h be5 born alive )\t m\?s1 & ev5 )\t heads1 & ( c\rse !y c\ld n h swall[$ any?+4 ,x is n[ g5]ally conc$$ by physiologi/s t ! mat]ial requir$ by ! ,ftus1 = its nutrition1 is obta9$ f ! blood ( ! "m1 ?r\gh ! m$ium ( ! ,plac5ta1 & ! vessels 9 ! ,umbilical cord4 ,x is1 h[ev]1 a matt] ( dispute :e!r ! mat]nal blood is s5t directly1 9 its ord9>y /ate1 into ! body ( ! *ild1 or :e!r x fir/ und]goes a prep>atory process1 :i* mo/ mod]n au?ors suppose x does4 ,f ! e>lie/ p]iod ( ge/ation1 ! middle membrane1 call$ ! *orion1 7g4 g4 ,p4 ,,xii47 is cov]$1 on its out] surface1 ) a numb] ( small protub]ances call$ villosities1 :i* subsequ5tly become true blood vessels4 ,ab\t ! f\r? mon? ^! h increas$ v mu* 9 size & numb]1 & h all become conglom]at$ into "o mass1 9 =m l a mu%room4 ,?is is call$ ! ,plac5ta4 ,x is almo/ entirely =m$ ( blood vessels1 :i* seem to atta* !mselves at "o end1 by op5 m\?s1 to ! op5 m\?s ( o!r blood vessels on ! inn] walls ( ! ut]us 7i4 i4 ,plate ,,xii47 ,at ! o!r end ^! vessels are drawn toge!r & l5g!n$ out into a long tube1 call$ ! umbilical cord1 or navel /r+1 :i* f9ally ent]s ! body ( ! *ild at ! navel & s e/abli%es ! connexion betwe5 x & ! "m4--7c4 ,plate ,,xii47 ,! blood vessels 9 ! plac5ta1 umbilicus1 & ftus1 l ^? 9 ! mat]nal body1 are ( two k9ds1 ,art]ies & ve9s4 ,! art]ies1 :i* come f ! left side ( ! he>t1 c>ry ! pure blood1 :i* conta9s all ! mat]ials = =m+ & n\ri%+ e "p ( ! sy/em4 ,! ve9s conta9 ! blood 9 its impure /ate1 & take x to ! "r side ( ! he>t1 f :5ce x is =c$ into ! lungs to be purifi$ by ! act ( brea?+4 ,! blood is made impure by "s ( its con/itu5ts be+ absorb$1 to =m ! diff]5t p>ts ( ! body1 & by hav+ ?r[n into x a quantity ( wa/e & poison\s matt] no long] ne$$4 ,! c\rse ( ! blood1 !re=e1 is f ! left side ( ! "m's he>t along h] art]ies till x rea*es ! art]ies ( ! ut]us1 f !m x passes into ^? ( ! plac5ta1 & !nce into ^? ( ! umbilicus :i* convey x into ! body ( ! *ild4 ,:5 !re x circulates 9 its art]ies1 supplies ! mat]ial = its fur!r increase & developm5t1 becomes 9 consequ5ce impure1 & passes into its ve9s1 ! same z 9 ! mat]nal body4 ,f ^! ve9s x passes into ^? ( ! umbilicus & plac5ta1 &1 app>5tly1 into ^? ( ! "m1 by :i* x is convey$ to ! "r side ( h] he>t1 & by its action to h] lungs1 to be aga9 purifi$ :5 %e brea!s4 ,?is expla9s :at 0 previ\sly /at$1 t ! *ild uses ! "m's he>t1 lungs1 & /oma*1 :ile 9 ! womb1 & has1 !re=e1 no occasion to use its own4 ,! diamet] ( ! plac5ta is ab\t six in*es1 & its ?ickness ab\t "o in* & a half4 ,! l5g? ( ! umbilical cord is f eighte5 to tw5ty-f\r in*es1 its diamet] ab\t half an in*4 ,^! dim5sions are1 h[ev]1 subject to great v>iation4 ,in/ances are m5tion$ ( ! cord be+ five feet long1 & z ?ick z ! *ild's arm4 ,i h se5 "o myself f\r feet long4 ,sometimes x w be v %ort1 n m ?an eight or t5 in*es4 ,x is compos$ ( "o art]y & two ve9s1 twi/$ toge!r l ! /r&s ( a cable1 & ( a %ea? surr\nd+ !m compos$ ( ! *orion & amnion4 ,betwe5 ! %ea? & ! vessels is a ?ick gelat9\s fluid call$ ! ,gelat9e ( ,:>ton4 ,?is explanation1 x mu/ be rememb]$1 is 9 fact m]ely hypo!tical4 ,! direct passage ( ! blood ?r\gh ! ,plac5ta1 f ! "m's vessels into ^? ( ! cord1 is d5i$ by _m physiologi/s1 :o cont5d t !re is an int]m$iate set ( vessels 9 ! ,plac5ta1 9 :i* x fir/ und]goes important *anges4 ,!y also cont5d t ! impure blood does n pass ?r\gh into ! "m's ve9s at all1 b is purifi$ 9 ! ,plac5ta1 & imm$iately return$4 ,"s h ev5 av]r$ t ! ,plac5ta is n requir$ at all1 to supply n\ri%m5t1 b is m]ely a purify+ organ4 ,x is n[ kn[n1 h[ev]1 t x is n absolutely ess5tial to ei!r process1 = *ildr5 h be5 born alive1 & p]fectly =m$1 :i* m]ely float$ loosely 9 ! amniotic liquor1 hav+ nei!r ,plac5ta nor cord1 nor any o!r connection ) ! "m4 ,h[ !y 7 n\ri%$ we _c tell4 ,^!1 h[ev]1 mu/ be reg>d$ m]ely z curi\s exceptions1 !re be+ little d\bt b t ftal nutrition is ord9>ily effect$ ?r\gh ! ,plac5ta & cord1 by means ( ! "m's blood1 some:at 9 ! mann] we h describ$4 ,,peculi>ities ,,( ,,! ,f,,tal ,,circulation4 ,f ! circum/ance ( ! ftus n us+ its he>t & lungs1 l ! adult1 its circulation has sev]al modifications4 ,! eng9e by :i* ! blood is =c$ along its vessels is ! he>t6 ,?is is divid$ into two di/9ct p>ts1 ea* ( :i* has two cavities1 ! upp] "o call$ ! auricle1 & ! l[] "o ! v5tricle1 :i* communicate ) ea* o!r by curi\s valves4 ,9 ! adult ! :ole ( ! impure blood is p\r$ into ! "r auricle1 t f ! l[] "p ( ! body by ! inf]ior v5a cava1 & t f ! upp] "p by ! sup]ior v5a cava4 ,f ! "r auricle x passes into ! "r v5tricle1 :i* pumps x into ! lungs1 by way ( ! pulmon>y art]y2 "h x is purifi$ by ! act ( respiration1 & !n br\ght1 :5 pure1 by ! pulmon>y ve9s1 into ! left auricle1 & passes f !nce into ! left v5tricle1 :i* pumps x into ! great aorta1 & f !nce into ! small] art]ies all ov] ! body4 ,! two sides ( ! he>t1 !re=e1 d n communicate directly ) ea* o!r1 b !re is a /rong p>tition betwe5 !m4 ,9 ! ftus ! art]ial blood f ! "m1 :5 x leaves ! umbilical art]y1 ent]s fir/ ! liv]1 runs ?r\gh its vessels1 gives (f ! bile f\nd 9 x1 & !n jo9s ! v5a cava inf]ior4 ,by ?is passage x is tak5 into ! "r auricle1 along ) ! impure blood ( ! v5a cava4 ,f ! "r auricle x passes ?r\gh a hole 9 ! p>tition directly into ! left auricle1 in/ead ( tak+ ! indirect r\te by ! lungs z 9 ! adult4 ,f ! left auricle x passes into ! left v5tricle1 & is f !nce di/ribut$ by ! art]ies all ov] ! body4 ,?is op5+ 9 ! p>tition is call$ ! =am5 ovale6 ,aft] bir?1 :5 ! blood beg9s to pass ?r\gh ! lungs1 ?is passage closes up4 ,by ! eigh? day x is g5]ally oblit]at$1 (t5 mu* soon]1 ?\gh occasionally x has rema9$ op5 long] )\t inconv5i5ce4 ,9 "s cases ! =am5 ovale does n close at all4 ,! *ild !n has :at is call$ ! blue disease6 ,! :ole body is ( a uni=m lead51 or blue color1 & ! :ole sy/em is g5]ally languid & sluggi%4 ,! blue color is caus$ by ! d>k blood ( ! ve9s mix+ ) t ( ! art]ies4 ,^! *ildr5 mo/ly die e>ly1 b "s live to be five or six ye>s old1 & "o ,i saw twelve1 b ?is is r>e4 ,no rem$y c be _h = ?is affliction1 & ,i h nev] kn[n x to cure spontane\sly4 ,"s *ildr5 are s v d>k = a few days aft] bir? z to cause great al>m4 ,?is is ow+ to ! =am5 ovale be+ v op5 & clos+ sl[ly4 ,no appreh5sion ne$ be exp]i5c$ 9 su* cases1 z x soon subsides4 ,! impure blood f ! upp] "p ( ! ftal body1 :i* is br\ght d[n by ! sup]ior v5a cava1 also ent]s ! "r auricle1 b does n pass f !nce ?r\gh ! =am51 l t f ! inf]ior v5a cava4 ,by a peculi> arrangem5t ?is blood is made to pass d[n into ! "r v5tricle1 & f !nce along ! pulmon>y art]y1 ! same z 9 ! adult /ate4 ,only a v small portion1 h[ev]1 passes into ! lungs1 ! great "p be+ tak5 along a tube call$ ! ductus art]iosus into ! great art]y call$ ! aorta1 :]e x beg9s to turn d[n to ! l[] "p ( ! body4 ,9 consequ5ce ( ?is1 ! art]ial blood go+ d[n to ! l[] "p ( ! body1 is mix$ ) ?is portion ( impure1 v5\s blood1 br\ght by ! ductus art]iosus f ! sup]ior v5a cava2 :ile t go+ to ! head1 & upp] "p ( ! body rema9s pure4 ,& ?is is ! reason :y ! l[] "p is always s mu* small] ?an ! upp] "p1 previ\s to bir?2 x receives less pure n\ri%m5t4 ,! head & *e/ appe>1 at an e>ly p]iod1 almo/ z l>ge z ! re/ ( ! body4 ,?is circum/ance also expla9s :y1 9 ! great majority ( cases1 ! "r arm is pref]r$ to ! left1 & has m real p[]4 ,! place :]e ! ductus art]iosus p\rs ! impure blood into ! aorta1 is almo/ imm$iately opposite to :]e ! art]y is giv5 (f :i* fe$s ! left arm4 ,9 consequ5ce ( :i*1 9 mo/ cases1 a small portion ( ?is impure blood becomes mix$ ) ! art]ial blood1 & ! left arm is1 !re=e1 9 ! same situation z ! l[] limbs1 & l !m is comp>atively imp]fectly develop$4 ,! "r arm is n liable to any su* deprivation4 ,9 "s cases ! ins]tion ( ! ductus art]iosus is l[] d[n1 s t no su* mixture occurs4 ,bo? arms are !n equal1 & ?is acc\nts = ! fact t 9 "s p]sons !re appe>s to be no diff]5ce4 ,9 "s cases1 no d\bt1 e>ly habit1 or imitation1 may ov]come ?is natural inf]iority1 & ev5 give ! pref]5ce to ! left arm2 b su* in/ances are r>e2 ! g5]al rule is ! contr>y1 & = ! reason /at$4 ,! ductus art]iosus closes up ab\t ! same "t z ! =am5 ovale4 ,! two ve9s :i* convey ! impure blood back to ! "m1 to be purifi$1 orig9ate f ! iliac art]y1 9 ! pelvis4 ,!y pass up ! sides ( ! bladd] t[>ds ! navel1 ent] ! %ea? ( ! cord1 & s rea* ! plac5ta4 ,^! vessels are oblit]at$ ab\t ! ?ird or f\r? day aft] bir?1 & rema9 aft]w>ds 9 ! =m ( a fibr\s cord4 ,! real s\rce ( all ! blood 9 ! body ( ! *ild is a my/]y2 x w\ld c]ta9ly appe> mo/ likely = ! :ole ( x to be d]iv$ f ! "m's vessels1 b !re are _m circum/ances :i* make x probable t ! *ild may =m "s itself1 by dige/+ ! fluid x is suppos$ to absorb4 ,?is view is support$ by ! fact t !re is f\nd 9 its b[els at bir?1 & ev5 be=e1 a gre5i% sub/ance l excrem5t1 call$ ,meconium4 ,?is has e appe>ance ( be+ ! product ( dige/ion1 ?\gh "s suppose x to be d]iv$ f ! liv]4 ,x occasionally conta9s hair1 & o!r anomal\s sub/ances4 ,,*apt] ,,iv4 ,,! ,,brea/4 ,! ,brea/s1 or ,mamm1 are n ne$$ 9 ! process ( g5]ation1 nor are !y absolutely necess>y ev5 aft] bir?2 b z !y are naturally associat$1 9 ! majority ( cases1 ) infantile nutrition1 & are besides liable to _m d]angem5ts & diseases dur+ pregnancy & *ild-bir?1 x is advisable to give "s acc\nt ( !m4 ,:5 "o ( ! brea/s is dissect$ x is f\nd to be compos$ *iefly ( a s+ul> body call$ ! ,mamm>y ,gl&1 :i* resembles some:at a v firm piece ( fat1 ( a yell[i% drab color4 ,9 ! sub/ance ( ?is ,gl& are an imm5se numb] ( little cells1 or vessels1 9 :i*1 by "s unexpla9able process1 ! milk is secret$1 or made f ! blood4 ,f ^! little vessels !re proce$s small tubes :i* gradually unite into l>g] ones1 & ^! aga9 into l>g] ones /ill1 until at la/ all ! milk is p\r$ into a few tubes1 or canals1 :i* t]m9ate 9 ! nipple4 ,! out] m\?s ( ^! t]m9al canals are only slightly contract$ toge!r1 s t ! suction ( ! *ild's m\?1 or ev5 ! pressure ( ! milk1 :5 ! brea/ is full1 w =ce !m op5 & all[ ! fluid to fl[ out4 ,! foll[+ plate repres5ts ! /ructure ( ! ,brea/1 & expla9s1 z f> z x c be expla9$1 ! mann] 9 :i* x p]=ms its functions4 ,,plate ,,xii4--a4 a4 a4 ,! cut edges ( ! sk94--b4 b4 ,! flaps ( ! sk9 ?r[n back4--c4 c4 c4 ,! fat :i* cov]s ! brea/4--d4 d4 ,! cells ( ! ,mamm>y gl&4--e4 e4 e4 ,! ,tubes or canals1 :i* convey ! milk f ! ,gl& to ! ,nipple4--f4 ,! ,nipple1 cut d[n ! middle1 to %[ ! ends ( ! milk tubes t]m9at+ 9 x2 ^! are usually ab\t fifte5 or eighte5 9 numb]4--x4 ,%[s a bun* ( ! little cells1 ) ! tubes proce$+ f !m1 z !y appe> :5 inject$4 ,illu/ration3 ,,! ,,female ,,brea/4 ,plate ,,xii4--a4 ,?is ,plate repres5ts ! /ructure ( ! ,brea/1 & expla9s ! mann] 9 :i* x p]=ms its functions4 ,sometimes !re has be5 se5 two & ev5 ?ree nipples on "o brea/1 & 9 a few cases "o ( ! brea/s has _h no nipple at all4 ,! two gl&s are n imm$iately connect$1 b h a v intimate sympa?y ) ea* o!r4 ,! size ( ! brea/ dep5ds m ^u ! ?ickness ( ! lay] ( fatty sub/ance1 ?an ^u ! developm5t ( ! gl&1 s t "o female1 ) a v full bosom1 may h b little milk1 :ile ano!r1 ^: brea/ is b little prom95t1 may h a sup]abundance4 ,! graceful swell ( ! fully develop$ brea/ is1 h[ev]1 a matt] ( positive utility1 z well z ( beauty1 because x bett] adapts x to ! use ( ! *ild1 & probably also adds to its pleasure1 z any "o may readily conceive :o w obs]ve ! delight ) :i* an infant1 ev5 :5 n nurs+1 w (t5 c>ess x4 ,sir ,a/ley ,coop] says1 ,! natural obliquity ( ! ,mamella1 or nipple1 =w>ds & outw>ds1 ) a slight turn ( ! nipple upw>ds1 is "o ( ! mo/ beautiful provisions 9 nature1 bo? = ! "m & ! *ild4 ,to ! "m1 because ! *ild re/s ^u h] arm & lap 9 ! mo/ conv5i5t position = suck+2 = if ! nipple & brea/ _h project$ directly =w>ds1 ! *ild mu/ h be5 support$ be=e h]1 9 ! "m's h&s1 9 a mo/ inconv5i5t & fatigu+ position1 in/ead ( x recl9+ ^u h] side & arm4 ,b x is wisely provid$ by nature1 t :5 ! *ild reposes ^u its "m's arm x has its m\? directly appli$ to ! nipple1 :i* is turn$ outw>ds to receive x1 :il/ ! l[] "p ( ! brea/ =ms a cu%ion1 ^u :i* ! *eek ( ! infant tranquilly reposes4 ,) ! exception ( ! d>k areola1 or circle1 & ! little tub]cles ar\nd ! nipple1 ! brea/ is ( ! mo/ delicate /ructure & color1 s t x blu%es1 or r$d5s1 l ! *eek1 f any sudd5 emotion1 & goes pale dur+ fa9t+4 ,z a g5]al rule no milk is secret$ 9 ^? :o h n become pregnant1 nor 9 ^? :o h pass$ ! turn ( life1 b occasionally exceptions are obs]v$ to ?is rule4 ,b&elocque tells u ( a girl only eight ye>s ( age1 :o suckl$ h] little bro!r m ?an a mon?6 ,& ,sir ,hans ,sloane tells u ( a lady ag$ sixty eight1 :o nurs$ sev]al ( h] gr&*ildr51 ?\gh %e _h _h no *ild h]self = tw5ty ye>s6 ,dr4 ,francis1 ( ,new ,york1 describes ! case ( a lady :o cont9u$ to secrete milk regul>ly = f\rte5 ye>s aft] hav+ lo/ h] *ild1 s t %e c\ld always nurse an infant2 & ,dr4 ,k5n$y relates an in/ance ( ano!r :o cont9u$ to suckle *ildr51 un9t]rupt$ly1 = =ty-sev5 ye>s1 & :o _h milk p]fectly sweet & good ev5 :5 eighty-"o ye>s old6 ,dr4 ,cl>k1 ( ,alabama1 in=ms u t a m>ri$ lady1 :o _h nev] be5 pregnant1 0 reque/$ to take *>ge ( an infant dur+ ! night1 & t to quiet x %e _h put h] nipple 9 its m\?4 ,?is 0 done frequ5tly1 & to ! great surprise ( all x induc$ a fl[ ( milk4 ,a s+ul> circum/ance connect$ ) ?is 0 t ! lady soon aft] became pregnant1 ?\gh previ\sly b>r56 ,?is w n appe> s surpris+1 h[ev]1 to ^? :o "k ! connection betwe5 ! brea/s & ! womb1 & :o h obs]v$ ! my/]i\s bond ( sympa?y by :i* _! functions are unit$4--7,see ! articles on ,m5/ruation1 & on ,/]ility1 9 my ,diseases ( ,woman1 = o!r in/ances ( ?is k9d47 ,! /ructure ( ! male brea/ is precisely ! same z t ( ! female1 b x is seldom develop$4 ,in/ances h be5 kn[n1 h[ev]1 ( ! milk be+ secret$ 9 m51 & ( *ildr5 hav+ be5 n\ri%$ by x6 ,humboldt gives u an in/ance ( ?is k9d1 & ,pr(essor ,hull1 ( ,m>yl&1 exhibit$ a color$ man to 8 class1 9 ! ye> #ahbg1 :o _h a l>ge full bosom1 l a female1 & :o _h (t5 (ficiat$ z wet nurse 9 ! family ( 8 mi/ress4 ,! secretion appe>s to h be5 e/abli%$ by 8 putt+ ! *ildr5 t he _h to nurse to ! nipple1 to quiet !m4 ,:5 ! milk 0 n ne$$ x 0 f\nd z difficult to dry x up z x is 9 "s females1 b x 0 soon made to fl[ aga91 by apply+ a *ild to ! brea/ = a few times4 ,?is man diff]$ 9 no o!r respect f any o!r man6 ,9 ! females ( "s races ( ! human k9d1 ! mamm atta9 a surpris+ l5g?1 & become v flaccid1 s t !y hang d[n to ! hips1 or l[]1 & may be ?r[n ov] ! %\ld] = ! *ild to nurse f :ile c>ri$ on ! back4 ,"s suppose ?is to con/itute a real v>iety ( ! human race1 b o!rs suppose x to result m]ely f habit1 :i* is probably correct4 ,:5 ! brea/s are small siz$ 9 "y females1 _! gr[? may (t5 be promot$1 b ! means ne$ n be po9t$ out "h4 ,,section ,,ii4 ,,signs ,,( ,,pregnancy1 ,,& ,,! ,,means ,,( ,,detect+ ,,x2 ,,its ,,duration1 ,,& ,,! ,,p]iod ,,at ,,:i* ,,! ,f,,tus ,,c ,,live4 ,x is always desirable1 & frequ5tly ( ! fir/ importance1 to be able to "k :e!r a female is pregnant or n1 bo? to ! acc\*eur & to ! individual1 or ev5 to be able to judge :e!r %e is probably or possibly s1 or n4 ,sometimes ?is c be decid$ positively1 b m frequ5tly x is a matt] ( great unc]ta9ty4 ,! presumptive & positive signs on :i* a judgm5t c be =m$ are ( v>i\s k9ds1 mo/ ( :i* c be readily obs]v$1 & easily made use ( by any p]son 9 possession ( ! in=mation already giv5 9 ! prec$+ section4 ,!y w be set =? 9 ! foll[+ ,*apt]s1 toge!r ) su* o!r matt] z app]ta9s to ?is "p ( ! subject1 9 su* a mann] z w make !m available ei!r = pr(essional or = private use4 ,,*apt] ,v4 ,,signs ,,( ,,pregnancy1 ,,& ,,! ,,means ,,( ,,detect+ ,,x4 ,! signs ( ,pregnancy are ( ?ree k9ds--,presumptive1 ,probable1 & ,c]ta94 ,,presumptive ,,signs4 ,! presumptive signs ( pregnancy are only ( value 9 ! fir/ ?ree mon?s4 ,!y consi/ ma9ly ( c]ta9 n]v\s & organic d]angem5ts1 & ( c]ta9 *anges 9 p]sonal appe>ance4 ,x is sc>cely possible to enum]ate all ^!1 nor is x necess>y2 we %all !re=e only specify ^? mo/ important1 & mo/ g5]ally met )4 ,colic pa9s1 & creep+ ( ! sk91 ) %udd]+ & fa9t+ fits1 v frequ5tly foll[ imm$iately on conception1 & 9 _m females in=m !m :5 t ev5t occurs4 ,"s p]sons speak ( o!r s5sations1 ( a peculi> nature1 by :i* !y always "k1 9 _! own cases1 :5 !y conceive2 b ^! s5sations are felt by s few1 & are s little capable ( be+ expla9$ or obs]v$1 t !y are ( no g5]al use4 ,9 mo/ cases1 )9 ! fir/ ?ree mon?s1 & sometimes 9 ! fir/ ?ree days1 ! face *anges rem>kably4 ,! eyes are sunk & dull1 & surr\nd$ by a black circle1 ! nose seems p9*$ up1 ! sk9 turns pale1 & r$ spots1 or freckles1 frequ5tly appe>4 ,_m females also compla9 ( a husky dry ?roat1 numbness 9 ! h&s & feet1 & a sudd5 s9k+ at ! he>t4 ,^! signs1 h[ev]1 are v unc]ta9 guides2 v (t5 none ( ^! are felt at all dur+ pregnancy1 & sometimes !y are all exp]i5c$ f o!r causes4 ,"o ( ! mo/ con/ant signs1 accord+ to "s1 & ! mo/ to be reli$ ^u1 is an increase 9 ! size ( ! neck4 ,?is ,i "k is (t5 v app>5t1 & at a v e>ly p]iod4 ,i am acqua9t$ ) females :o1 by simply keep+ ! measure ( _! necks1 c always tell :5 !y are pregnant4 ,! increase is (t5 consid]able 9 a few days4 ,9 "y p]sons ( a c]ta9 temp]am5t h[ev]1 ! neck is apt to swell m]ely f m>riage1 ?\gh !y d n conceive2 & "s old nurses1 we are told1 be+ acqua9t$ ) ?is fact1 judge ( ! hone/y ( _! unm>ri$ *>ges by su* admeasurem5ts6 ,?is s+ul> developm5t is ow+1 probably1 to a sympa!tic connection betwe5 ! ut]9e organs & c]ta9 p>ts ( ! bra91 & l>ge n]ves 9 ! neck4 ,suppression ( ! ,m5ses is "o ( ! /ronge/ presumptive signs ( pregnancy t c be obs]v$1 b does n always accompany x1 & frequ5tly arises f o!r causes4 ,9 ! great majority ( cases1 x is true1 ! m5ses cease to fl[1 imm$iately conception occurs2 sometimes !y w cont9ue = "o or m p]iods aft]1 & occasionally dur+ ! :ole "t ( ge/ation1 ev5 up to a few days be=e deliv]y4 ,?is1 h[ev]1 is a v unusual occurr5ce1 & ! /oppage ( ! m5ses is by no means s /rong a sign t pregnancy has occurr$1 z _! cont9uance is t x has n4 ,"s females are always irregul>1 s t pregnancy makes little diff]5ce1 & 9 !m ( c\rse ^! signs are ev5 less to be dep5d$ ^u ?an usual4 ,!re h cases be5 kn[n ev5 ( wom5 :o h conceiv$ )\t hav+ m5/ruat$1 & ( o!rs :o nev] m5/ruat$ except :5 !y 7 pregnant2 & x is n at all unusual to see o!rs :o w conceive :ile nurs+1 & nev] m5/ruate betwe5 ! two pregnancies4 ,!re=e we c only say t ! m5ses usually /op :5 conception occurs1 & t _! cont9uance is /rong evid5ce t x has n occurr$1 b /ill bo? signs may fail4 ,x is also prop] to rem>k t sev]al m$ical m5 h advanc$ ! op9ion t ! dis*>ge :i* appe>s dur+ pregnancy is n ! m5/rual fluid1 b real blood4 ,x has h[ev] be5 accurately exam9$1 & f\nd 9 no respect to diff] f ! usual dis*>ge4 ,9 my own op9ion !re is no d\bt b t "s females really d m5/ruate :ile pregnant4 ,z an in/ance t ! pres5ce ( ! m5ses is no pro( t pregnancy has n occurr$1 ,i give ! foll[+ case3--,n long s9ce ,i 0 reque/$ to see a lady :o 0 suppos$ to labor "u a polypus 9 ! womb4 ,%e _h be5 m>ri$ six ye>s1 b _h no (fspr+4 ,on see+ h] ,i sugge/$1 f c]ta9 peculi>ities 9 h] appe>ance & mann]1 t possibly %e might be pregnant4 ,! sugge/ion 0 met ) a smile1 p>ticul>ly by ! m$ical att5dant :o 0 pres5t1 & ,i 0 told t !re 0 no sign ( su* a ?+1 & moreov] x c\ld n be1 = %e _h nev] /opp$ m5/ruat+1 nor 0 !re ! slighte/ *ange 9 ! brea/s1 nor any di/urbance 9 ! /oma*1 m9d1 or feel+s4 ,on mak+ ! usual exam9ation h[ev]1 ,i felt fully conv9c$ ,i 0 "r1 & told !m s1 b my op9ion _h no o!r effect ?an to induce !m n to int]f]e = a "t4 ,!y _h be5 talk+ ( an op]ation imm$iately4 ,%e /ill cont9u$ to m5/ruate = ?ree mon?s aft]1 b 9 six weeks f h] la/ p]iod 0 safely deliv]$1 )\t assi/ance1 ( a v f9e liv+ *ild4 ,no "p ( ! body _h und]gone any mat]ial *ange1 except ! abdom51 ?\gh _m ( ! usual *anges occurr$ aft] deliv]y4 ,9 ?is case ! delay probably sav$ ! lives ( bo? "m & *ild1 & deeply grateful !y all 7 = ! escape4 ,9 my "w on ! ,diseases ( ,woman _m fatal cases w be f\nd ( pregnant females :o h be5 kill$ f mi/akes ( ?is k9d1 ow+ to a bl9d reliance on su* unc]ta9 signs4 ,di/urbance ( ! ,dige/ive ,functions4--,x is v seldom1 inde$1 t pregnancy does n produce m or less di/urbance 9 ^! functions1 ?\gh x mu/ be rem>k$ t m>riage also does ! same sometimes1 ev5 )\t conception4 ,^! di/urbances are g5]ally manife/$ by loss ( appetite2 sickness1 p>ticul>ly 9 ! morn+2 vomit+1 & deprav$ ta/e2 ! individual frequ5tly tak+ a fancy to ! mo/ extraord9>y articles1 & mak+ h]self extremely unhappy if %e _c obta9 !m4 ,?us "s h eat5 flies1 spid]s1 mice1 & o!r liv+ ?+s1 & o!rs aga9 h regal$ !mselves ^u *>coal1 *alk1 slate p5cils1 & ev5 e>? or a%es4 ,su* freaks are call$ long+s1 & x is ?\ght highly improp] n to indulge !m1 :i* is c]ta9ly "r :5 !y are = articles n positively injuri\s2 b ,i h kn[n ?is notion c>ri$ to a v injuri\s & absurd ext5t4 ,!re is no d\bt b ^! vag>ies ( ! /oma* arise1 ma9ly1 f its sympa?y ) ! ut]us1 b x is highly probable t !y are (t5 exagg]at$1 & frequ5tly ev5 produc$1 by a morbid /ate ( ! s5sibilities1 & by vacuity ( m9d4 ,! t5d5cy to imitation also1 s /rong 9 mo/ females1 (t5 leads to ! same result4 ,a "y female :o is decl>$ to be1 or :o fancies h]self1 pregnant1 li/5s eag]ly to all t is said ab\t t int]e/+ /ate1 by old] acqua9tances1 & :5 told t !y always long$1 imm$iately beg9s to long also4 ,i h kn[n "y p]sons consid]ably advanc$ 9 ge/ation1 :o _h nev] long$ at all be=e1 d s imm$iately aft] a conv]sation ( ?is k9d4 ,x mu/ be rememb]$ h[ev]1 t ! sympa?ies ( ! dige/ive organs ) ! womb are v /rong1 & t ! appetite & ta/e are frequ5tly r5d]$ v caprici\s at ?is "t1 s t ! female really likes or dislikes _m ?+s t %e did n be=e2 b /ill ,i feel conv9c$ t ! absurd ways 9 :i* ?is caprice exhibits itself1 are (t5 ow+ to ! causes ,i h /at$4 ,! wond]+ ignorance1 9 :i* mo/ females are kept1 makes !m dispos$ to be l$ away by a morbid imag9ation1 & con/antly liable to be impos$ ^u by silly & errone\s /atem5ts1 :i* !y ( c\rse implicitly believe4 ,^! long+s are always ! /range/1 & mo/ frequ5tly met )1 among ! mo/ un9=m$ & un?9k+1 ?\gh !y are occasionally met ) "u all circum/ances4 ,z a sign ( pregnancy ?is long+ is n mu* to be reli$ ^u alone1 because m>riage alone (t5 produces x1 & s d _m ut]9e d]angem5ts4 ,usually all ^! di/urbances disappe> by ! ?ird or f\r? mon?1 ! appetite becomes regul>1 & sometimes ev5 voraci\s1 & ! dige/ion improves1 s t ! individual may become q fat1 ?\gh previ\sly %e 0 v ?94 ,"s suff] f con/ipation1 & o!rs f di>rha1 b ?is is m r>e4 ,n]v\s ,d]angem5ts4--,! *anges produc$ 9 ! m9ds & feel+s ( pregnant females are sometimes ( ! mo/ extraord9>y "*4 ,individuals :o possess1 ord9>ily1 ! mo/ agreeable temp]s1 & ! mo/ amiable dispositions1 w become peevi% & fretful1 & (t5 ev5 viol5tly passionate & malici\s4 ,"s h ev5 be5 kn[n to h a disposition to commit v>i\s crimes1 ( :i* !y _h ! greate/ horror 9 _! natural /ate4 ,o!rs1 on ! contr>y1 :o are usually ill-temp]$ & unhappy1 atta9 a *>m+ t5d]ness ( mann]1 & a mo/ pleas+ s]5ity ( m9d4 ,_! lik+s & dislik+s also *ange v mu*1 s t _! mo/ valu$ fri5ds w become hateful to !m1 & ^? :om !y habitually dislike w seem end[$ ) e loveable quality4 ,"s w become p]fect misan?ropes1 or weep & fret )\t int]mission1 :ile o!rs w exhibit ! mo/ reckless & boi/]\s gaiety4 ,i h kn[n "s mu* dispos$ to /udy :ile pregnant1 & o!rs :o w\ld draw1 or pa9t1 mo/ excell5tly1 ?\gh at o!r times !y 7 b indiff]5t arti/s4 ,9 %ort1 x is impossible to d5ote half ! s+ul> *anges ( ?is k9d t are ?us produc$4 ,suffice x to say t1 :5 well m>k$1 !y are /rong presumptive signs ( pregnancy1 especially :5 com+ 9 connection ) o!r evid5ces4 ,x mu/ be rememb]$ h[ev]1 t hy/]ia1 & "s o!r ut]9e diseases1 are (t5 accompani$ by simil> *anges4 ,alt]ation 9 ! appe>ance ( ! ,brea/4--,! direct1 & sympa!tic connection betwe5 ! womb & ! brea/ is s great t pregnancy usually causes correspond+ *anges 9 bo?1 ?\gh n always4 ,9 mo/ cases h[ev]1 ! brea/s swell1 & become pa9ful4 ,! nipple becomes elevat$1 & ! circle ar\nd x assumes a d>k br[n color1 & is dott$ ) small tub]cles1 f :i* a ?9 wat]y liquor may (t5 be press$4 ,! nipple w also enl>ge1 or become erect on be+ rubb$1 &1 z ge/ation advances1 milk may be =c$ f x4 ,mo/ ( ^! signs h[ev]1 may be want+ 9 pregnancy1 & may arise indep5d5t ( x4 ,*ronic inflammation1 & o!r diseases ( ! womb1 w frequ5tly produce !m1 z may be se5 9 my ,diseases ( ,woman4 ,m>riage alone frequ5tly causes su* symptoms1 p>ticul>ly 9 c]ta9 temp]am5ts1 & d]ang$ m5/ruation w frequ5tly produce !m4 ,! alt]ation 9 ! color ( ! areola1 or circle r\nd ! nipple1 is a sign mu* reli$ ^u by "s1 b is frequ5tly a deceptive "o1 m]ely f want ( close obs]vation4 ,i h kn[n _m females1 ?\gh frequ5tly mo!rs1 ^: brea/s always reta9$ ! bright rosy color !y _h previ\s to m>riage2 & ,i h kn[n "y unm>ri$ females ) ! brea/s q d>k4 ,! peculi> hue t arises f pregnancy h[ev]1 is diff]5t f any?+ ,i ev] saw 9 non-pregnant females2 &1 ?\gh n always to be met )1 is1 9 my op9ion1 an infallible sign :5 pres5t4 ,! celebrat$ ,john ,hunt] reg>d$ ?is sign z an unmi/akeable "o1 & he gave a rem>kable in/ance ( x 9 8 lectures4 ,9 mak+ a po/ mortem exam9ation ( ! body ( a "y female1 he obs]v$ ?is peculi> color1 & at once proclaim$ h] pregnant1 ?\gh ! hym5 0 unbrok54 ,on dissection he 0 f\nd to be correct--%e 0 f\r mon?s advanc$4 ,if ?is sign 7 con/ant1 pregnancy c\ld ne>ly always be asc]ta9$1 b frequ5tly x does n appe>4 ,! peculi> color mu/ be se5 to be recogniz$1 z x _c be accurately describ$2 p]haps ! ne>e/ approa* to x is ! %ell ( a fre% ripe *e/nut1 b x is mu* d>k] 9 "s ?an 9 o!rs4 ,! d>k circle is ne>ly always m elevat$ ?an ! re/ ( ! brea/1 z may be se5 by tak+ a pr(ile view4 ,illu/ration3 ,,plate ,,xiii4 ,view ( ! ,brea/ ab\t ! ,f\r? ,mon?4--a4 a4 ,! ,brea/4--b4 ,! ,nipple4--c4 ,! ,areola1 or "p :i* becomes br[n2 x is elevat$ above ! re/ ( ! ,brea/1 z may be se54--d4 d4 ,! little ,tub]cles4 ,mo/ frequ5tly ! brea/s d n swell1 nor ! areola *ange color1 nor ! tub]cles appe>1 till ab\t ! f\r? mon?1 & frequ5tly mu* lat]4 ,all ^! *anges 9 ! brea/ are also liable to become m or less p]man5t1 aft] ! fir/ pregnancy1 s t !y are ( mu* less s]vice1 & less to be dep5d$ ^u1 9 all succe$+ ones4 ,!y also rema91 ) mo/ females1 dur+ nurs+1 & are !re=e n available 9 ^? :o conceive :ile !y are nurs+4 ,on ! :ole h[ev]1 ^! signs1 especially 9 ^? n previ\sly pregnant1 may be pretty confid5tly reli$ ^u1 & w seldom deceive an exp]i5c$ obs]v]4 ,! secretion ( milk is1 by mo/ p]sons1 consid]$ a positive sign ( pregnancy1 b x is n s1 = x sometimes takes place 9 "y girls m]ely f ! e/abli%m5t ( pub]ty1 & 9 "s females x always occurs at ea* mon?ly p]iod1 ?\gh !y h nev] be5 pregnant4 ,in/ances h be5 kn[n ( wom5 nurs+ o!r p's *ildr5 ?\gh !y _h nev] conceiv$ !mselves4 ,miscellane\s signs4--,!re are a few o!r presumptive signs1 n easily classifi$1 "s ( :i* are ( value1 :ile o!rs are s unc]ta91 or s little available1 z to be almo/ wor?less4 ,all ^! h[ev]1 x is necess>y to po9t out1 because "s ( !m may be made use ( 9 cases :]e ! m ord9>y signs are abs5t4 ,9 ! unimpregnat$ /ate ! mucus membrane1 :i* l9es ! ,vag9a1 is ( a bright rose color1 b 9 ne>ly e case ( pregnancy x *anges to a blui%1 or purpli% hue4 ,i d n recollect a s+le in/ance1 9 ! c\rse ( my own obs]vation1 9 :i* ?is *ange has n occurr$1 & ! same /atem5t is made by sev]al em95t au?ors4 ,x is true t 9 "s "y females ! mucus l9+ is naturally d>k] ?an x is 9 o!rs1 b1 l ! areola r\nd ! nipple1 ?is natural t+e is n l t produc$ by pregnancy4 ,x is ( c\rse impossible to say :e!r ?is blue t+e is always produc$1 ?\gh ,i am incl9$ to ?9k x is1 & ,i %\ld c]ta9ly consid] x an almo/ infallible sign :5 pres5t4 ,p>5t ,du*atelet /ates t he 0 pres5t :5 ,m4 ,jacquem9 prov$ ?is1 )\t a s+le failure1 9 f\r ?\s& five hundr$ cases4 ,_m females are also w>n$ ( _! condition by pa9s 9 v>i\s p>ts ( _! bodies1 ! mo/ frequ5t ( :i* is "o felt at ! top ( ! head4 ,"s always h palpitation at ! he>t1 & o!rs exp]i5ce a s+ul> k9d ( flutt]+ 9 ! womb4 ,_m m$ical m5 rely altoge!r on c]ta9 peculi>ities 9 ! ur9e1 & z ?is sign is really a valuable "o1 9 "s cases1 ,i w describe ! mode ( exam9ation fully4 ,! ur9e is put 9 a clean vessel1 & all[$ to /& p]fectly /ill4 ,9 a %ort "t1 v>y+ f two to six days1 a numb] ( little opaque bodies beg9 to rise f ! bottom1 l flocks ( cotton1 :i* unite toge!r at ! top into a ?9 b firm lay]1 or pellicle1 l cream on ! top ( milk4 ,?is lay] is frequ5tly s consi/5t t x c almo/ be rais$ out ( ! vessel1 by tak+ hold ( "o edge1 & may be easily drawn out by pass+ ! f+] "u x4 ,?is sub/ance is call$ kye/e94 ,x is ( a :iti% color1 semi-transp>5t1 & looks z if x 7 p>tly cry/aliz$4 ,aft] a few days1 if left undi/urb$1 ! ur9e becomes ?ick & muddy1 & ! pellicle ( kye/e9 breaks up & falls to ! bottom4 ,accord+ to ! exp]i5ce ( _m m$ical m51 & s f> z ,i h se5 myself1 ?is peculi> sub/ance is always to be f\nd 9 ! ur9e ( pregnant females1 aft] ! fir/ mon?1 & frequ5tly ev5 e>li]4 ,sometimes a sub/ance simil> to x is obs]v$ 9 ! ur9e ( ^? n pregnant1 b !re is1 9 mo/ ( ^! cases1 suffici5t diff]5ce betwe5 !m to enable any "o1 :o has se5 bo?1 to di/+ui% "o f ! o!r4 ,! only "t1 except dur+ ge/ation1 :5 real kye/e9 appe>s to be =m$1 is :ile ! milk is be+ secret$ & n freely dis*>g$4 ,?us x may (t5 be f\nd :5 ! female is wean+1 &1 "s writ]s assure u1 9 "s cases dur+ ! :ole p]iod ( nurs+4 ,on ! :ole ?is sign is a v valuable "o1 & may be mu* reli$ ^u4 ,! *anges 9 ! pulse1 on :i* "s p]sons rely1 are ( no value :atev] z a sign ( pregnancy1 s9ce !y are no m frequ5t1 & n at all diff]5t1 s f> z ,i h se51 f :at ord9>ily occur f o!r causes4 ,! developm5t ( ! abdom51 ?\gh an inv>iable accompanim5t ( pregnancy1 is by no means a c]ta9 sign ( x1 s9ce x may be produc$ by o!r causes2 & besides1 x is sometimes b little to be obs]v$ till a late p]iod4 ,! peculi> mann] ( ! developm5t h[ev]1 is usually some:at diff]5t f t produc$ by tumors1 & o!r diseases4 ,v (t5 ! abdom5 w be tol]ably l>ge by ! second mon?1 & !n aga9 become s mu* small] t ! female w ?9k %e is c]ta9ly n pregnant4 ,?is is ow+ *iefly to flatul5ce1 produc$ by dige/ive di/urbance dur+ ! e>ly p]iods1 b :i* aft]w>ds subsides4 ,9 a %ort "t h[ev]1 ! ut]us n only enl>ges m1 b rises1 & ! developm5t becomes p]man5t4 ,?is circum/ance ( !re be+ (t5 two developm5ts has deceiv$ _m1 & ,i h kn[n females decl>$ to be n pregnant1 simply because ! developm5t ( ! abdom5 w5t d[n1 :o1 9 a %ort "t aft]1 exhibit$ unequivocal evid5ces ( be+ 9 t condition4 ,! fir/ developm5t1 or swell+1 is m]ely simil> to :at (t5 arises f indige/ion1 & o!r causes1 & is !re=e no sign ( pregnancy2 b ! second developm5t is accompani$ by o!r *anges1 besides be+ m p]man5t4 ,! l9ea alba1 or :ite l9e1 :i* may be se5 ext5d+ f ! navel to ! pubis1 9 ! ord9>y /ate1 becomes mu* d>k]1 ! sk9 ( ! abdom5 wr9kles1 & ! umbilicus1 or navel1 becomes prom95t4 ,swell+ ( ! eyelids1 & puff+ ( ! face1 are exp]i5c$ by "s females1 b are n v g5]al1 & s frequ5tly result f o!r causes t !y are ( little value z evid5ces 9 ?is case4 ,?is1 ,i believe1 comprises all ! presumptive signs ( ,pregnancy t are wor?y ( notice4 ,"s ( !m are valuable & may be dep5d$ ^u1 p>ticul>ly ! pres5ce ( kye/e9 9 ! ur9e1 :i* may almo/ be call$ a c]ta9 sign4 ,o!rs ( !m are ( little value alone1 b are useful 9 ! way ( corroboration4 ,! m !re are ( !m obs]v$ toge!r1 9 any case1 ( c\rse ! m gr\nds !re are = ! presumption t pregnancy exi/s1 & ! rev]se4 ,x mu/ be c>efully rememb]$ h[ev]1 t ^! presumptive signs are precisely ^? mo/ likely to be produc$ by o!r causes1 p>ticul>ly by m>riage only2 !y mu/ !re=e be well weigh$1 & unless v num]\s1 or v di/9ctly m>k$1 mu/ n be reg>d$ z conclusive4 ,z already rem>k$1 x is only dur+ ! fir/ ?ree mon?s t mo/ ( ^! presumptive signs are tak5 mu* notice (2 aft] t we h o!rs t c be m dep5d$ ^u1 & :i* w be describ$ 9 ! succe$+ articles4 ,,probable ,,signs4 ,end ( ! ?ird mon?4--,! probable signs n[ to be describ$ are seldom recogniz$ be=e ?is "t1 & n g5]ally ) di/9ctness till a /ill lat] p]iod4 ,!y *iefly consi/ ( c]ta9 *anges 9 ! =m1 developm5t1 & position ( diff]5t p>ts ( ! ut]us1 to asc]ta9 :i* requires an int]nal exam9ation4 ,^! *anges are n obs]vable till ! end ( ! ?ird mon?1 previ\s to :i* "t we _c be c]ta9 t ! womb has really increas$ beyond its normal size4 ,& ev5 !n1 :5 ! increase is obvi\s1 we _c tell h[ x has be5 produc$2 x is n till a mu* lat] p]iod1 till five or six1 or ev5 sev5 mon?s are elaps$1 t pregnancy c be asc]ta9$ ) any?+ l c]ta9ty4 ,! *anges to be notic$ are 9 ! =m1 & size1 ( ! neck & body ( ! womb1 & 9 its m\?1 & also 9 ! weight ( ! :ole organ4 ,no "o1 ( c\rse1 c expect to recognize ^! *anges :o is n acqua9t$ ) ! p>ts 9 ! unimpregnat$ /ate1 bo? 9 ! virg9 & 9 ^? :o h borne *ildr54 ,! mode ( conduct+ ! requisite exam9ation is1 by introduc+ ! index f+] ( ! "r h&1 cov]$ ) oil or mucilage1 into ! ,vag9a1 & !n c>ry+ x upw>ds till x rea*es ! ,os ,t9c4 ,by means ( ?is f+] ! position & l5g? ( ! neck ( ! womb are asc]ta9$1 & also ! /ate ( its m\?1 :e!r x is op5$ or clos$1 & to :at ext5t4 ,if x be !n plac$ at ! top ( ! neck1 on ! "u side1 & ! o!r h& ^u ! fundus ( ! womb ext]nally1 & press+ firmly ^u x1 ! organ is enclos$ z x 7 betwe5 ! two h&s1 s t its size & =m may be pretty accurately asc]ta9$1 & also its degree ( firmness1 by :i* a judgm5t may be =m$ z to :e!r x is occupi$ by any solid body1 or fluid1 or :e!r x is empty4 ,9 addition to ?is a pretty accurate e/imate may be made ( its comp>ative weight1 by balanc+1 & rais+ x up on ! f+]4 ,?is is call$ by ! ,fr5* ,ballotm5t1 &1 z w be %[n fur!r on1 is a valuable means1 at c]ta9 /ages1 ( asc]ta9+ pregnancy4--7,see ,plate ,,xvi47 ,! female may be exam9$ ei!r /&+ or ly+ d[n1 ?\gh ! recumb5t position is be/1 except 9 c]ta9 displacem5ts ( ! womb1 :5 x is mo/ likely to be ?r[n into a position 9 :i* ! neck c easily be rea*$ by ! female /&+4 ,! position ( ! neck is v diff]5t 9 _m ( ^! displacem5ts1 & dur+ pregnancy1 to :at x is 9 ! ord9>y /ate1 & a p]son n acqua9t$ ) ^! *anges might frequ5tly be mu* puzzl$ to f9d x4 ,z we h already rem>k$1 also1 !re are c]ta9 diff]5ces betwe5 ^? :o h _h *ildr5 & ^? :o h n4 ,! foll[+ ?ree diagrams repres5t ! *anges j spok5 ( at ?ree diff]5t p]iods3-- ,,plate ,,xiv4 ,figure #a1 repres5ts ! =m & size ( ! body1 neck1 & m\? ( ! ,womb1 at ab\t ! ?ird mon?4 ,figure #b1 ! same at ab\t ! sev5? mon?4 ,figure #c1 ! same at ! n9? mon?4 ,! ref]5ces are ! same 9 all4 a4 ,! ,neck ( ! ,womb4--b4 b4 ,! ,body ( ! ,womb4--c4 ,! ,os ,t9c1 or ,m\? ( ! ,womb4--d4 d4 ,! cut edges ( ! ,vag9a4 ,illu/ration3 ,fig4 #a4 ,fig4 #b4 ,fig4 #c4 ,plate ,,xiv4 ,! =m & size ( ! body1 neck1 & m\? ( ! ,womb1 at ab\t ! ?ird1 sev5? & n9? mon?s4 ,x w readily be se5 by ^! diagrams t ! alt]ations 9 ! neck & m\? ( ! womb are v m>k$1 & ( a "* easily to be asc]ta9$ by ! t\*4 ,^! ?ree %\ld be comp>$ ) ! section ( ! womb 9 ,plate ,,iv1 :i* repres5ts x 9 ! unimpregnat$ /ate4 ,! diff]5ce betwe5 ^? :o h borne *ildr51 & ^? :o h n1 is well repres5t$ 9 ,plate ,,xv1--! draw+s be+ "o-?ird ( ! natural size1 & repres5t+ ! appe>ance at ab\t ?ree mon?s4 ,illu/ration3 ,,plate ,,xv4 ,primip>a1 or ! fir/ ,pregnancy4 ,woman :o has borne *ildr5 be=e4 a4 a4 ,! neck ( ! ,womb4--b4 b4 b4 ,! body ( ! ,womb4--c4 ,! ,os ,t9c1 or m\? ( ! ,womb4--d4 d4 ,! cut edges ( ! ,vag9a4--e4 ,! ,ftus4--f4 f4 ,! ,fallopian ,tubes1 ,ov>ies1 & ,r\nd ,ligam5ts4--g4 ,! ,plac5ta4 ,mo/ ( ! *anges produc$ c be readily di/+ui%$ by ! f+]1 aft] see+ ?is repres5tation1 & mak+ a prop] comp>ison betwe5 x & ! natural /ate 9 ,plate ,,iv4 ,! ,neck is n mu* enl>g$ at ?is p]iod1 b its l[] "p is some:at s(t to ! feel+4 ,! ,os ,t9c is m r\nd$ ?an 9 ! unimpregnat$ /ate1 p>ticul>ly 9 ! ,primip>a1 9 :om 9 fact x is ne>ly circul>1 ! lips be+ q smoo? & clos$4 ,9 ! female :o has already borne *ildr5 x is some:at op51 s t ! f+] may (t5 be introduc$2 & ! lips feel r\gh1 ow+ to sc>s & lac]ation 9 previ\s deliv]ies4 ,x is also l>g] altoge!r1 & s(t]1 ?an 9 ! primip>a4 ,! :ole l5g? ( ! neck at ?is /age is ab\t two in*es4 ,! body ( ! ut]us1 :5 press$ betwe5 ! two h&s1 w be f\nd mu* l>g] ?an ord9>y1 & m r\nd1 & x w feel heavy :5 pu%$ up by ! f+]4 ,9 reg>d to ! precise value ( ^! probable signs1 x c only be said1 :5 !y are obs]v$1 t x is c]ta9 t ! womb is enl>g$1 & mo/ probably f pregnancy4 ,b at ! same "t x mu/ be rememb]$ t sev]al diseases1 & p>ticul>ly suppress$ & irregul> m5/ruation1 or ! developm5t ( tumors & polypi1 w effect v simil> *anges1 & t x is n always possible to say :e!r !y arise f ^! abnormal gr[?s or f pregnancy1 ?\gh x c g5]ally be done4 ,b ?\gh we _c1 9 e case1 say :5 ^! signs exi/1 t ! female mu/ be pregnant1 we c ne>ly always say1 :5 !y d n exi/1 t %e _c be s1 p>ticul>ly if ! o!r usual signs are abs5t4 ,end ( ! f\r? mon?4--,by ?is "t ! neck has become a little %ort] /ill1 & ! m\? m op51 b on ! :ole !re is n mu* *ange to be felt int]nally4 ,! body ( ! womb h[ev]1 has n[ asc5d$ above ! sup]ior /rait ( ! ,pelvis1 & beg9s p]man5tly to enl>ge ! ,abdom54 ,x may be di/9ctly felt betwe5 ! two h&s1 l a firm r\nd ball1 some:at ela/ic1 & resi/+ :5 press$4 ,?is is ! p]iod :5 ! motions ( ! ftus are usually felt fir/1 & ^! motions1 ) ! asc5sion ( ! womb1 are sometimes exp]i5c$ v sudd5ly1 s z to al>m ! female1 & produce c]ta9 curi\s s5sations1 ) mu* n]v\s d]angem5t4 ,?is is call$ quick5+1 &1 ) "s p]sons1 is always s well m>k$ z to indicate n only _! condition1 b ! v p]iod1 ) great precision4 ,_m h[ev]1 nev] exp]i5ce any?+ at all peculi> at ?is "t4 ,x is cu/om>y = ! m$ical att5dant1 z a means ( mak+ ! *ild move1 to put 8 h& fir/ 9 cold wat]1 & !n ov] ! fundus ( ! ut]us2 ! s5sation ( cold ?us convey$ usually caus+ x to move imm$iately4 ,great c>e mu/ be tak5 h[ev]1 t o!r motions be n mi/ak5 = ^? ( ! *ild1 an error n at all uncommon4 ,_m a female1 & _m a m$ical man also1 has be5 deceiv$ 9 ?is way1 p>ticul>ly 9 cases ( ut]9e or ov>ian dropsy1 & tumor1 & ev5 9 ord9>y flatul5ce & hy/]ia4 ,females :o mu* desire (fspr+ frequ5tly deceive !mselves 9 ?is way1 & x is sometimes next to impossible to conv9ce !m ( _! error4 ,"s wom5 possess ! p[] ( imitat+ ! movem5ts ( ! *ild1 ) great exactness2 & in/ances h be5 kn[n :]e !y h successfully impos$1 bo? on _! fri5ds & m$ical att5dants1 = a long "t1 9 ?is way4 ,mr4 ,dubois m5tions in/ances ( females :o possess$ ?is extraord9>y p[]1 & :o1 ?\gh n pregnant1 us$ to pres5t !mselves to 8 class1 = ! pupils to asc]ta9 ! motions ( ! *ild4 ,9 %ort1 ?is sign mu/ n be too mu* reli$ ^u1 nor too confid5tly expect$1 = _m females obs]ve no ftal motions at all till ! six? or sev5? mon?1 & ev5 !n v indi/9ctly4 ,sometimes also1 aft] hav+ be5 di/9ctly felt1 ^! motions w altoge!r /op = a long "t1 & !n appe> aga94 ,at ?is "t h[ev]1 ,ballotm5t c beg9 to be practis$1 ?\gh x is n q s c]ta9 z at a mon? lat]4 ,! mann] ( p]=m+ ?is important manipulation has already be5 p>tly describ$1 & by exam9+ ,plate ,,xvi1 & att5d+ to ! foll[+ rem>ks1 x may be readily und]/ood & practis$4 ,,plate ,,xvi4 ,?is ,plate repres5ts ! mode ( p]=m+ ! ,ballotm5t1 to detect pregnancy4 ,! outl9e ( ! figure is ! same z 9 ,plate ,i1 & mo/ ( ! organs are lett]$ ! same4 ,! index f+] ( ! "r h& is pass$ into ! ,vag9a till x t\*es ! body ( ! ,womb1 ! neck be+ ?r[n back1 ow+ to ! tilt+ ( ! ,fundus =w>d4 ,! left h& is press$ firmly ^u ! ,abdom51 j ov] ! pubic bone4 #a1 ,is ! ,ftus4--#b1 ,! ,plac5ta1 connect$ ) ! ,ftus by ! cord4--#c1 ,is ! index f+] ( ! "r h&1 )9 ! ,vag9a4--#d1 ,is ! left h&4 ,! developm5t ( ! ,womb1 & ! *ange 9 its position1 are v well repres5t$ 9 ! ,plate1 & s are ! alt]ations 9 "s ( ! o!r organs4 ,! mann] 9 :i* ! ,bladd]1 ,a1 is press$ out ( its usual %ape & size1 may be se5 by comp>+ ?is ) ,plate ,i4 ,! %ort5+ ( ! ,vag9a1 & ! expansion ( its upp] "p1 are also equally obvi\s1 & ! mann] 9 :i* ! m\? ( ! ,womb is ?r[n back aga9/ ! ,rectum4 ,illu/ration3 ,plate ,,xvi4 ,?is ,plate repres5ts ! mode ( p]=m+ ! ,ballotm5t1 to detect pregnancy4 ,! outl9e ( ! figure is ! same z 9 ,plate ,i1 & mo/ ( ! organs are lett]$ ! same4 ,:5 ! "r h& f+] 7#a ,plate ,,xvi17 is c>ri$ to ! top ( ! ,vag9a1 x meets ) a r\nd s(t tumor1 :i* is ! head ( ! *ild felt ?r\gh ! walls ( ! womb4 ,z soon z ?is is di/9ctly felt1 ! f+] mu/ be )drawn a little1 & !n pu%$ sudd5ly aga9/ ! tumor ) a j]k2 ?is w displace ! ftus1 & cause x to rise 9 ! liquor amnii t[>ds ! ,fundus1 s t ! r\nd tumor w h disappe>$4 ,9 a few mom5ts x w s9k d[n & may be aga9 felt1 & aga9 displac$ 9 ! same mann]4 ,?is is call$ ! ,ballotm5t1 or balanc+ x on ! end ( ! f+]4 ,! s5sation convey$ on t\*+ ! ,ftus1 & :5 x rises aft] be+ pu%$1 are s peculi> t !y are n likely to be ov]look$1 or mi/ak5 = any?+ else1 aft] be+ once exp]i5c$4 ,! j]k is n requir$ to be at all viol5t1 & _h bett] be made at fir/ v slight1 z x c easily be repeat$ a little m =cibly if ! tumor does n rise at fir/4 ,"s practition]s practice ! ,ballotm5t 9 ?is way1 us+ ! "o h& only2 b o!rs place ! left h& also on ! ,abdom51 7#d ,plate ,,xvi17 at ! same "t1 & imm$iately aft] j]k+ upw>ds ) ! "r h&1 !y sudd5ly depress ! ,abdom51 j ov] ! pubes1 ) ! f+]s ( ! left1 s z to s5d ! ,ftus d[n aga9 m quickly & m =cibly4 ,?is is seldom ne$$1 b if ! fir/ way does n succe$ ! two h&s may be tri$4 ,a species ( ballotm5t may ev5 be practis$ ext]nally1 9 ! foll[+ way3--,! f+]s ( ! "r h& are plac$ on ! ,abdom51 j ov] ! fundus ( ! womb1 l ! left h& 9 ,plate ,,xvi1 & a sm>t j]k is giv5 d[nw>ds & backw>ds1 sev]al times 9 quick succession4 ,?is also displaces ! ,ftus1 :i* may be di/9ctly felt to float away1 ea* "t ! p]cussion is made4 ,no "o c mi/ake ?is peculi> motion :o has once felt x4 ,sometimes "o ( ^! manuvres w succe$ :5 ! o!r fails1 s t x is well to practise !m all4 ,!y may be p]=m$ ) ! female ei!r /&+ or ly+ d[n1 & w sometimes succe$ "o way :5 !y w n ! o!r4 ,x is requisite to rememb] t 9 pres5tations ( ! bree*1 or trunk1 ! ballotm5t may n succe$ z well z :5 ! head pres5ts2 or x may ev5 fail altoge!r1 s t :5 x is unsuccessful we mu/ n imm$iately conclude !re is no pregnancy4 ,tumors 9 ! womb1 /one 9 ! bladd]1 & v>i\s ut]9e displacem5ts1 may also create unc]ta9ty1 or cause failure1 b ^! accid5ts are r>ely met )1 & only int]f]e mat]ially at an e>ly /age2 aft]w>ds ballotm5t c be practis$ not)/&+ !m1 or auscultation may be resort$ to4 ,9 %ort1 ?is mode ( detect+ pregnancy is "o ( ! mo/ c]ta91 & ! mo/ g5]ally applicable1 t we possess4 ,end ( ! fif? mon?4--,at ?is "t ! ,ut]us has increas$ consid]ably 9 size1 & has asc5d$ s high 9 ! ,abdom5 t ! ,fundus is level ) ! umbilicus1 or navel1 9 a fir/ pregnancy1 ?\gh some:at l[] 9 ^? :o h borne *ildr5 be=e4 ,?is ris+ ( ! womb makes ! ,vag9a long]1 & br+s ! neck ( ! womb ne>] to its c5tre4 ,9 ! previ\s /age ! neck 0 ?r[n s f> back t x 0 difficult to rea*1 b n[ x is mu* m favorably situat$1 ?\gh mu* high]4 ,its sub/ance is s(t] ?an be=e1 & ! two lips are ne>ly on a level1 & some:at op5$1 p>ticul>ly 9 ^? :o h borne *ildr5 be=e4 ,inde$1 9 !m ! po9t ( ! f+] may be introduc$1 z se5 bel[3-- ,illu/ration3 ,,plate ,,xvii4 ,neck ( ! ,womb 9 a fir/ ,pregnancy1 v slightly op5$4 ,neck ( ! ,womb 9 a female :o has borne *ildr5 be=e1 %[+ h[ x admits ( ! introduction ( ! f+]4 ,?is is at ! end ( ! ,fif? ,mon?1 & ! draw+s are ab\t "o-?ird ( ! natural size4 ,ballotm5t is n[ mu* m easily practis$1 & is m conclusive4 ,a new sign is also to be di/+ui%$1 by :i* we are furni%$ ) ano!r valuable means ( detect+ pregnancy4 ,! *ild's he>t beg9s to beat s /rongly1 & its circulation is s vigor\s1 t ! s\nd ( x c be he>d ext]nally4 ,! same means are tak5 to asc]ta9 ?is t are us$ 9 s\nd+ ! *e/ ( an adult4 ,if ! e> be plac$ on ! ,abdom51 ov] ! womb1 ! beat+ ( ! ftal he>t may be he>d q pla9ly2 & if ! /e?oscope be us$ x w be /ill m di/9ct4 ,?is practice is call$ ,auscultation4 ,! signs furni%$ by x are c]ta9ly ( ! greate/ value1 & frequ5tly enable u to detect pregnancy ) un]r+ c]ta9ty4 ,inde$1 n only c we tell by !m t a *ild is 9 ! womb1 b (t5 ev5 ! v position 9 :i* x lies1 & :e!r !re be tw9s1 or m4 ,?is is done by not+ :]e ! he>t is situat$1 by ! s\nd1 & :e!r ! beat+ is s+le or d\ble4 ,! nature ( ^! s\nds1 & ! mann] ( detect+ !m1 require to be c>efully expla9$4 ,if ! p]son wi%+ to notice ?is sign is n already famili> ) ! beat+ ( ! adult he>t1 he _h bett] become s fir/4 ,! e> %\ld be plac$ on ! left side ( a gr[n up p]son1 on ! sk91 j b5ea? ! brea/1 & held v /ill4 ,! he>t w !n be he>d to beat v di/9ctly1 !re be+ two s\nds1 a long "o & a %ort "o1 alt]nat+ ) ea* o!r4 ,:5 ?is has be5 li/5$ to = "s "t1 ! e> w be able to cat* any simil> s\nd1 & ! auscultation may !n be practis$ to detect pregnancy4 ,! e> mu/ be plac$ on ! ,abdom51 ab\t midway betwe5 ! ,pubes & ! umbilicus1 & t[>ds ! left side4 ,no weight %\ld be borne on ! body1 b ! e> mu/ be laid suffici5tly close to exclude all ext]nal s\nds1 & no motion %\ld take place1 p>ticul>ly ) ! clo!s4 ,if ! s\nd be n he>d 9 ! position fir/ assum$1 move a little1 9 diff]5t directions1 till t po9t is atta9$ :]e x is mo/ di/9ct4 ,x c sc>cely fail to be he>d1 ) ord9>y c>e4 ,a practis$ e> w sometimes di/+ui% ! s\nd z e>ly z ! f\r? mon?1 b g5]ally x _c be he>d be=e ! end ( ! fif?1 or ev5 till ! six? mon?4 ,!re are sev]al s\nds t may ei!r be mi/ak5 = x1 or t may confuse ! e>4 ,! beat+ ( ! "m's he>t w sometimes be v di/9ct1 z f> z ! l[] "p ( ! ,abdom51 b x is mu* sl[]2 ! *ild's he>t ?robb+ ne>ly twice z fa/4 ,! movem5ts ( ! ,ftus1 & ! rumbl+ ( ! inte/9es1 w also int]f]e2 b :5 once ! prop] s\nd has be5 caught x may be kept indep5d5tly ( all ^!4 ,! mann] 9 :i* ! *ild lies 9 ! womb w det]m9e :]e ! he>t %all be opposite1 & z its position frequ5tly v>ies1 bo? 9 diff]5t individuals1 & at diff]5t p]iods1 9 ! same p]son1 ! s\nd mu/ be s\ght = at sev]al po9ts1 till ! "r "o is f\nd4 ,! mo/ usual position w be se5 9 sev]al ( our plates1 & !y w give suffici5t indication to enable almo/ any "o to practise ?is mode ( detection ) success4 ,dur+ ! e>ly mon?s ! *ild moves ab\t a good deal1 s t ! s\nd may be he>d "o day 9 "o place1 & ! next 9 ano!r4 ,ab\t ! sev5? mon? h[ev]1 x becomes m fix$1 s t ! place ( ! he>t c be pretty c]ta9ly asc]ta9$1 & ?us ! position ( ! :ole body is made out1 :e!r ! head is d[nw>ds or upw>d1 & a tol]able idea c be =m$ ev5 z to ! direction ( ea* "p4 ,_m p]sons h fail$ 9 _! attempts to he> ! ,ftal pulsation1 b ,i _c b ?9k x mu/ h be5 ei!r f inatt5tion1 or f n be+ acqua9t$ ) ! s\nd ( ! he>t at all4 ,i nev] recollect an in/ance :5 ,i c\ld n d s1 at ! prop] "t4 ,m4 ,*ailly says he does n hesitate to affirm t 9 e in/ance !y c be detect$2 & ,m4 ,p4 ,dubois di/9ctly he>d !m 9 "o hundr$ & eighty-five females1 out ( "o hundr$ & n9ety-five1 9 ! o!r t5 ! *ild be+ probably dead4 ,inde$1 ! abs5ce ( ?is s\nd is ! mo/ c]ta9 sign ( ! dea? ( ! ,ftus1 z its exi/5ce is ( its be+ alive2 & m$ical m5 n[ tell :e!r ! *ild is dead or n by ^! v means4 ,9 conduct+ ! auscultation ! female mu/ recl9e1 & keep z /ill z possible1 brea?+ l[4 ,! ,abdom5 may be cov]$ ) a s+le ?9 g>m5t1 if absolutely insi/$ ^u2 b ! judgm5t w be s mu* ! m unc]ta91 ow+ bo? to ! dead5+ ( ! s\nd & to ! friction ( ! mat]ial4 ,! exp]im5t] mu/ also recollect t if ! head be held d[n too long1 ! blood w ru% to x1 & cause a humm+ 9 ! e>s1 :i* w confuse him2 x w !re=e be bett] if ! b$ be high4 ,x is always be/ to use ! /e?oscope1 z x cov]s only a small space1 conveys ! s\nd m directly1 & %uts out ext]nal noises m effectually4 ,?is in/rum5t is extremely simple1 consi/+ m]ely ( a tube ( wood1 glass1 metal1 gum ela/ic1 or almo/ any o!r mat]ial4 ,"o end %\ld be exp&$ a little1 l a bell1 & ! o!r made small1 s z to fit close 9 ! e>--! l>ge end be+ plac$ on ! ,abdom54 ,x may be ab\t a foot 9 l5g?1 ?\gh a little %ort] or long] w n make mu* diff]5ce4 ,i once us$ a *ild's t9 trumpet1 hav+ no regul> /e?oscope ) me1 & succe$$ ) x p]fectly4 ,! l>ge end %\ld be press$ on ! ,abdom51 & ! small] "o into ! e>1 suffici5tly close to %ut out all o!r s\nds b ^? com+ f ! body4 ,?is is ! same in/rum5t t ! lungs are s\nd$ )1 :5 we want to judge ( _! action & condition4 ,?is is an invaluable means ( detect+ pregnancy2 9 fact1 at ! prop] "t1 & ) due c>e1 x may be said to be c]ta94 ,end ( ! six? mon?4--,?is is ! p]iod :51 accord+ to ! law1 ! *ild c live4 ,!re are no new signs at ?is "t1 b ^? previ\sly notic$ are n[ m di/9ct4 ,! neck ( ! womb is /ill s(t] & %ort]1 & ! f+] c p5etrate fur!r 9 ! passage ?an be=e4 ,! fundus ( ! womb is n[ above ! umbilicus1 9 primip>a1 ?\gh n s high 9 ^? :o h borne *ildr52 & ! bladd] is above ! sup]ior /rait4 ,ballotm5t c n[ be practis$ ) c]ta9ty1 ! fall+ & ris+ ( ! ,ftus be+ v di/9ct4 ,auscultation also becomes m positive1 ! s\nds be+ l\d] & m easily asc]ta9$4 ,end ( ! sev5? mon?4--,! fundus ( ! womb has n[ ris5 /ill high]1 & ! ,bladd] is pu%$ completely above ! upp] /rait1 s t ! :ole l5g? ( ! ,ure?ra lies beh9d ! pubic bone4 ,x is !n mu* press$ ^u & swoll51 & be+ mu* long]1 & b5t out ( its usual c\rse1 ! ur9e is (t5 pass$ ) difficulty1 & ! ca!t] c sc>cely be introduc$4 ,! upp] "p ( ! ,womb n[ lies ov] t[>ds ! "r side ( ! body1 v evid5tly4 ,?is direction is ne>ly con/ant1 9 all females1 b ! reason = x is n kn[n4 ,!re h be5 _m !ories to acc\nt = ! peculi>ity1 b none ( !m are ei!r s plausible1 or s well support$ by facts1 z to be g5]ally adopt$4 ,! upp] "p ( ! ,womb be+ tilt$ to ! "r side1 ! neck ( c\rse po9ts to ! left1 & backw>ds4 ,x is n[ v %ort1 ev5 9 primip>a1 b 9 ^? :o h borne *ildr5 x is sc>cely to be di/+ui%$ at all4 ,! f+] may n[ be introduc$1 ev5 9 primip>a1 half way up ! neck2 & 9 o!rs x w rea* ev5 into ! ut]9e cavity4 ,illu/ration3 ,,plate ,,xviii4 ,fir/ *ild4 ,woman :o has borne *ildr54 ,! neck ( ! ,womb 9 a fir/ pregnancy1 & 9 a female :o has borne *ildr5 be=e1 at ! end ( ! sev5? mon?4 ,! "p bel[ ! l[] l9e "h1 %[s t "p ( ! neck :i* is conta9$ 9 ! ,vag9a4 ,x w easily be se5 h[ mu* %ort] ?is "p is1 & h[ mu* m op5 ! passage is1 9 ! female :o has borne *ildr51 ?an 9 a fir/ pregnancy4 ,ballotm5t & ,auscultation bo?1 n[ af=d unmi/akeable evid5ces z to ! condition ( ! pati5t4 ,end ( ! eigh? mon?4--,by ref]r+ to ! prec$+ ,plates1 x w be se5 t ! "p ( ! neck ( ! ,womb above ! ,vag9a1 :i* is plac$ betwe5 ! two dott$ cross l9es1 rema9s almo/ un*ang$1 :ile ! "p )9 ! ,vag9a1 or t bel[ ! l[e/ l9e1 becomes less & less1 till at ?is "t1 9 ^? :o h borne *ildr51 x c sc>cely be felt at all2 & ev5 9 a primip>a x is m]ely l a small tub]cle4 ,ab\t ?is "t h[ev]1 ! upp] "p ( ! neck beg9s to %ort5 also1 ?\gh t is n s obvi\s1 & !re=e n s useful = our pres5t purpose4 ,on mak+ an exam9ation1 ! m\? ( ! ,womb itself may n[ be felt1 at ! upp] "p ( ! ,vag9a1 & f> back4 ,x is h[ev]1 v difficult to rea*1 on acc\nt ( its position4 ,! f+] w n[ pass1 9 ^? :o h previ\sly borne *ildr51 into ! cavity ( ! ,womb itself1 b 9 o!rs x w sc>cely rea* s f>4 ,! l9ea alba becomes d>k] at ?is p]iod1 & s does ! areola ar\nd ! nipple4 ,c]ta9 peculi> m>ks also appe> on ! ,abdom51 & upp] "p ( ! ?ighs1 almo/ l ! pits f small pox4 ,!y are usually diamond %ap$1 slightly depress$1 & d>k 9 color4 ,!y appe> to be ow+ to ! ov] /ret*+ ( "s ( ! p>ts "u ! cuticle1 & :i* give way 9 consequ5ce4 ,9 fir/ pregnancies1 & 9 ^? :o enl>ge v mu*1 ^! m>ks are sometimes v num]\s1 & rema9 = a long "t aft] deliv]y1 sometimes ev5 !y nev] disappe>4 ,z signs ( pregnancy h[ev]1 !y are b ( little value1 because !y are (t5 produc$ by o!r causes t di/5d ! ,womb4 ,none ( ^! presumptive signs are n[ ne$$1 & !re=e !y are ( little consequ5ce1 because !re are o!rs m c]ta94 ,! motions ( ! *ild itself c n[ be g5]ally bo? felt & se51 & an exp]i5c$ obs]v] may ev5 pr$icate f !m1 ) tol]able c]ta9ty1 ! position 9 :i* x lies4 ,ballotm5t1 by "o h& on ! ,abdom51 may /ill be practis$ ) success2 b 9 ! ,vag9a x is difficult1 because ! ,ftus is bo? m fix$ & heavi]4 ,auscultation is n[ ! sure/ dep5d5ce h[ev]1 & may be advantage\sly resort$ to also z a means ( det]m9+ be=eh& ! position ( ! *ild4 ,?is may be done ev5 a mon? e>li]1 b n s c]ta9ly z n[4 ,to und]/& h[ ?is important po9t is det]m9$1 x is only necess>y to recollect1 z w be v evid5t1 t ! pulsation w be he>d ! l\de/ imm$iately ov] ! he>t2 & z we "k ! =m & g5]al size ( ! ,ftus1 & ! mann] 9 :i* x usually lies1 x becomes possible1 :5 ! position ( its he>t is discov]$1 to trace out1 f t1 ! position ( e o!r "p4 ,?is w be evid5t by ref]r+ to ,plates ,,xix1 ,,xx1 & ,,xxi4 ,x w !n be se5 t1 if a l9e be drawn across ! middle ( ! ,abdom51 ! he>t w be above t l9e :5 ! bree* pres5ts1 & bel[ x :5 ! head pres5ts1 & on ! "r or left side1 z ! case may be1 9 ea* position4 ,9 case ( tw9s !re w be two pulsations1 & !y s mu* int]f]e ) ea* o!r t x is difficult to di/+ui% ei!r4 ,! two *ildr5 be+ g5]ally dispos$ ) ! head ( "o to ! heels ( ! o!r1 "o he>t w be above ! l9e1 & ! o!r bel[1 on opposite sides1 z %[n 9 ,plate ,,xxii4 ,,plate ,,xix4 ,?is ,plate repres5ts ! ,ftus 9 ! mo/ usual position1 ! head d[nw>ds1 & ! back ( x pres5t+ to ! left side4 ,! black spot a1 %[s ! situation ( ! he>t2 usually imm$iately "u t "p :]e ! s\nd is he>d ! /ronge/4--,x is bel[ ! l9e4 ,illu/ration3 ,plate ,,xix4 ,?is ,plate repres5ts ! ,ftus 9 ! mo/ usual position1 ! head d[nw>ds1 & ! back ( x pres5t+ to ! left side4 ,,plate ,,xx4 ,?is ,plate repres5ts ! ,ftus 9 ! next mo/ frequ5t position1 ! head d[nw>ds1 b ! back ( x pres5t+ to ! "r side4 ,! black spot a1 %[s ! situation ( ! he>t z 9 ! previ\s ,plate4 ,x is n[ bel[ ! l9e1 z be=e1 b on ! opposite side4 ,illu/ration3 ,plate ,,xx4 ,?is ,plate repres5ts ! ,ftus 9 ! next mo/ frequ5t position1 ! head d[nw>ds1 b ! back ( x pres5t+ to ! "r side4 ,,plate ,,xxi4 ,?is ,plate %[s ! position ( ! ,ftus 9 a pres5tation ( ! ,pelvis1 or bree*1 :i* happ5s1 comp>atively1 b seldom4 ,! black spot a1 d5otes ! situation ( ! he>t1 :i* is "h above ! l9e1 in/ead ( bel[4 ,9 ?is case1 z 9 ! o!rs1 ! he>t may be on ei!r side ( ! body1 accord+ z ! *ild faces1 b always above ! l9e4 ,illu/ration3 ,plate ,,xxi4 ,?is ,plate %[s ! position ( ! ,ftus 9 a pres5tation ( ! ,pelvis1 or bree*1 :i* happ5s1 comp>atively1 b seldom4 ,,plate ,,xxii4 ,?is repres5ts ! position ( ,tw9s1 z mo/ usually obs]v$1 "o hav+ a head pres5tation1 & ! o!r a bree*4 ,! black spot a1 on bo?1 d5otes ! position ( ! he>t1 :i* 9 "o case is above ! l9e1 & 9 ! o!r bel[4 ,! head h[ev]1 may be on ! "r side in/ead ( ! left1 & s rev]se ! position ( ! two he>ts1 b ?is is v seldom ! case4 ,:5 !re are m ?an two1 ! confusion & unc]ta9ty becomes /ill great]4 ,illu/ration3 ,plate ,,xxii4 ,?is repres5ts ! position ( ,tw9s1 z mo/ usually obs]v$1 "o hav+ a head pres5tation1 & ! o!r a bree*4 ,at ?is p]iod ! signs previ\sly obs]v$ become m di/9ct1 b !re are few new ones4 ,! ext]nal lips sometimes swell1 & ! brea?+ becomes m difficult1 ow+ to pressure on ! diaphragm4 ,! tr\ble ) ! ur9e is also apt to increase1 & little mucus tub]cles1 l pimples1 occasionally =m ar\nd ! ,os ,t9c1 & on ! upp] "p ( ! ,vag9a4 ,end ( ! n9? mon?4--,!re is b little diff]5ce betwe5 ?is & ! previ\s p]iod4 ,! m\? ( ! ,ut]us is m op51 &1 9 ^? :o h _h *ildr51 ! f+] w pass directly into ! ,womb1 & feel ! *ild1 b 9 primip>a !re is /ill a small portion ( ! neck left4 ,illu/ration3 ,,plate ,,xxiii4 ,fig4 #a4 ,! neck ( ! ,womb1 at ne> ! end ( n9e mon?s 9 a primip>a4 ,fig4 #b4 ,! neck ( ! ,womb1 at ne> ! end ( n9e mon?s1 9 a woman :o has previ\sly borne *ildr54 ,ballotm5t is n[ m obscure ?an be=e1 z ! ,ftus is v heavy1 & q l[ d[n1 & pretty firmly fix$4 ,auscultation is di/9ct en\gh1 b n m s ?an at ! previ\s p]iod4 ,! swell+ ( ! lips1 & ( ! ve9s ( ! legs1 may increase1 & s may ! difficulty ) ! ur9e2 b ! brea?+ g5]ally becomes easi]1 ow+ to ! ,womb hav+ desc5d$ a little1 & s press+ ! diaphragm less4 ,^! comprise all ! signs & indications ( pregnancy t possess any real value4 ,"s ( !m1 at c]ta9 times1 & "u p>ticul> circum/ances1 may be call$ positive2 su* z ^? discov]$ by ,ballotm5t & ,auscultation1 & also ! pres5ce ( ,kye/e9 9 ! ur9e4 ,mo/ ( ! o!rs m]ely make x probable t pregnancy exi/s1 or w>rant u 9 presum+ z mu*4 ,!y are n to be dep5d$ on implicitly alone1 b :5 _m ( !m are obs]v$ toge!r1 & no o!r cause c be assign$ = _! production1 ! presumption becomes s well support$ z almo/ to be call$ a moral c]ta9ty4 ,a p]son ( exp]i5ce1 :o is famili> ) all ^! signs1 & ) ! o!rs produc$ by disease :i* resemble !m1 w seldom f9d x difficult to decide2 b /ill !re are cases 9 :i* pregnancy proce$s1 ev5 to its t]m9ation1 ) b few unusual symptoms1 s t bo? pati5t & att5dant are completely at fault4 ,?is h[ev] is v r>e1 & _m em95t au?ors cont5d t x is always possible to detect pregnancy1 aft] ! six? mon?1 & ,i ?9k s myself1 unless ! *ild be dead1 9 :i* case x w soon be evid5t 9 ano!r way4 ,,*apt] ,,vi4 ,,duration ,,( ,,pregnancy4 ,! duration ( pregnancy1 or ! precise t]m ( ,ut]o ,ge/ation1 is n fix$4 ,x appe>s1 f accurate obs]vation1 t !re is no absolute p]iod det]m9$ by natural laws1 & !re=e !re is none laid d[n by human enactm5ts4 ,an approximation c be made1 by tak+ ! av]age ( a numb] ( cases1 & ! p]iod ( limitation may also be det]m9$ 9 ! same way4 ,! mo/ usual p]iod is ab\t n9e mon?s1 or f ?irty-five to =ty weeks1 "s females go+ beyond ! ?irty-six weeks1 & o!rs n s long4 ,fir/ *ildr5 are frequ5tly born "u ! n9e mon?s1 & m s ?an ^? t come aft]2 ?is is a fact n g5]ally kn[n1 & ignorance ( x has (t5 giv5 rise to unju/ suspicions4 ,x is q possible = a female to be deliv]$1 ) ! *ild at full p]iod1 9 a little ov] eight mon?s aft] m>riage1 )\t !re be+ any j gr\nds :atev] = suspect+ unfai?fulness4 ,dr4 ,r4 ,lee1 9 8 ,lectures on ! ,!ory & ,practice ( ,midwif]y1 gives ! be/ summ>y t we h 9 ! language1 ( our in=mation on ?is subject2 ,i w !re=e quote f 8 "w1 mak+ su* comm5ts & additions z ,i may ?9k advisable4 ,! ,roman law fix$ ! p]iod ( ge/ation at t5 lun> mon?s4 ,! civil code ( ,prussia orda9s t a *ild born #cjb days aft] ! dea? ( ! husb& %all be consid]$ legitimate4 ,by ! law ( ,france1 ! legitimacy ( a *ild _c be call$ 9 "q :o is born #cjj days aft] ! dea? or dep>ture ( ! husb&4 ,! laws ( ,engl& decl>e t ! usual p]iod ( human ut]o-ge/ation is n9e cal5d> mon?s1 or =ty weeks2 f>!r ?an ?is !y d n fix a def9ite p]iod3 ! law is n exact z to a few days4 ,n9e cal5d> mon?s conta9 only #bge days1 & only #bgc or #bgb if ,febru>y be includ$4 ,to fix ba/>dy on a *ild 9 ,scotl&1 abs5ce mu/ cont9ue till )9 six mon?s ( ! bir?1 & a *ild born aft] ! t5? mon? is acc\nt$ illegitimate4 ,! difficulty ( det]m9+ ! precise "t :5 impregnation takes place 9 ! human subject1 r5d]s x almo/ impossible1 9 any case1 to calculate ) absolute c]ta9ty ! duration ( pregnancy4 ,we are1 h[ev]1 9 possession ( a suffici5t numb] ( obs]vations to e/abli% ! fact t ! ord9>y p]iod is ab\t =ty weeks1 or #bhj days2 b x is c]ta9 t x does occasionally exce$ or fall %ort ( ?is p]iod by sev]al days4 ,z we c nev] be c]ta9 ( ! precise day1 betwe5 ! p]iods ( m5/ruation1 :5 conception occurs--:e!r x takes place imm$iately aft] ! la/ p]iod1 or be=e ! expect$ p]iod1 or midway betwe5 ^!--x is obvi\s t all calculations f\nd$ ^u ! cessation ( ! catam5ia mu/ be extremely unc]ta94 ,! error ( ! calculation w be /ill great] if ! catam5ia %\ld h appe>$1 or a dis*>ge l ! catam5ia %\ld h occurr$ once or twice aft] conception4 ,impregnation mo/ frequ5tly takes place soon aft] m5/ruation1 b 9 o!rs x does n happ5 till a few days be=e ! expect$ p]iod2 s t two wom5 may h m5/ruat$ at ! same "t1 & "o may h rea*$ ! full p]iod ?ree weeks be=e ! o!r2 & to ?is ext5t1 or ne>ly s1 an op9ion f\nd$ on ! disappe>ance ( ! catam5ia may be errone\s4 ,calculations ( ! duration ( pregnancy1 f\nd$ ^u :at has be5 obs]v$ to occur aft] casual int]c\rse1 or p]haps a s+le act1 9 individuals :o c h no motive to tell u :at is false1 are likely to be mu* m correct2 & ! conclusion to be drawn f ^! is1 t labor usually1 b n inv>iably1 comes on ab\t #bhj days aft] conception1 a mature *ild be+ sometimes born be=e ! expiration ( =ty weeks1 & at o!r times n until ! =ty weeks h be5 exce$$ by sev]al days4 ,a case came "u my obs]vation v lately1 9 :i* ,i _h no d\bt ! pregnancy exi/$ #bhg days3 ! labor did n take place till #bhg days _h elaps$ f ! dep>ture ( ! husb& ( ?is lady = ! ,ea/ ,indies4 ,"s wom5 are always deliv]$ be=e ! end ( ! =ty weeks1 accord+ to ! usual calculation1 & _! *ildr5 are mature4 ,9 ! evid5ce giv5 on ! ,g>dn] ,pe]age cause1 ! p]iod ( ut]o-ge/ation 0 limit$1 b n /rictly1 by "s ( ! witnesses1 to =ty weeks1 or #bhj days2 by o!rs x 0 ext5d$ to #caa days4 ,dr4 ,m]riman1 ^: op9ion is always entitl$ to mu* respect1 ?9ks ! greate/ numb] ( wom5 complete ge/ation 9 ! #dj? week1 & next to t 9 ! #da/4 ,( #aad pregnancies1 calculat$ by him f ! la/ day ( m5/ruation1 & 9 :i* ! *ildr5 appe>$ to be mature1 #c deliv]ies took place at ! end ( ! #cg? week2 #ac 9 ! #ch?2 #ad 9 ! #ci?2 #cc 9 ! #dj?2 #bb 9 ! #da/2 #ae 9 ! #db;d2 #aj 9 ! #dc;d2 & #d 9 ! #dd? week4 ,h[ long be=e ! expiration ( ! #dj weeks a *ild may be born ) ! p[] ( support+ life has n be5 det]m9$4 ,:]e ,i h induc$ premature labor = di/ortion ( ! pelvis be=e ! end ( ! sev5? cal5d> mon? f ! la/ m5/ruation1 ,i h nev] se5 a *ild re>$4 ,! lady ( ! cl]gyman 9 ,fife1 ^: case has lately giv5 rise to s mu* discussion1 0 deliv]$ #age days aft] m>riage1 & ! *ild liv$ five mon?s4 ,to :at ext5t ge/ation may be protract$ 9 "s cases beyond ! #bhj days x is v difficult to det]m9e1 & ! op9ions ( ! mo/ em95t writ]s diff] ^u ! subject4 ,i %\ld suspect "s great error 9 ! calculation :]e ! p]iod ( ge/ation exce$$ #cjj days4 ,b ! exp]im5ts made on ! l[] animals prove t !re exi/s 9 !m a great v>iation betwe5 ! %orte/ & ! longe/ ge/ation2 & x is difficult to compreh5d :y !re %\ld be a diff]5ce 9 ?is respect 9 ! human species4 ,9 a trial :i* took place 9 ?is c\ntry1 9 ! c\nty ( ,lanca/]1 ,pa41 z report$ 9 ! ,m$ical ,exam9] = ,june1 #ahdf1 x 0 decid$ t ,ge/ation may be prolong$ to ?ree hundr$ & ?irte5 days6 ,! female swore t conception mu/ h tak5 place on ! tw5ty-?ird ( ,m>*1 #ahde1 & ! *ild 0 n born till ! ?irtie? ( ,janu>y1 #ahdf1 or ov] elev5 mon?s4 ,! judge direct$ ! jury to return a v]dict 9 h] favor1 & ,i suppose ?is case e/abli%es a prec$5t = ,am]ica4 ,9 a rec5t numb] ( ! ,m$ical ,gazette1 ,i f9d a case report$ :]e9 ! p]iod 0 said to be prolong$ /ill f>!r4 ,a man left 8 wife 9 ,new ,s\? ,wales1 he com+ to ,engl&1 & twelve mon?s aft] he left %e 0 deliv]$ ( a *ild1 :i* %e claim$ to be legitimate4 ,he d5i$ ?is h[ev]1 & ! judge 9 ! ,consi/ory ,c\rt decid$1 )\t hesitation1 9 8 favor4 ,tak+ ! m$ium betwe5 ^! two cases !re=e1 x appe>s to be decid$ t ! extreme limits is some:]e betwe5 elev5 & twelve mon?s6 ,x mu/ be recollect$ h[ev]1 t bo? 7 p]fectly arbitr>y1 & t1 = any?+ kn[n positively on ! subject1 bo? may be ei!r "r or wrong4 ,except :5 labor is br\ght on prematurely by viol5ce1 x always comm5ces at :at w\ld h be5 "o ( ! mon?ly p]iods2 or 9 o!r words1 aft] a c]ta9 numb] ( full mon?s1 & nev] at any "t betwe56 ,if !re=e a female passes ov] ! n9? mon?1 %e w probably g to ! t5?4 ,?is has be5 prov$ by ext5sive obs]vation1 & is only ano!r pro( ( ! regul> me?od 9 :i* nature conducts all h] op]ations4 ,! same law is also obs]v$ 9 abortions1 :i* g5]ally take place at "o ( ! mon?s1 unless br\ght on sudd5ly by viol5ce4 ,,*apt] ,,vii4 ,,p]iod ,,:5 ,,! ,,*ild ,,c ,,live4 ,! precise p]iod :5 ! *ild c live1 if br\ght into ! _w1 is n det]m9$1 any m ?an ! "t x may rema9 9 ! ,womb4 ,"s *ildr5 may be able to live a consid]able "t be=e ! full p]iod ( ,ge/ation1 & o!rs may n till "s "t aft]1 !re be+ a great diff]5ce 9 reg>d to _! developm5t4 ,"o may be z fully develop$ at six1 z ano!r at sev5 mon?s4 ,! common op9ion is t ! *ild _c live if born be=e sev5 mon?s4 ,?is1 h[ev]1 is incorrect4 ,_m in/ances h be5 kn[n ( bir?s at six mon?s1 & ev5 e>li]1 9 :i* ! *ild liv$1 & became /rong & heal?y4 ,van ,swiet5 m5tions ! case ( "o ,=tunio ,liceti1 :o 0 born be=e ! six? mon?4 ,he 0 n l>g] ?an ! h&1 b grew to ! av]age size1 & liv$ to be sev5ty-"o ye>s old4 ,dr4 ,gunn+ ,b$=d m5tions a simil> case1 9 8 translation ( ,*ailly's ,midwif]y4 ,!re are ev5 cases m5tion$ ( *ildr5 liv+ at five mon?s1 b x mu/ be borne 9 m9d t x is seldom possible to det]m9e ! exact p]iod4 ,z a g5]al rule h[ev]1 ! *ild does n live till aft] ! sev5? mon?1 ?\gh !re und\bt$ly h be5 cases :]e x has liv$ be=e ! end ( ! six? mon?4 ,! law adopts ! m$ium p]iod1 & decl>es ! *ild capable ( liv+ at ! end ( ! six? mon?1 & n be=e4 ,!re is no reason :atev] = suppos+ t x is less likely to live at eight mon?s ?an at sev51 or t x w n live at all at eight mon?s1 z "s d4 ,,section ,,iii4 ,,! ,,=m1 ,,size1 ,,& ,,position ,,( ,,! ,f,,tus1 ,,& ,,its ,,app5dages1 ,,at ,,full ,,t]m4 ,,*apt] ,,viii4 ,,=m ,,& ,,size ,,( ,,! ,f,,tus ,,at ,,full ,,t]m4 ,,size ,,& ,,=m ,,( ,,! ,,body4 ,! av]age l5g? ( ! ,ftus1 at full t]m1 is ab\t twelve in*es f ! head to ! bree*1 & ab\t eighte5 in*es f ! head to ! feet4 ,its weight v>ies f five to eight p\nds1 p]haps av]ag+ ab\t six1 ?\gh "s h be5 born weigh+ only ?ree p\nds1 or less1 & "s ev5 z high z twelve4 ,! bread? across ! %\ld]s is ab\t f\r in*es1 & ! same across ! hips1 b bo? are s easily compress$ t dur+ deliv]y !y only measure ab\t ?ree in*es1 or ?ree & a half at mo/4 ,,size ,,& ,,=m ,,( ,,! ,,head4 ,! head is ! mo/ important "p1 because x is ! l>ge/1 & usually pres5t fir/4 ,x is !re=e necess>y to describe x fully1 & ) special ref]5ce to its importance1 9 ! e>ly /ages ( labor1 z ! "p by :i* ! position is usually det]m9$4 ,,plate ,,xxiv4 ,! head is g5]ally divid$ into ! ,cranium1 or t "p :i* conta9s ! bra91 & ! ,face4 ,! ,bones ( ! ,cranium4--,^! are sev5 9 numb]1 viz41 two ,frontal ,bones1 or ^? =m+ ! =ehead2 #a1 #a1 ,figs4 #a & #b1 7,plate ,,xxiv47--,two ,p>ietal bones1 or ^? =m+ ! sides ( ! head2 #b1 #b1 ,figs4 #a & #b4--,! ,occipital bone1 or t =m+ ! back ( ! head2 #c1 #c1 ,figs4 #a & #b4--;,& two ,temporal bones1 :i* lie ov] & betwe5 ! e> & ! eye2 #d1 ,fig4 #b4 ,! ,bones ( ! ,face4--,^! are five 9 numb]1 viz41 two ,sup]ior ,maxill>y1 or upp] jaw bones2 #e1 ,fig4 #b4--,two ,mal>1 or *eek bones2 #f1 ,fig4 #b4--;,& "o ,inf]ior ,maxill>y1 or l[] jaw bone2 #g1 ,fig4 #b4 ,illu/ration3 ,,! ,f,,tal ,,head4 ,plate ,,xxiv4 ,! head is g5]ally divid$ into ! ,cranium1 or t "p :i* conta9s ! bra91 & ! ,face4 ,! bones ( ! cranium are n clos$ toge!r1 z !y are 9 ! adult1 b are sep>at$ to a consid]able di/ance1 9 c]ta9 p>ts1 & connect$ by a /rong membrane4 ,^! membran\s spaces are call$ ,sutures & ,fontanelles1 & a k ( !m is absolutely necess>y1 z a means ( asc]ta9+ ! position ( ! head4 ,! ,sutures4--,! fir/ ( ^! spaces1 :i* ext5ds f ! l[e/ "p ( ! middle ( ! =ehead to ! occipital bone1 is call$ ! ,sagittal ,suture1 or ant]o po/]ior ,suture3 ,a1 ,b1 ,c1 ,figs4 #a & #b4 ,x sep>ates ! two frontal1 & ! two p>ietal bones4 ,! spaces betwe5 ! two frontal & ! two p>ietal bones are call$ ! ,frontal ,p>ietal ,sutures1 o4 o4 ,fig4 #a2 & ^? betwe5 ! two p>ietal bones & ! occipital1 l4 l4 ,figs4 #a & #b1 are call$ ! ,lambdoidal ,sutures4 ,! ,fontanelles4--,:5 ! diff]5t ,sutures meet at a po9t1 ! membran\s space is great] ?an at o!r p>ts1 & is call$ a ,fontanelle4 ,?us :5 ! two ,frontal ,p>ietal ,sutures meet ! ,sagittal ,suture1 at ,b1 ,figs4 #a & #b1 !re is q a l>ge diamond %ap$ space betwe5 ! diff]5t bones1 fill$ up ) membrane4 ,?is is call$ ! ,ant]ior ,fontanelle1 or bregma4 ,:]e ! ,sagittal ,suture jo9s ! two ,lambdoidal !re is ano!r space1 n s l>ge1 & diff]5t 9 %ape1 be+ triangul>2 ?is is call$ ! ,po/]ior ,fontanelle1 c4 ,figs4 #a & #b4 ,& :]e ea* ( ! temporal bones jo9s ! p>ietal !re are two o!r spaces1 call$ ! ,temporal ,fontanelles1 t4 ,fig4 #b1 :i* are also irregul>ly diamond %ap$1 b n ne>ly s l>ge z ! ant]ior fontanelle4 ,x is evid5t t if a p]son c di/+ui% ^! ,fontanelles1 :5 he t\*es !m ) 8 f+]1 he c tell :at "p ( ! head is pres5t+1 & h5ce _! use4 ,^! spaces all[ ( ! bones lapp+ ov] ea* o!r1 dur+ deliv]y1 & ?us ! head is made small]4 ,!y d n disappe> till sometime aft] bir?1 & 9 v "y *ildr5 ! bra9 may be felt1 & se5 to "w1 at ! ant]ior fontanelle4 ,ev5tually h[ev]1 ! bones come close toge!r1 & are jo9$ by a curi\s k9d ( dovetail+4 ,! two frontal bones h[ev]1 completely coalesce1 & =m b "o1 9 ! adult4 ,sometimes ! bones w be v p]fectly =m$1 & ! fontanelles ne>ly fill$ up1 be=e bir?1 & !n ! head _c be cru%$ mu* small]1 & s ! labor becomes bo? pa9ful & difficult4 ,?is is usually call$ an ossifi$1 or solid head4 ,diamet]s ( ! ,head4--,! diamet]s ( ! head are ! di/ances betwe5 its mo/ prom95t po9ts4 ,!y are necess>y to be kn[n be=e we c judge z to ! possibility ( its pass+ ! /raits ( ! ,pelvis1 9 ! v>i\s positions4 ,g5]ally !re are reckon$ t5 diamet]s1 & !y are repres5t$ 9 ! foll[+ ,plate3-- ,illu/ration3 ,,plate ,,xxv4 ,diamet]s ( ! ,head4 #a4 ,! ,occipito ,m5tal1 or f ! back ( ! head to ! *91 ,m1 ,o1 ,fig4 #a1 five in*es4 #b4 ,! ,m5to ,bregmatic1 or f ! *9 to ! ant]ior fontanelle at ! top ( ! head1 ,m1 ,o1 ,fig4 #a1 f\r in*es4 #c4 ,! ,occipito ,frontal1 or f ! back ( ! head to ! top ( ! =ehead1 ,o1 ,f1 ,fig4 #a1 f\r in*es4 #d4 ,! ,tra*elo ,occipital1 or f ! ?roat to ! back ( ! head1 ,t1 ,o1 ,fig4 #a1 f\r in*es4 #e4 ,! ,sub ,occipito ,bregmatic1 or f ! nape ( ! neck to ! top ( ! head1 ,s1 ,b1 ,fig4 #a1 ?ree in*es & a half4 #f4 ,! ,tra*elo ,bregmatic1 or f ! top ( ! ?roat to ! top ( ! head1 ,t1 ,b1 ,fig4 #a1 ab\t ?ree in*es & a half4 #g4 ,! ,tra*elo ,frontal1 or f ! top ( ! ?roat to ! top ( ! =ehead1 ,t1 ,f1 ,fig4 #a1 ab\t ?ree in*es4 #h4 ,! ,sub ,occipito ,frontal1 or f ! nape ( ! neck to ! top ( ! =ehead1 ,s1 ,f1 ,fig4 #a1 ab\t ?ree in*es4 #i4 ,! ,bi ,p>ietal1 or across ! head f "o side to ! o!r at ! middle ( ! p>ietal bones1 ! wide/ "p1 ,b1 ,p1 ,fig4 #b1 ?ree in*es & a qu>t] to ?ree & a half4 #aj4 ,! ,bi ,temporal1 or across ! head f "o temporal bone to ! o!r1 ,b1 ,t1 ,fig4 #b1 ab\t two in*es & a half4 ,! necessity = kn[+ ^! diamet]s w be obvi\s4 ,x is only by be+ acqua9t$ ) !m1 & ) ! /raits ( ! ,pelvis1 already describ$1 t we c tell :e!r ! *ild c pass or n 9 c]ta9 positions1 & h[ we mu/ *ange its position1 :5 possible1 to give relief4 ,on comp>+ ! diamet]s ( ! head ) ^? ( ! ,pelvis1 x w be se5 t "s ( !m correspond 9 size :ile o!rs d n1 s t 9 "o position deliv]y c take place spontane\sly1 :ile 9 ano!r x w be difficult1 & 9 "s ne>ly impossible1 )\t assi/ance4 ,?us1 = in/ance1 if ! head %\ld pres5t by ! occipito m5tal diamet]1 7,o1 ,m1 ,fig4 #a17 x evid5tly c\ld n pass :ile 9 t position1 because by ?is diamet] x is five in*es 9 wid?1 & ! greate/ diamet] ( ! ,pelvis is only ab\t f\r in*es & a half4 ,its position mu/ !re=e be *ang$1 & ! acc\*eur mu/ "k h[ to *ange x ) advantage4 ,,attitude ,,( ,,! ,f,,tus ,,at ,,full ,,t]m4 ,! attitude ( ! ,ftus is repres5t$ 9 ! foll[+ ,plate3-- ,illu/ration3 ,,plate ,,xxvi4 ,attitude ( ! ,ftus4 ,! arms1 x w be se51 are cross$ on ! brea/1 ^u :i* ! *9 is also b5t2 ! ?ighs are close toge!r1 & br\ght aga9/ ! ,abdom52 ! legs are close b5t on ! ,?ighs1 & ! feet are turn$ up aga9/ ! front ( ! legs1 ! :ole body be+ curv$ =w>d4 ,! position 9 :i* ! ,ftus mo/ usually lies 9 ! ,womb has already be5 %[n1 p>ticul>ly 9 ,plate ,,xii1 & 9 ,plate ,,xvi4 ,! head is d[nw>ds1 & ! back "p ( x turn$ to ! "m's left side4 ,:at is ! cause ( ?is almo/ univ]sal position is n c]ta9ly kn[n4 ,x 0 =m]ly ?\ght to dep5d on ! head be+ heavi] ?an ! o!r p>ts1 & ?us s9k+ d[n2 b ?is supposition has be5 %[n to be entirely )\t f\ndation4 ,m4 ,p4 ,dubois has lately advanc$ ! notion t x dep5ds on an in/9ctive feel+ 9 ! ,ftus itself1 :i* directs x to take t position by :i* x c mo/ easily make its exit4 ,?is op9ion appe>s v reasonable1 & is app>5tly well f\nd$4 ,x is well kn[n t ! ,ftus is susceptible ( v>i\s impressions :ile 9 ! ,womb1 & impell$ by un]r+ in/9ct to take ! brea/ imm$iately x is born2 nay1 x has ev5 be5 kn[n to suck ! f+] ( ! assi/ant1 9 cases ( face pres5tation1 ev5 be=e bir?6 ,we c readily believe1 !re=e1 t x is direct$ to place itself 9 ! ,womb1 9 ! be/ position1 ! same z x is direct$ to take ! f+] 9 its m\?4 ,9 ! "y ( _m ( ! l[] animals ?is is also /rik+ly exemplifi$4 ,! "y duck 9 ! %ell taps ) its little beak aga9/ ! "p t is to be brok51 & ru%es into ! wat] ev5 ) a "p ( ! %ell /ill on its back4 ,! "y oppossums1 :o are born imp]fect f ! ,womb1 %elt] !mselves1 imm$iately !y come into ! _w1 9 ! p\* on ! "m's brea/1 & fa/5 !mselves to ! mamm till !y are m p]fectly gr[n4 ,x mu/ be rem>k$ h[ev]1 t ! head does n always pres5t fir/1 ?\gh x usually does s4 ,occasionally we h ! bree* pres5t1 & /ill r>] ev5 o!r p>ts2 b ^! are m]ely exceptional deviations1 ! causes ( :i* are unkn[n4 ,out ( e sixte5 *ildr5 born1 fifte5 usually come head fir/4 ,?is h[ev]1 w be %[n bett] fur!r on4 ,,*apt] ,,ix4 ,,! ,,app5dages ,,( ,,! ,f,,tus ,,at ,,t]m4 ,,! ,,membranes4 ,! uses & arrangem5ts ( ! membranes surr\nd+ ! ,ftus h already be5 expla9$1 s t little m is ne$$ to be said "h1 because !y are n mu* diff]5t at ! full t]m f :at !y are at an e>li] p]iod1 except+ p]haps t ! amnion is a little m d5se & firm4 ,?is membrane appe>s n only to surr\nd ! ,ftus l a bag1 to conta9 ! wat]s1 b is also reflect$ close on to its body1 l its sk91 ) :i* 9 fact x is ?\ght by "s to be connect$4 ,! *ild is c]ta9ly born ) ?is membrane /ill on its body1 & does n "p ) x till "s days aft] bir?1 :5 x peels (f l a ?9 dead sk91 or p[d]4 ,! wat]s1 enclos$ )9 ! ,amnion1 7see ,plate ,,xii17 h n[ increas$ to _! greate/ quantity2 & !re is also1 9 mo/ cases1 a second body ( fluid betwe5 ! ,amnion & ! ,*orion1 :i* com+ away be=e ! real dis*>ge1 is call$ ! false wat]s4--7,see ,plate ,,xii47 ,! quantity ( ! true wat]s1 at bir?1 is ab\t tw5ty1 or f t to ?irty ounces1 b is v v>iable4 ,x is ( a gre5i% color1 r muddy1 & heavi] ?an wat]4 ,x conta9s album51 7:ite ( egg17 sulphate ( soda1 & lime4 ,n9ety-eight p] c5t4 ( x h[ev]1 is pure wat]4 ,x appe>s to be excret$1 l p]spiration1 f ! surface ( ! membranes1 & mo/ likely is m]ely ! wat]y portion ( ! blood exud$ ?r\gh4 ,! uses ( ?is fluid are v>i\s4 ,z already /at$1 x probably supplies "s nutrim5t to ! ftus1 :i* x also protects1 9 a great measure1 f pressure & f concussions4 ,x also prev5ts ! limbs f adh]+1 & helps to di/5d ! m\? ( ! ,womb1 9 ! e>li] /ages ( labor1 besides af=d+ an abundant slipp]y fluid = ! purpose ( lubricat+ ! passages1 ?us mak+ ! passage ( ! *ild m easy4--7,see ,plate ,,xii47 ,! o!r two membranes1 ! ,*orion & ,decidua1 are n ( mu* importance 9 our pres5t explanation2 & practically1 9 fact1 ! :ole ?ree may be reg>d$ z "o envelope1 surr\nd+ ! *ild & ! wat]s 9 :i* x floats4 ,,! ,,plac5ta4 ,at ! full t]m ! ,plac5ta1 7,see ,plate ,,xii17 is ab\t six or sev5 in*es 9 diamet]1 & ne>ly circul>1 ?\gh (t5 irregul>4 ,its ?ickness v>ies f "o to two in*es1 & is greate/ :]e ! cord is ins]t$4 ,sometimes x is v l>ge1 or v ?ick1 & may !n be difficult to extract1 & ev5 cause s]i\s accid5ts4 ,z already expla9$ ! ,plac5ta is compos$ ( a mass ( blood-vessels1 by means ( :i* ! blood ( ! ftus is1 9 "s way1 br\ght into contact1 or comm+l$ ) t ( ! "m4 ,its ut]9e face is irregul>1 be+ brok5 into lobes1 or cotyl$ons1 on :i* may be se5 a va/ numb] ( little ve9s & art]ies1 correspond+ ) o!rs on ! inn] surface ( ! ,womb4 ,its out] surface is ( a grey r$ color1 & cov]$ ) ! ftal membranes1 "u :i* ! l>ge blood-vessels c be trac$4 ,! ,plac5ta is usually atta*$ to "o side ( ! ,ut]us1 ne> ! fundus1 or at ! fundus1 b sometimes x gr[s :olly1 or 9 "p1 ov] ! m\? ( ! ,womb2 an occurr5ce :i* may cause s]i\s consequ5ces4 ,:5 !re is m ?an "o *ild ea* usually has a sep>ate plac5ta1 & !y are all intimately connect$4 ,9 "s r>e cases h[ev]1 "o plac5ta only exi/s ) tw9s4 ,ea* *ild has also a sep>ate amnion1 & wat]s2 b !re may be only "o *orion & decidua = ! :ole1 or ea* may h a complete set ( membranes itself4 ,in/ances h be5 kn[n h[ev]1 ( two *ildr5 be+ enclos$ 9 ! same amnion1 & surr\nd$ by ! same wat]s1 hav+ b "o plac5ta betwe5 !m4 ,^! possible div]sities %[ ! acc\*eur h[ necess>y x is = him1 9 any case ( multiple pregnancy1 to be sure t he has ab/ract$ all ! aft] bir?2 & !y also caution him n to proce$ to unnecess>y manipulations m]ely because x is n ! same z 9 o!r cases4 ,,! ,,umbilical ,,cord4 ,?is is compos$1 z already /at$1 ( an art]y & two ve9s1 :i* twi/ r\nd ! art]y1 l ! /r&s ( a rope4 ,^! are all enclos$ 9 a %ea?1 & surr\nd$ by a ?ick k9d ( mucus1 call$ ! ,gelat9e ( ,:>ton4 ,its ?ickness is ab\t t ( ! little f+]1 ?\gh x may be mu* l>g]1 hav+ be5 se5 z ?ick z ! *ild's body4 ,its usual l5g? is ab\t eighte5 or tw5ty in*es1 b x has measur$ z mu* z five feet4 ,!n aga9 x has be5 f\nd s small t ! vessels 9 x c\ld n n\ri% ! *ild4 ,^! exceptional v>iations h[ev]1 are v r>e4 ,! ve9s may also be enl>g$1 or full ( knots1 & ! circulation may be s mu* imp$$ !reby z to cause abortion4 ,! v>i\s accid5ts :i* may result f anomalies 9 ! cord w h[ev]1 engage our att5tion 9 ano!r place4 ,,section ,,iv4 ,,! ,,me*anism ,,( ,,deliv]y ,,9 ,,all ,,! ,,diff]5t ,,pres5tations ,,& ,,positions ,,( ,,! ,f,,tus4 ,,*apt] ,x4 ,,pres5tations ,,& ,,positions ,,( ,,! ,f,,tus4 ,! *ild may pres5t sev]al diff]5t p>ts ( its body1 at ! comm5cem5t ( deliv]y1 & !y may be 9 diff]5t positions relatively to ! diff]5t p>ts ( ! ,pelvis4 ,all ^! require to be kn[n4 ,diff]5t au?ors h made diff]5t classifications ( ! pres5tations & positions1 & h diff]5tly nam$ !m2 b ?is is ( little consequ5ce1 s9ce !y are /ill ! same1 no matt] h[ !y are nam$4 ,i %all foll[ ! arrangem5t ( ,m4 ,*ailly1 because ,i ?9k x equally p]fect1 & mu* m simple & practical1 ?an any o!r yet propos$4 ,,pres5tations4 ,! ftus may pres5t at ! m\? ( ! ,womb ei!r by ! head1 ! mo/ usual way--by ! l[] extremities1 :i* is ! mo/ frequ5t way aft] ! head--or by v>i\s p>ts ( ! trunk1 :i* is ! lea/ frequ5t way ( all4 ,9 ea* ( ^! ?ree full pres5tations !re may be c]ta9 v>iations1 :i* require to be notic$4 ,! head1 = in/ance1 may pres5t ei!r by ! cranium or by ! face2 ! l[] "p ( ! body may pres5t ei!r by ! feet1 ! knees1 or ! bree*1 accord+ z ! legs & ?ighs are flex$ or ext5d$2 & ! trunk may pres5t ei!r on ! "r or left side1 & incl9$ t[>ds ! back or t[>ds ! *e/1 ?\gh nei!r ! back nor abdom5 ev] fully pres5t4 ,ea* ( ^! v>iations may also h slight v>iations aga94 ,?us ! face may pres5t full1 or by "o or ! o!r *eek1 & s on4 ,^! v>iations h[ev]1 are ( little practical consequ5ce1 because we only f9d !m at ! v comm5cem5t ( ! labor1 & !y always *ange to ! full pres5tation4 ,practically speak+ !re=e1 !re are five full pres5tations1 viz41 ! ,cranium1 ! ,face1 ! ,bree*1 ! ,feet1 or knees1 & ! ,trunk1 ei!r by ! "r or left side4 ,! v>ieties ( ^!1 z already rem>k$1 n requir+ any special att5tion f ! acc\*eur1 provid+ he is n puzzl$ or misl$ by !m4 ,,positions4 ,! position means ! p>ticul> direction 9 :i* ! pres5t+ "p ( ! ,ftus is plac$ 9 relation to ! ,pelvic /raits4 ,! ,pelvis itself is suppos$ to be divid$ into two simil> halves1 ! "r & ! left1 & ea* pres5t+ "p has "o p>ticul> place :i* is ref]r$ to z ! indicat+ po9t4 ,?us1 = in/ance1 9 ! ,cranium ! ,occipit1 or beh9d "p ( ! head1 is ! indicat+ po9t2 & we !re=e say1 9 ,cranium pres5tations1 t x is a "r or left ,occipital position1 accord+ z ! back ( ! head is to ! "r or left side ( ! ,pelvis4 ,9 face pres5tations1 ! *9 7m5tor7 is ! indicat+ po9t1 & we !re=e say x is a "r or left m5to position1 accord+ z ! *9 is t[>ds ! "r or left side4 ,9 bree* pres5tations1 ! *ild's sacrum is ! indicat+ po9t1 & we !n say x is a "r or left sacral position1 accord+ z ! ,sacrum is t[>ds ! "r or left side ( ! ,pelvis4 ,9 trunk pres5tations1 :i* are always crosswise1 ! head 7cephalo7 is ! indicat+ po9t1 & we !re=e say x is a "r or left cephalo position1 accord+ z ! head lies t[>ds ! "r or left side ( ! "m's body4 ,9 ,cranium pres5tations also1 ! back ( ! head is n m]ely on ! "r or left side1 b may be at two diff]5t po9ts on ea* side4 ,x may be ei!r ne>e/ to ! ,sacrum 7po/]ior71 or ne>e/ to ! pubes 7ant]ior71 b /ill aga9/ ! ,ilium2 x is !re=e call$ a "r or left ant]ior1 or po/]ior1 occipito iliac position1 z ! case may be4 ,sometimes also1 ! occiput lodges imm$iately on ! pubis1 in/ead ( go+ to ei!r side1 & t is call$ an occipito pubic position2 at o!r times1 on ! contr>y1 x is plac$ aga9/ ! ,sacrum1 in/ead ( be+ on ei!r side1 & t is call$ an occipito sacral position4 ,9 pres5tations ( ! head !re=e1 we may reckon six positions--! "r & left ant]ior & po/]ior occipito iliac1 & ! pubic & sacral4 ,9 pres5tations ( ! face ! same2 !y be+ m5to iliac & s on1 in/ead ( occipito4 ,9 pres5tations ( ! l[] extremities also ! same1 except+ t !y are sacro iliac & s on1 in/ead ( occipito4 ,9 pres5tations ( ! trunk we h b two positions = ea* side1 ! "r & left cephalo iliac2 accord+ z ! head is on ! "r or left side ( ! "m's body4 ,! *ild always ly+1 9 pres5tations ( ! trunk1 crosswise--! feet on "o side & ! head on ! o!r4 ,mo/ au?ors enum]ate _m m pres5tations & positions1 b !y are ( little practical utility4 ,:5 ! head pres5ts1 = in/ance1 ! deliv]y takes place 9 ne>ly ! same mann]1 let x be 9 :at position x may4 ,& 9 pres5tations ( ! face1 or ( ! l[] extremities1 ! p>ticul> position is ( little consequ5ce1 ! deliv]y be+ usually effect$ mu* ! same 9 !m all4 ,"s ( ! positions are1 x is true1 mu* m favorable ?an o!rs1 b a spontane\s deliv]y1 g5]ally speak+1 occurs 9 all ( !m1 :5 ! head1 face1 or l[] extremities pres5ts4 ,v frequ5tly inde$1 ! less favorable positions are *ang$ to ! m favorable ones1 & ! wor/ seldom d m ?an imp$e deliv]y = a "t1 unless !re be "s mal=mation1 or loss ( p[]4 ,i !re=e ref] to !m m = conv5i5ce 9 future explanations1 & to enable my read]s to "k :at is meant by !m1 :5 !y read o!r books2 n because !y are really necess>y to be und]/ood1 or ( any great practical use4 ,! celebrat$ ,baudelocque admitt$ sev5ty-f\r positions1 & tw5ty-two pres5tations2 & ! numb] might be made /ill great]1 if all ! v>iations 7 to be enum]at$4 ,su* classifications h[ev]1 are m +5i\s ?an useful1 & !y are b little notic$ ev5 by m$ical m54 ,i %all m]ely describe ! me*anism ( labor 9 ! mo/ frequ5t positions1 9 ea* pres5tation1 because ! o!rs usually *ange into ^!2 & ev5 :5 !y d n1 ! process ( deliv]y is ess5tially ! same1 & also ! mode ( assi/+ x4 ,,mode ,,( ,,asc]ta9+ ,,! ,,pres5tation ,,& ,,position4 ,! ,pres5tation4--,al?\gh 9 g5]al x is n possible to asc]ta9 ) c]ta9ty1 :at "p ( ! ftus pres5ts to ! m\? ( ! ,womb1 until labor comm5ces1 yet a tol]able judgm5t c frequ5tly be =m$ be=e4 ,9 head pres5tations1 on p]=m+ ballotm5t1 ! head is felt1 l a firm r\nd tumor1 occupy+ all ! space :i* ! f+] c rea*1 v diff]5tly f any o!r "p4 ,! peculi> cramps 9 ! female's l[] limbs1 & frequ5t incl9ation to ur9ate1 m5tion$ 9 ! signs ( labor1 are also /rong indications ( ?is pres5tation1 be+ seldom exp]i5c$ 9 any o!r4 ,:5 ! labor has actually comm5c$ !re c be b little unc]ta9ty 9 ^! cases1 =1 imm$iately ! m\? ( ! ,womb is suffici5tly op51 ! f+] c be introduc$1 & ! head felt l a smoo?1 r\nd1 & ela/ic bony tumor1 n likely to be mi/ak5 = any?+ else1 if ord9>y c>e be tak54 ,aft] ! wat]s h escap$1 x c ( c\rse be felt /ill m di/9ctly4 ,if ev5 an inexp]i5c$ p]son be>s 9 m9d ! %ape ( ! head1 & reflects h[ x mu/ fill up ! passage1 & h[ x mu/ feel1 f be+ compos$ ( sep>at$ ?9 bony plates1 ly+ on a s(t yield+ sub/ance l ! bra91 he c sc>cely fail to recognize x4 ,! s5sation is v mu* l t ( press+ a piece ( firm c>d bo>d on an inflat$ bladd]1 :i* =ms a tol]able repres5tative ( ! ftal head4 ,sometimes !re is a difficulty f a great quantity ( wat] be+ intrud$ betwe5 ! membranes & ! head1 :i* some:at obscures ! t\*1 b ?is only necessitates great] c>e4 ,! wat] h[ev]1 may be 9 su* quantity z to entirely prev5t ! t\*1 9 :i* case no?+ c be done till ! membranes break2 ! pres5tation c !n be asc]ta9$ ) c]ta9ty1 & x w be q e>ly en\gh to r5d] assi/ance1 if x %\ld be an unfavorable "o4 ,i h kn[n "s inexp]i5c$ p]sons mi/ake ! bag ( wat] itself = ! head1 & commit great errors 9 consequ5ce4 ,! ,face c seldom be mi/ak51 because ! nose1 or m\?1 may be felt2 &1 by pass+ ! f+] up ! side ( ! head1 ! e>s also4 ,! trunk is 9 g5]al easy ( recognition4 ,ne>ly always ! "r or left %\ld] occupies ! passage1 or is ne> to x1 s t ! f+] may be readily pass$ "u ! arm pit4 ,! %\ld] jo9ts1 ! ribs1 or ! %\ld] blade bone1 all feel v diff]5t to ! head1 & are n likely to be tak5 = x4 ,9 pres5tations ( ! l[] extremities !re is /ill less dang] ( error4 ,if ! feet1 or knees1 occupy ! passage1 !y c sc>cely be mi/ak54 ,! bree* is c]ta9ly some?+ l ! head 9 its =m1 b feels diff]5t1 & is divid$ d[n ! middle by ! ind5tation betwe5 ! two *eeks1 along :i* ! f+] c be pass$ till x ent]s betwe5 ! limbs4 ,9 irregul> pres5tations1 z ( ! arms = in/ance1 or ( "o leg1 or an arm & leg1 x is only necess>y to c>efully feel !m1 s z to asc]ta9 _! =m1 & ! relation ( _! p>ts4 ,?us ! f+]s c be di/+ui%$ f ! toes1 & ! feet f ! h&s1 p>ticul>ly if ! ankle c be felt4 ,! acc\*eur %\ld asc]ta9 ! p>ticul> pres5tation z e>ly z possible1 because he may sometimes be ( s]vice 9 correct+ an unfavorable "o1 if he is c]ta9 ( x 9 "t1 & kn[s :at he is ab\t4 ,he %\ld n h[ev]1 use any degree ( =ce to asc]ta9 x1 9 case he _c d s )\t1 b wait till ! conditions are m favorable4 ,nei!r %\ld he1 ) ! same object1 rupture ! membranes too soon1 = he may !reby cause consid]able delay & difficulty1 )\t any good to c\nt]balance x4 ,all ! above-nam$ pres5tations may1 & usually d1 t]m9ate spontane\sly1 except ^? ( ! trunk1 & ev5 !y d occasionally1 ?\gh m frequ5tly !y require assi/ance4 ,relative frequ5cy ( ! diff]5t pres5tations4--,! mo/ favorable pres5tations1 & positions also1 are always ! mo/ frequ5t1 :ile ! unfavorable ones are b seldom met )4 ,accord+ to ,madame ,la*apelle1 9 fifte5 ?\s& six hundr$ & fifty-two labors !re are ab\t f\rte5 ?\s& sev5 hundr$ & =ty-n9e pres5tations ( ! head & face2 ab\t five hundr$ & eighty-six ( ! bree*1 knees1 & feet2 & only ab\t sixty-eight ( ! trunk1 or %\ld]s4 ,positions4--,! position is g5]ally ( b little consequ5ce1 because 9 all ! favorable pres5tations spontane\s deliv]y occurs 9 e position alike1 & 9 ! unfavorable pres5tations ! same assi/ance is requir$ 9 "o position z 9 ano!r4 ,9 "s cases an unfavorable position ( ! head may be *ang$ h[ev]1 to a bett] "o2 & !re=e1 s f> z ! head is conc]n$1 ! positions are wor? asc]ta9+4 ,! mode ( det]m9+ ! position is by feel+ = ! sutures & fontanelles1 describ$ 9 ,*apt] ,,viii2 & ?is _c be usually done till aft] ! membranes are brok51 :5 ! head c be di/9ctly t\*$4 ,by ref]r+ to ,plate ,,xxiv1 ! %ape & position ( ! ,fontanelles w be se51 & if ! head be suppos$ plac$ ) ! top d[nw>ds1 & ! back ( x to ! "m's left side1 !y may be readily f\nd ) ! f+]4 ,9 ! left ant]ior occipito iliac position1 or t :5 ! back ( ! *ild's head is aga9/ ! left side ( ! "m's pelvis1 & ne>e/ ! pubes1 :ile its =ehead is aga9/ ! "r side1 & ne>e/ ! sacrum1--! sagittal suture1 or op5+ along ! top1 w ( c\rse run across f "r to left4 ,?is op5+ may be di/9ctly felt ) ! f+]1 :i* %\ld be pass$ along x t[>ds ! "r side1 & x w !n rea* ! ant]ior fontanelle2 aft]w>ds x %\ld also be pass$ to ! left side1 & !n x w rea* ! po/]ior fontanelle4 ,! diff]5ce betwe5 ^! two op5+s1 9 %ape & size1 is %[n 9 ,plate ,,xxiv1 & ev5 if a p]son has nev] se51 or felt1 ! head ( a newborn *ild1 !y c sc>cely be tak5 = ea* o!r1 aft] notic+ t ,plate4 ,if ! ant]ior fontanelle %\ld be felt on ! left side in/ead ( ! "r1 & ne> ! pubes1 :ile ! po/]ior fontanelles is to ! "r1 & ne> ! sacrum1 ! position mu/ be ! "r po/]ior occipito iliac1 or j ! rev]se ( ! =m]4 ,if ! sagittal suture %\ld be f\nd to run across f ! pubes to ! sacrum1 in/ead ( f "o side to ! o!r1 x w !n indicate ei!r an occipito pubic1 or occipito sacral position1 accord+ z ! back ( ! head is beh9d or be=e2 & ?is c be readily asc]ta9$ by f9d+ ei!r ( ! fontanelles4 ,9 %ort1 if ! relative position1 =ms1 & directions ( ^! op5+s 9 ! *ild's head be cle>ly und]/ood1 ! position ( ! head c ne>ly always be det]m9$ by feel+ !m1 z w be evid5t by ref]r+ to our =m] explanation ( !m4 ,sometimes h[ev]1 ! bones ov]lap a good deal1 f ! head be+ press$1 & !n in/ead ( an op5+ along ! top1 a seam w be felt4 ,& sometimes1 f long cont9u$ pressure1 a quantity ( blood1 & wat]y fluid1 w be effus$ "u ! scalp1 s z to prev5t ! bone be+ di/9ctly t\*$4 ,b ^! accid5ts seldom happ51 & ) ord9>y c>e & p]sev]ance1 ne$ n prev5t ! position be+ det]m9$1 aft] a little delay4 ,! position ( o!r pres5t+ p>ts is easily asc]ta9$1 by feel+ = "s kn[n po9t--z ! nose1 or ! face1 ! depression betwe5 ! *eeks1 or ! bree*1 & s on4 ,relative frequ5cy ( ! diff]5t positions4--,! mo/ favorable positions1 l ! mo/ favorable pres5tations1 are also ! mo/ frequ5t4 ,accord+ to ,baudelocque1 9 t5 ?\s& ?ree hundr$ & tw5ty-two cases1 ( head pres5tation1 !re 7 eight ?\s& five hundr$ & tw5ty-two cases :5 ! back ( ! *ild's head 0 on ! "m's left side1 & t[>ds ! front1 7or 9 ! left ant]ior occipito iliac position72 "o ?\s& sev5 hundr$ & fifty-f\r :5 x 0 on ! "r side t[>ds ! front1 7"r ant]ior occipito iliac72 tw5ty-five times to ! "r side1 b t[>ds ! ,sacrum1 7"r po/]ior occipito iliac72 & n9ete5 times on ! left1 b t[>ds ! ,sacrum1 7left po/]ior occipito iliac47 ,be+ mo/ frequ5tly ) ! back ( ! head t[>ds ! front on ! left side1 z %[n 9 ,plate ,,xxvii2 next t[>ds ! front on ! "r side2 & b seldom t[>ds ! ,sacrum1 or back1 on ei!r side4 ,9 all ^! t5 ?\s& cases we d n f9d a s+le in/ance ( ! head ly+ f back to front1 9 ! occipito pubic1 or occipito sacral positions1 commonly call$ transv]se2 nei!r d we f9d a s+le in/ance 9 fifte5 ?\s& six hundr$ & fifty-two cases record$ by ,madame ,la*apelle2 :i* w %[ h[ r>e su* un=tunate positions mu/ be4 ,:at ?is great frequ5cy ( "o p>ticul> position dep5ds ^u we d n "k--possibly on t cause1 previ\sly allud$ to1 :i* det]m9es ! mo/ frequ5t pres5tation4 ,9 ! next ,*apt]1 ! me*anism ( deliv]y1 or ! mann] 9 :i* ! *ild escapes out ( ! body1 z x mo/ frequ5tly occurs1 w be fully expla9$4 ,,*apt] ,,xi4 ,,! ,,me*anism ,,( ,,deliv]y1 ,,9 ,a ,,pres5tation ,,( ,,! ,,head4 ,,! ,,left ,,ant]ior ,,occipito ,,iliac ,,position4 ,?is is ! pres5tation & position mo/ frequ5tly obs]v$1 p]haps fifte5 out ( sixte5 times4 ,9 mo/ ,ob/etrical works x is call$ ! fir/ position4 ,by obs]v+ ! foll[+ ,plates1 & ref]r+ to ! previ\s explanations ( ! diamet]s ( ! ,pelvis1 & ftal head1 9 ,plates ,,ix & ,,xxv1 x w be se5 t ?r\gh all its *anges ( position1 :ile mak+ its exit1 ! head always pres5ts by "o ( its %orte/ diamet]s to "o ( ! l>ge/ diamet]s ( ! ,pelvis1 s t ! relation betwe5 !m is inv>iably ! be/ t c\ld be e/abli%$2 & _m peculi> turn+s & revolutions occur1 app>5tly = ! express purpose ( br++ ?is ab\t4 ,be=e ! rupture ( ! membranes ! head pres5ts its occipito frontal diamet]1 :i* measures f\r in*es1 to ! "r oblique diamet] ( ! ,pelvis1 :i* measures f\r in*es & a half2 :ile its bi-p>ietal diamet]1 :i* measures only ab\t ?ree in*es & a half1 is pres5t$ to ! o!r oblique diamet]1 also measur+ f\r & a half--7,see ,plate ,,xix47 ,ev5 "h x w be se5 t ! passage is l>g] ?an ! head :i* has to pass ?r\gh x1 b a m favorable position /ill c be obta9$1 by a slight movem5t ( ! ,ftus1 :i* nature accord+ly accompli%es1 & also foll[s by o!rs1 to pres]ve ! advantage1 :i* w next be describ$4 ,movem5ts ( ! ,ftal ,head4--,!re are ?ree ( ^! peculi> movem5ts1 ea* ( :i* takes place at a p>ticul> p]iod ( ! labor1 & mu/ be describ$ sep>ately4 ,fir/ movem5t1 flexion1 & desc5t4--,imm$iately aft] ! ,membranes are brok51 ! contractions ( ! ,ut]us =ce ! head into ! upp] /rait1 by ! occipito frontal diamet] ( f\r in*es1 z already %[n2 b !n comm5ces ! fir/ movem5t1 :i* consi/s 9 a b5d+ ( ! *ild's *9 d[n ^u its brea/1 s t ! =ehead is c>ri$ up into ! ,womb2 & ! mo/ prom95t po9t ( ! back ( ! head pres5ts to ! middle ( ! passage1 by ! occipito bregmatic diamet]1 :i* is only ab\t ?ree in*es in/ead ( f\r4 ,?is ( c\rse makes ! passage s mu* easi]1 & g5]ally1 imm$iately aft] ?is *ange1 ! head desc5ds into ! bas9 ( ! ,pelvis4 ,x is n absolutely necess>y h[ev]1 = ?is movem5t to occur1 = 9 a well =m$ ,pelvis ! head c desc5d )\t x1 ?\gh n s easily2 & sometimes1 9 fact1 x does n take place1 b ?is is unusual4 ,x mu/ be recollect$ t ?is %ift+ ( ! head alt]s ! position ( ! fontanelles--! po/]ior "o be+ br\ght m to ! c5tre ( ! /rait1 & ! ant]ior "o c>ri$ up out ( rea*1 :ile previ\s to ! movem5t !y 7 bo? on a level4 ,if an exam9ation is n made !re=e1 till aft] ?is *ange1 x may be difficult to det]m9e ! position1 unless ?is is borne 9 m9d4 ,! foll[+ ,plates %[ ?is v well4 ,,plate ,,xxvii4 ,x w be se5 "h t ! neck is /raight5$ out1 & t ! two fontanelles are on a l9e ) ea* o!r4 ,note4--,! front ( ! bones are repres5t$ 9 ?is & ! two foll[+ ,plates1 z if transp>5t1 s t ! head may be se5 ?r\gh !m4 ,illu/ration3 ,plate ,,xxvii4 ,?is ,plate repres5ts ! head j ent]+ ! upp] ,/rait4 ,,plate ,,xxviii4 ,at ?is "t ! ant]ior fontanelle c sc>cely be rea*$1 b ! po/]ior "o is easily to be rea*$1 be+ 9 ! op5 passage1 on ! left side4 ,! head is n[ fairly )9 ! ,pelvic cavity1 b /ill lies across f "r to left4 ,second ,movem5t1 ,rotation ( ! ,head4--,:5 ! ,ftus is ?us br\ght to ! bottom ( ! ,pelvis1 its head turns completely r\nd1 ! back ( x be+ br\ght to ! front1 or "u ! pubes ( ! "m1 & its =ehead turn$ aga9/ h] ,sacrum1 z repres5t$ 9 ,plate ,,xxix4 ,illu/ration3 ,plate ,,xxviii4 ,?is ,plate repres5ts ! head desc5d$ /ill l[] 9 ! ,pelvis4 ,,plate ,,xxix4 ,"h ! head is se5 j beg9n+ to turn--! "r side1 & "p ( ! back ( x1 j pass+ "u ! pubes4 ,z ! rotation becomes complete ! neck /raight5s1 s t ! two fontanelles are aga9 f\nd on ! same level4 ,f9ally ! back ( ! head fully em]ges f "u ! pubic ar*1 & ! *9 slides gradually out aft] x b5ea?1 s t ! neck ( ! *ild is encircl$ by ! r+ ( ! ,vulva4 ,illu/ration3 ,plate ,,xxix4 ,?is ,plate repres5ts ! head /ill fur!r d[n1 & beg9n+ to ,rotate4 ,illu/ration3 ,,plate ,,xxx4 ,9 ,fig4 #a1 ! back ( ! head is ne>ly "u ! pubic bone1 :ile ! =ehead is j pass+ ! ext]nal op5+ bel[4 ,9 ,fig4 #b1 ! back ( ! head is completely extrud$1 & also ! *91 s t ! :ole head is n[ born4--7p4 is ! pubic bone1 9 front47 ,9 ,fig4 #a x w be se5 h[ ! ,os ,coccygis1 or l[e/ "p ( ! back bone1 7c17 is /rait5$ out1 backw>d1 :ile ! head is pass+1 z ,i expla9$ be=e2 & 9 ,fig4 #b x has return$ aga9 to its natural position4 ,! reason = ?is rotation ( ! head w be obvi\s on call+ to m9d ! =m ( ! ,pelvis & ! ext]nal op5+4 ,on exam9+ ,plates ,,ix & ,x1 x w be se5 t ! longe/ diamet] ( ! ,vulva1 or ext]nal op5+1 ! ant]o po/]ior1 is ne>ly at "r angles to ! longe/ diamet]s ( ! upp] /rait1 ! oblique4 ,n[ ! longe/ diamet] ( ! head is adapt$ to ?is oblique diamet]1 on ent]+ ! upp] /rait1 z already expla9$1 & x is necess>y = x also to be adapt$ to ! longe/ diamet] ( ! ext]nal op5+1 ! ant]ior po/]ior :5 mak+ its exit2 b z ! two are n p>allel ! head is compell$ to turn1 or rotate1 9 ord] to pass f "o to ! o!r4 ,to accompli% ?is h[ev]1 ! neck has to be twi/$ consid]ably4 ,b :5 ! head is fully deliv]$1 x is imm$iately /rait5$ aga91 by ! back ( ! head turn+ t[>ds ! "m's left side1 s t its prop] relations ) ! trunk is re-e/abli%$4 ,?ird ,movem5t1 ,rotation ( ! ,%\ld]s4--,:5 ! head is deliv]$ ! %\ld]s come next1 :i* also require to turn r\nd a little1 to adju/ !mselves to ! long diamet] ( ! l[] /rait2 & z !y turn )9 ! ,pelvis ! head also turns1 to correspond1 & ?us ! back ( x is br\ght opposite ! middle ( ! "m's left ?igh4 ,imm$iately ?is movem5t is effect$1 ! %\ld]s rapidly escape ?r\gh ! ext]nal op5+1 ! "r "o be+ 9 front1 a little to ! left ( ! symphysis pubes1 & ! left "o beh9d1 a little to ! "r ( ! os coccygis4 ,! body !n curves upw>ds1 to accommodate itself to ! curv$ axis ( ! ,pelvis1 & spe$ily foll[s ! %\ld]s4 ,^! curi\s movem5ts cause ! *ild to pass 9 a spiral direction1 s t ea* "p may pass ?r\gh ! ,pelvis 9 ! mo/ favorable position4 ,sometimes all ^! movem5ts are n effect$1 & yet ! deliv]y may occur1 ?\gh n s spe$ily1 or safely1 z :5 !y are4 ,! %\ld]s d n always fully rotate1 b may nev]!less pass ! op5+1 if ! p>ts be l>ge1 & well relax$4 ,x is que/ionable h[ev]1 if ! head c ev] pass ! l[] /rait )\t rotat+1 :5 x ent]s ! ,pelvis diagonally1 ! occipit on "o side & ! =ehead on ! o!r2 z x is necess>y = ei!r "o or ! o!r ( ^! p>ts to pass "u ! pubes4 ,,me*anism ,,( ,,deliv]y ,,9 ,,all ,,o!r ,,positions ,,( ,,! ,,head4 ,! "r po/]ior occipital position4--,?is position1 call$ ! second by "s au?ors1 & ! f\r? by o!rs1 is exactly ! rev]se ( ! "o j describ$1 ! head ly+ 9 ! same direction1 b ! back ( x be+ beh9d1 to ! "r ( ! ,sacrum1 & ! =ehead to ! left ( ! pubes4 ,precisely ! same movem5ts are gone ?r\gh 9 ?is position z 9 ! o!r1 except+ t ! head has to rotate consid]ably fur!r4 ,9 ! =m] position ! back ( ! head is only a little to ! left ( ! pubis1 & !re=e has n f> to turn to pass "u x2 b 9 ?is position ! back ( ! head is beh9d1 & !re=e has to turn v f> r\nd to rea* ! same position4 ,! rotation is !re=e m difficult1 n s soon effect$1 & sometimes likely to be dang]\s to ! *ild4 ,9 ! o!r movem5ts !re are no diff]5ce wor?y ( notice1 b x mu/ be borne 9 m9d t !y all occur ! rev]se way1 to :at !y d 9 ! fir/ position1 because ! occiput is on ! "r side in/ead ( ! left4 ,! "r ant]ior occipital position4--,?is position is precisely ! same z ! fir/1 b on ! o!r side4 ,! back ( ! head is 9 front1 b to ! "r ( ! pubis in/ead ( ! left1 :ile ! =ehead is beh9d1 to ! left ( ! ,sacrum4 ,?is w be app>5t en\gh by obs]v+ ,plate ,,xxxi4 ,,plate ,,xxxi4 ,?is is ! second mo/ frequ5t position2 ! left ant]ior occipito iliac be+ ! mo/ frequ5t4 a4 ,! ,acetabulum1 or socket ( ! hip jo9t4 c4 ,! cut edge ( ! ,womb4 c4 ,! ,=am5 ,ovale4 d4 ,! top ( ! ilium bone1 call$ ! cre/4 h4 ,! ,symphysis ,pubes4 i4 ,! is*ium4 ,k4 ,k4 ,! pubic bones4 ,illu/ration3 ,plate ,,xxxi4 ,head 9 ! "r ant]ior occiput iliac position4 ,! me*anism ( deliv]y is precisely ! same1 & all ! movem5ts occur 9 ! same ord] & mann]1 z 9 ! fir/ position1 b ! rev]se way4 ,! rotation1 = in/ance1 be+ f "r to left1 in/ead ( f left to "r1 & s ( all ! o!rs4 ,! left po/]ior occipital position4--,deliv]y is effect$ ! same 9 ?is z 9 ! left ant]ior1 or fir/ position1 except+ t ! rotation is m ext5d$1 ow+ to ! occiput be+ beh9d1 z expla9$ 9 ! "r po/]ior occipital position4 ,,g5]al ,,rem>ks ,,on ,,! ,,diff]5t ,,positions ,,( ,,! ,,head4 ,9 all ! o!r positions1 & _! v>ieties1 !re is no?+ t calls = special notice1 or t is mat]ial 9 practice1 ! deliv]y be+ ne>ly ! same 9 !m all4 ,no matt] :at position ! head is plac$ 91 ! back ( x ne>ly always comes to ! front1 "u ! pubes1 ev5 ?\gh x h to turn half r\nd to d s4 ,! cause ( ?is is suppos$ to be ! peculi> =m ( ! p>ts1 :i* give x a screw l motion1 9 its desc5t1 & ! %ape ( ! ext]nal op5+1 :i*1 be+ longe/ f be=e to beh9d1 c only all[ ! long diamet] ( ! head to pass ?r\gh 9 ! same direction4 ,sometimes1 x is true1 ! occiput passes beh9d1 in/ead ( com+ to ! front1 & !n ! *9 comes "u ! pubes1 :ile ! occiput presses on ! coccygis4 ,?is is v seldom obs]v$1 & :5 x occurs ! labor is m difficult & t$i\s1 ?\gh x may /ill t]m9ate spontane\sly4 ,! resi/ance ( ! s(t p>ts1 ext]nally1 appe>s to be ! *ief cause ( ! head turn+2 = :5 !y are mu* relax$1 & ! *ild's head small1 x w sometimes pass )\t1 or 9 ! ant]ior po/]ior position4 ,& sometimes1 :5 ! head is l>ge1 s t x di/5ds ! p>ts v mu*1 ! %\ld]s w pass cross wise1 !re be+ room en\gh = !m )\t turn+4 ,9 "s females1 =m$ l>ge1 ^: organs are excessively relax$1 & ^: *ildr5 are small1 ! deliv]y takes place )\t any ( ! movem5ts be+ effect$1 ! *ild pass+ /raight ?r\gh 9 :atev] position x may happ5 to be3 ?is is r>ely se5 h[ev]4 ,:5 !re are tw9s !y d n usually bo? pres5t by ! head1 b "o by ! feet2 & frequ5tly ! p>ts are s relax$ by ! passage ( ! fir/1 t ! second is deliv]$ )\t rotat+ at all1 ?\gh 9 g5]al x foll[s precisely ! same movem5ts4 ,x sometimes happ5s h[ev]1 t ! second bir? does n take place till "s h\rs1 or ev5 days1 aft] ! fir/4 ,x may be said1 9 g5]al1 t all positions ( ! head are favorable to bo? "m & *ild1 & may t]m9ate spontane\sly4 ,x is seldom t any?+ m ?an ord9>y assi/ance is requir$ 9 any ( !m1 & !y c\ld 9 g5]al t]m9ate )\t any at all1 ?\gh sometimes ) difficulty4 ,! wor/ cases are ^? 9 :i* ! head does n turn r\nd1 b rema9s across1 or :]e ! back ( x turns beh9d1 in/ead ( com+ to ! front4 ,9 ^! cases !re is great dang] ( ! p]9eum1 or ext]nal lips1 be+ mu* lac]at$1 or ev5 ( an artificial passage be+ torn ?r\gh ! p]9eum1 lead+ to ! mo/ s]i\s aft] results4 ,ab\t "o *ild also1 out ( e fifty1 is lo/ 9 ^! unfavorable positions4 ,,*apt] ,,xii4 ,,me*anism ,,( ,,deliv]y ,,9 ,,pres5tations ,,( ,,! ,,l[] ,,extremities4 ,?is pres5tation includes ! feet1 ! knees1 ! bree*1 & also ! hips1 !re be+ no diff]5ce 9 ! deliv]y = all ^! p>ts4 ,x is ! same also :e!r !re be "o foot1 or knee1 or bo? feet & knees4 ,!re are b two positions wor?y ( notice 9 ?is pres5tation1 & !y are det]m9$ by ! *ild's sacrum4 ,if ! sacrum1 or po/]iors1 are to ! "r ( ! "m's ,pelvis1 x is call$ ! "r sacro iliac position2 b if !y are on ! left side x is call$ ! left sacro iliac position4 ,! direction 9 :i* ! *ild's pelvis is plac$1 is analag\s to t ( ! head1 ! sacrum answ]+ to ! occiput4 ,?us mo/ frequ5tly ! sacrum is on ! left side1 a little to ! left ( ! pubes1 7left ant]ior7 :ile ! abdom5 faces ! "r side ne> ! sacrum4 ,:5 on ! "r side h[ev]1 x is mo/ usually ne>e/ ! sacrum1 ) ! abdom5 fac+ ! left side ne> ! pubes4 ,! l[] extremities pres5t mo/ frequ5tly next aft] ! head1 b /ill !y are b seldom met )4 ,m4 ,p4 ,dubois tells u t out ( tw5ty ?\s& labors he only met ) eighty-five su* cases4 ,9 ^! eighty-five cases ! bree* pres5t$ fifty-f\r times1 & ! feet tw5ty-six1 ! knees be+ f\nd b once4 ,a pres5tation ( ! l[] extremities may g5]ally be recogniz$ at an e>ly /age1 by ! head be+ felt at ! fundus ( ! ,ut]us1 & by ! pulsations ( ! ftal he>t be+ he>d above ! umbilicus1 z expla9$ 9 ! section on ,auscultation4 ,aft] labor has comm5c$ ! "p felt at ! m\? ( ! ,womb is irregul>1 & s diff]5t f ! head1 t x is n likely to be mi/ak5 = x4 ,if ! knees or feet pres5t1 !y c always be di/+ui%$2 & if ! bree* pres5ts x c easily be recogniz$ by its =m1 & p>ticul>ly by ! os coccygis1 :i* c be di/9ctly felt at ! bottom ( ! depression betwe5 ! two *eeks4 ,! side on :i* x is felt ( c\rse det]m9es ! position1 & ! same ) ! front ( ! knees1 or ! heels4 ,! ,rectum c also be rea*$ ) ! f+]1 :5 ! bree* is t\*$2 b great c>e mu/ be tak5 n to intrude x too f>1 because ) a female *ild ! ,vulva might be mi/ak5 = x1 & ?us ! hym5 be brok51 & o!r injury committ$4 ,! g5itals ( a male *ild are m obvi\s1 s t ! sex ( ! *ild may be usually asc]ta9$1 along ) ! position4 ,= want ( prop] c>e ! bree* has be5 mi/ak5 = ! head1 & face1 b ?is c sc>cely happ5 if ! acc\*eur is att5tive4 ,x is simply necess>y to call to m9d :at mu/ be felt 9 ea* pres5tation1 z ! nose & m\? ) ! face2 ! two *eeks ( ! po/]iors1 ) ! op5+ betwe5 !m2 & also ! g5itals1 ) ! bree*2 & x c be c]ta9ly asc]ta9$ :i* ( ^! p>ts are really at ! op5+4 ,) ! knees or feet !re c sc>cely be a d\bt4 ,,deliv]y ,,9 ,a ,,bree* ,,pres5tation ,,9 ,,! ,,left ,,ant]ior ,,sacro-,,iliac ,,position4 ,9 ?is position ! legs & ?ighs are turn$ up aga9/ ! abdom51 ! bree* 9 full occupy+ ! passage1 ) ! sacrum to ! left & 9 front ( ! "m's pelvis4 ,! desc5t ( ! bree* usually takes place )\t mu* difficulty1 into ! ,pelvis1 x be+ small & easily compress$4 ,x desc5ds 9 ! same direction 9 :i* x fir/ pres5ts--t is diagonally1 l ! head--& also rotates1 or turns r\nd1 s t ! left buttock comes 9 front1 j to ! "r ( ! pubis1 :ile ! "r "o goes beh9d1 to ! left ( ! sacrum4 ,! left buttock rea*es ! m\? ( ! ,vulva fir/1 9 ?is position1 & !n rema9s /ation>y !re :ile ! "r "o slides along ! curve ( ! sacrum & p]9eum1 & passes out fir/ at ! l[] "p ( ! ext]nal op5+4 ,! left h[ev]1 spe$ily foll[s1 & :5 ! :ole bree* is born x rotates aga91 "o hip com+ imm$iately 9 front1 & ! o!r go+ imm$iately beh9d4 ,ow+ to ?is movem5t ! long diamet] ( ! bree* is adapt$ to ! long diamet] ( ! ,pelvis1 z 9 ! case ( ! head4 ,?is w be evid5t f ! foll[+ ,plate3-- ,illu/ration3 ,,plate ,,xxxii4 ,deliv]y 9 a bree* pres5tation1 ! buttocks hav+ j pass$ ! ,vulva4 c4 ,! ,coccygis1 mu* /raight5$4 p4 ,! pubic bone1 9 front4 ,! re/ ( ! body !n rotates 9 ! same way1 & ! arms & %\ld]s pass ?r\gh ! ext]nal op5+ 9 ! same direction z ! hips4 ,! left %\ld] fir/ moves to ! "r ( ! pubes1 :ile ! left passes beh9d2 & !n1 j :5 !y are bo? pass+ out1 "o comes imm$iately 9 front1 & ! o!r imm$iately beh9d1 plac+ !mselves 9 ! long diamet] ( ! ,vulva4 ,! head passes ?r\gh ! sup]ior /rait 9 ! left1 ant]ior occipital position1 & is (t5 deliv]$ 9 t way2 b sometimes x rotates1 & ! =ehead passes into ! curve ( ! sacrum1 :ile ! occiput is plac$ beh9d ! pubes4 ,:5 ?is occurs ! body also rotates1 to accompany ! head4 ,?is /ate ( ! p>ts is repres5t$ 9 ! foll[+ ,plate3-- ,illu/ration3 ,,plate ,,xxxiii4 ,ant]ior po/]ior position ( ! head1 ! occiput be+ 9 front1 aft] ! deliv]y ( ! body4 c4 ,! ,coccygis4 p4 ,! pubic bone1 9 front4 ,at ?is p]iod ! head is pass$ ! ut]us1 & !re is !re=e little or no contraction to expel x1 s t x (t5 rema9s a long "t undeliv]$4 ,x w be se5 t ! position is v unfavorable1 ! longe/ diamet] ( ! head1 ! occipito frontal1 be+ ! pres5t+ "o1 :i* makes x lie immoveably across4 ,! means ( assi/+ 9 su* a case are pla9 en\gh1 ! =ehead mu/ be br\ght d[n :ile ! body is rais$1 t[>ds ! "m's abdom52 ?is w ?r[ ! top ( ! head back1 t[>ds ! sacrum1 & *ange ! pres5t+ diamet]4 ,! =ehead & bregma rapidly escape bel[1 & ! occiput passes out la/4 ,?is is ! way 9 :i* nature h]self also completes ! deliv]y 9 su* cases1 :5 %e has ! p[]4 ,,deliv]y ,,by ,,! ,,bree* ,,9 ,,! ,,"r ,,po/]ior ,,sacro ,,iliac ,,position4 ,?is position is ! rev]se ( ! prec$+ "o1 ! ,sacrum be+ beh9d1 & to ! "r1 :ile ! ,abdom5 is to ! left 9 front4 ,! same movem5ts are p]=m$ z 9 ! fir/ position1 & ! :ole process is simil>1 only ! rev]se way4 ,! ,sacrum be+ beh9d h[ev]1 has to rotate mu* fur!r to come 9 front1 precisely ! same z ) ! head :5 9 ! po/]ior position4 ,! head g5]ally foll[s ! ,sacrum1 & ! occiput comes "u ! pubes1 z already expla9$2 b sometimes only at ! mom5t :5 be+ dis5gag$4 ,,deliv]y ,,by ,,! ,,bree* ,,9 ,,! ,,full ,,po/]ior1 ,,or ,,sacro ,,sacral ,,position4 ,9 ?is position !re is no rotation at all1 ! back ( ! *ild be+ turn$ full to ! back ( ! "m1 & ! :ole body1 & head1 be+ expell$ 9 t position4 ,9 g5]al !re is no p>ticul> difficulty f ?is position1 b on ! contr>y x is ?\ght by "s to be r favorable ?an o!rwise4 ,! longe/ diamet] ( ! ftal pelvis1 & %\ld]s1 are adapt$ to ! longe/ diamet] ( ! "m's pelvis1 at ! upp] /rait1 & easily pass x4 ,!y w also g5]ally pass ! ext]nal op5+ 9 ! same direction1 unless x be v unyield+1 or ! *ild v l>ge2 & if !y pass ! head usually foll[s1 because ! p>ts h be5 s mu* dilat$ by ! passage ( ! body t !y (f] b little resi/ance4 ,,g5]al ,,rem>ks ,,on ,,! ,,pres5tation ,,( ,,! ,,l[] ,,extremities4 ,z a g5]al rule deliv]y by ! bree*1 or by any o!r position ( ! l[] extremities1 is less favorable ?an by ! head4 ,! labor is usually long]1 m pa9ful1 & m exhau/+2 /ill h[ev]1 x is g5]ally spontane\s1 & n necess>ily dang]\s to ! "m4 ,to ! *ild1 on ! contr>y1 x is dang]\s1 on _m acc\nts4 ,x appe>s1 f ! obs]vations ( ,m4 ,p4 ,dubois1 t 9 ?is pres5tation "o *ild is lo/ out ( e twelve1 :ile only "o out ( fifty is lo/ 9 head pres5tations6 ,! *ief cause = ?is great] mortality appe>s to be ! compression ( ! umbilical cord1 :i* is great]1 & la/s mu* long]1 ?an :5 ! head pres5ts1 z w be evid5t on exam9+ ! circum/ances "u :i* deliv]y is effect$ 9 ea* case4 ,:5 ! head pres5ts x passes1 & also ! %\ld]s1 be=e ! umbilicus is rea*$2 ! "m's organs are !re=e mu* dilat$1 & only ! smalle/ p>ts ( ! ftus are left1 :5 ! cord is engag$ 9 ! passage2 x _c !re=e be mu* compress$1 nor = any long "t1 because ! labor is !n soon ov]4 ,:5 ! l[] extremities pres5t ?is is n ! case1 ! smalle/ p>ts !n pass be=e ! umbilicus is rea*$1 s t ! cord has to pass along ) ! head & %\ld]s1 :i* are bo? ! l>ge/ & ! longe/ 9 be+ deliv]$4 ,?is compression ( ! cord /ops ! circulation ( blood betwe5 ! ftus & ! ,plac5ta1 z w be evid5t on ref]r+ to ! description =m]ly giv5 ( ,ftal nutrition2 & ! /opp+ ( ?is circulation is z fatal1 to x1 z /opp+ ! brea? is to an adult4 ,:5 ! bree* pres5ts altoge!r1 !re is n s mu* dang] z ) ! feet1 or knees1 because x is l>ge1 & 9 its passage dilates ! p>ts s mu* t ! re/ ( ! body1 & ! head1 foll[ m quickly4 ,!re is1 ( c\rse1 no dang] till aft] ! hips h pass$1 because ! cord is n rea*$ be=e2 b ! deliv]y %\ld be complet$ z soon aft] !y are born z possible1 = e m9ute's delay makes ! *ances = ! *ild's life s mu* less4 ,,*apt] ,,xiii4 ,,me*anism ,,( ,,deliv]y ,,9 ,,pres5tations ,,( ,,! ,,face4 ,pres5tations ( ! face appe> to result f ! head be+ b5t backw>ds1 in/ead ( =w>ds ^u ! *e/4 ,!y are easily recogniz$1 because ! face has s _m peculi> p>ts1 z ! nose & m\?1 = in/ance1 :i* are altoge!r unlike :at c be felt 9 any o!r pres5tation4 ,9 a v e>ly /age ! =ehead may be tak5 = ! vortex1 unless c>e be us$1 because x feels r\nd & s(t l x1 b ! mi/ake _c la/ long4 ,! positions 9 ?is pres5tation1 z =m]ly expla9$1 are det]m9$ by ! *91 & 9 practice only two are notic$--! "r po/]ior m5to iliac1 & ! left ant]ior m5to iliac4 ,9 ! fir/ ! *9 is on ! "r side1 ne> ! sacrum1 & 9 ! second x is on ! left side1 ne> ! pubes4 ,^! answ]1 x w be se51 to ! two pr9cipal positions ( ! head itself4 ,x is g5]ally consid]$ t1 ?\gh ! *91 l ! head1 may assume o!r positions1 yet x does s 9 b v few cases1 & ^! pres5t+ no peculi>ities :i* require special notice4 ,,deliv]y ,,9 ,,! ,,"r ,,po/]ior ,,m5to ,,iliac ,,position ,,( ,,! ,,face4 ,! head desc5ds ) ! =ehead & *9 ne>ly on a level1 & ! nose occupy+ ! middle ( ! passage4 ,:5 fairly 9 ! cavity x rotates1 ! *9 be+ br\ght "u ! pubes1 :ile ! back ( ! head passes into ! curve ( ! sacrum4 ,?is is ne>ly always ! process2 no matt] :]e ! *9 may be :5 ! labor comm5ces1 x seldom fails to move "u ! pubes be=e x concludes4 ,occasionally x may rotate ! o!r way1 & pass into ! holl[ ( ! sacrum1 :ile ! occiput comes 9 front1 b ?is is v r>e4 ,! *9 is born fir/1 & !n foll[s1 bel[1 ! =ehead1 top ( ! head1 & f9ally ! occiput--! face turn+ upw>ds t[>ds ! "m's abdom51 z ea* "p is successively deliv]$4 ,:5 ! head is fully born1 ! body rotates inside ! same z 9 ! head pres5tation1 & ! deliv]y concludes 9 precisely ! same way4 ,illu/ration3 ,,plate ,,xxxiv4 ,fig4 #a4--,! *9 j pass$1 9 pres5tation ( ! face4 ,fig4 #b4--,! head full born 9 pres5tation ( ! face4--p4 ,! ,pubic bone4--c4 ,! ,coccygis4 ,,deliv]y ,,9 ,,o!r ,,positions ,,( ,,! ,,face4 ,! deliv]y is precisely ! same 9 all ! o!r positions ( ! face1 except+ t 9 "s ( !m ! *9 has fur!r to rotate be=e x c pass "u ! pubes4 ,9 all cases h[ev]1 x may be safely calculat$ t x w d s1 !re hav+ be5 s few in/ances kn[n 9 :i* x has rotat$ ! o!r way1 into ! holl[ ( ! sacrum1 :i* is =tunate1 = !re is always m or less difficulty & dang] :5 x does s4 ,sometimes ! rotation does n take place at all1 b ! face desc5ds diagonally1 z ! head occasionally does4 ,on ! :ole pres5tations ( ! face are n p>ticul>ly to be fe>$1 z reg>ds ! "m4 ,"s au?ors ev5 consid] !m q favorable1 & reckon !m only z v>ieties ( ! head pres5tation4 ,madame ,la*apelle /ates z a pr9ciple1 t face pres5tations %\ld always be left to nature4 ,& ,m4 ,*ailly says he mu/ admit t1 9 all positions ( ! face1 ! labor may t]m9ate spontane\sly1 except+ :5 ! *9 passes beh9d1 9 :i* case x w be protract$1 & mo/ likely fatal to ! *ild4 ,! labor is g5]ally a little long]1 & m pa9ful1 ow+ to ! face n be+ s p]fectly adapt$ to ! passage z ! head is2 b /ill x mu/ be reg>d$ z favorable to ! "m1 ?\gh assi/ance is (t5] requir$ ?an ) ! head4 ,!re is m or less dang] to ! *ild h[ev]1 ow+ to ! head be+ kept "u pressure = an unusual "t1 :i* produces conge/ion4 ,! neck is also =c$ aga9/ ! pubic bone1 z w be se5 by ,figs4 #a & #b1 ,plate ,,xxxiv1 & ?us ! jugul> ve9s are compress$4 ,if !re be any delay1 x is cu/om>y to obs]ve ! face closely1 aft] ! *9 is born2 & if x appe>s f any indications t conge/ion is tak+ place1 assi/ance is r5d]$ at once4 ,! face w sometimes become s tumefi$1 & engorg$ ) blood1 f ?is prolong$ pressure1 t x w n appe> natural till sev]al days aft] bir?4 ,probably ab\t "o *ild is lo/ 9 t5 or twelve deliv]ies 9 ^! cases2 & if ! *9 pass beh9d its dea? is almo/ c]ta94 ,x 0 =m]ly ! practice to endeavor to turn ! face upw>ds1 :5 at ! sup]ior /rait1 & s *ange ! pres5tation to "o ( ! head4 ,?is h[ev]1 is n[ ab&on$1 because ! attempt is seldom successful1 & does n mat]ially improve ! condition ( ?+s1 besides be+ pa9ful to ! "m4 ,! only extra dang] ) ! face pres5t+ is to ! *ild1 & ?is is n remov$ by ! op]ation2 to ! "m ! face is ne>ly z favorable z ! cranium4 ,9 reg>d to ! frequ5cy ( face pres5tations1 we f9d t ,madame ,la*apelle met ) b sev5ty-two cases 9 fifte5 ?\s& six hundr$ & fifty-two deliv]ies4 ,,*apt] ,,xiv4 ,,me*anism ,,( ,,deliv]y ,,9 ,,pres5tations ,,( ,,! ,,trunk4 ,x has already be5 /at$ t 9 pres5tations ( ! ,trunk x is ne>ly always ! "r or left %\ld] :i* occupies ! passage4 ,x is /at$1 by "s au?ors1 t !y h felt ! back1 & abdom51 b o!rs ?9k !y 7 mi/ak52 & mo/ c]ta9ly su* positions are extremely r>e1 if !y actually d ev] exi/4 ,!re are two pres5tations ( ! ,trunk1 det]m9$ by ! side on :i* ! ftus lies1 & d5om9at$ accord+ly "r or left lat]al pres5tations4 ,ea* ( ^! pres5tations has two correspond+ positions1 det]m9$ by ! side on :i* ! *ild's head lies4 ,if ! head be on ! "m's "r side x is call$ ! "r cephalo iliac position1 & if x be on ! left side x is d5om9at$ ! left cephalo iliac position4 ,! me*anism ( spontane\s deliv]y is ! same 9 !m bo?1 & 9 all _! v>ieties1 & s is ! mode ( r5d]+ assi/ance1 s t a description ( "o w suffice4 ,sometimes1 :5 ! labor has la/$ long )\t assi/ance1 "o arm w be =c$ d[n fir/1 & ev5 appe> ext]nally4 ,?is us$ to be consid]$ a sep>ate pres5tation1 & describ$ z su*1 "u ! "n ( pres5tation ( ! h& & arm4 ,!re is no reason = describ+ x sep>ately h[ev]1 & no utility 9 do+ s1 z x diff]s 9 no ess5tial p>ticul> f ord9>y pres5tation ( ! %\ld]s1 & mu/ receive ! same assi/ance4 ,:at x is t produces pres5tations ( ! ,trunk1 & o!r unfavorable p>ts1 is n kn[n1 ?\gh !y are g5]ally ?\ght to be ow+ to excessive motion 9 ! *ild1 or obliquities ( ! ,womb4 ,m4 ,la*apelle met ) sixty-eight cases ( ,trunk pres5tation 9 fifte5 ?\s& six hundr$ & fifty-two labors1 :i* is ne>ly ! same z ! face4 ,! "r side pres5ts m frequ5tly ?an ! left1 & ! head is on ! left side (t5] ?an on ! "r1 z x is 9 ord9>y head pres5tations4 ,z a g5]al rule assi/ance is always r5d]$ 9 pres5tations ( ! ,trunk1 & is g5]ally consid]$ absolutely necess>y4 ,x is und\bt$ly true h[ev]1 t nature has effect$ deliv]y 9 su* cases unaid$1 ?\gh r>ely1 & su* in/ances are consid]$ z extremely =tunate exceptions to ! g5]al rule4 ,m4 ,*ailly says t ! acc\*eur %\ld nev] leave su* cases to nature alone1 b always aid h]2 b o!r au?ors tru/ to h] a little m4 ,! mo/ usual mode ( r5d]+ assi/ance is to turn ! *ild1 & br+ d[n ! feet1 a manuvre :i* w be fully describ$ h]eaft]4 ,9 "s cases ! *ild turns itself1 f ! contractions ( ! ,womb1 be=e x ent]s ! upp] /rait2 & 9 o!r cases1 :5 v small1 or long dead1 x w pass fold$ d\ble4 ,?is self-turn+ h[ev]1 _c take place aft] ! escape ( ! wat]s1 s t x seldom occurs :5 ! membranes are brok54 ,,me*anism ,,( ,,deliv]y ,,9 ,,pres5tations ,,( ,,! ,,trunk ,,by ,,spontane\s ,,evolution4 ,?is is ! mo/ usual mode = ! ftus to escape1 9 ea* pres5tation1 & 9 e position4 ,by ref]r+ to ! foll[+ ,plates1 & ! accompany+ descriptions1 x w be readily und]/ood4 ,illu/ration3 ,,plate ,,xxxv4 ,position ( ! ,ftus 9 a pres5tation ( ! "r %\ld]1 & 9 ! left cephalo iliac position4 ,previ\s to ! rupture ( ! membranes ! *ild's body lies across1 z =m]ly expla9$2 b imm$iately aft] ! rupture ! %\ld]s desc5d into ! ,pelvis1 z se5 9 ! above ,plate1 :ile ! head rema9s above ! pubes2 ! arm frequ5tly1 b n always1 protrud+ ext]nally4 ,! %\ld] !n cont9ues to desc5d1 ! body foll[+1 b5t up aga9/ ! face1 z se5 9 ,plate ,,xxxvi4 ,illu/ration3 ,,plate ,,xxxvi4 ,desc5t ( ! %\ld] 9 a ,trunk pres5tation1 at a m advanc$ p]iod4 ,"h ! %\ld] is protrud$ f ! ,vulva1 ! back be+ ne>ly fold$1 & ! knees turn$ up aga9/ ! face4 ,illu/ration3 ,,plate ,,xxxvii4 ,desc5t ( ! %\ld] & trunk at a /ill lat] p]iod4 ,! :ole ,trunk is n[ fully deliv]$1 fold$ almo/ d\ble1 & ! legs & feet are turn$ up aga9/ ! face4 ,!y spe$ily foll[ h[ev]1 & !n no?+ is left b ! head1 & p]haps "o or bo? arms1 plac$ aga9/ ! sides ( x1 z %[n 9 ,plate ,,xxxviii4 ,illu/ration3 ,,plate ,,xxxviii4 ,! ,trunk has fully desc5d$1 & only ! head is left1 ) "o arm4 ,! arm is g5]ally v easily br\ght d[n1 or x may rema9 & come ) ! head4 ,! deliv]y ( ! head is effect$ ! same z 9 pres5tations ( ! pelvis1 & is seldom att5d$ ) mu* difficulty1 ! p>ts hav+ be5 s mu* di/5d$4 ,! body always rotates s t ! back comes 9 front1 & ! *9 passes into ! curve ( ! ,sacrum4 ,?is is ! way 9 :i* ! deliv]y is effect$ by nature 9 su* cases1 & x w readily be conceiv$ h[ dang]\s x is to bo? "m & *ild1 & h[ seldom x c be accompli%$4 ,if ! ,ftus be ( a full size1 & ! "m's pelvis no l>g] ?an ord9>y1 x is almo/ impossible = ?is spontane\s evolution to take place2 & ev5 :5 x does1 x is ) ! greate/ difficulty1 ! "m suff]+ 9 an extreme degree1 & runn+ great risk1 n only ( ! mo/ s]i\s aft] results1 b ev5 ( dea?4 ,to ! *ild ! dang] is equally great1 ow+ to ! sev]e & long-cont9u$ compression x receives1 & ! unnatural position x assumes4 ,m4 ,velpeau tells u t 9 "o hundr$ & ?irty-sev5 su* cases1 "o hundr$ & tw5ty-five ( ! *ildr5 di$4 ,! numb] ( ! mo!rs also1 :o ei!r di$ or 7 made suff]]s all _! future lives1 0 und\bt$ly great1 ?\gh unkn[n4 ,x is evid5t !re=e1 t pres5tations ( ! ,trunk are ! mo/ unfavorable kn[n1 & labor 9 !m is b r>ely spontane\s4 ,nature c b v seldom effect ! deliv]y ( ! ,ftus h]self1 & ev5 :5 %e does x is ) ! greate/ risk1 bo? to x & ! "m4 ,! acc\*eur %\ld always assi/ !re=e1 if he c1 because ev5 if nature c complete ! deliv]y x is ) su* dang]4 ,! means ( assi/+1 by turn+1 w be describ$ 9 ano!r ,*apt]4 ,if ! ftus is n at full t]m1 & ( c\rse is "u ! full size1 its expulsion may be left to nature safely1 b n o!rwise4 ,,section ,v4 ,,! ,,physiology ,,( ,,spontane\s ,,deliv]y1 ,,or ,,*ildbir?1 ,,& ,,! ,,mann] ,,( ,,conduct+ ,a ,,natural ,,labor4 ,hav+ n[ complet$ ! description ( ! ,me*anism ( ,deliv]y1 9 all ! v>i\s pres5tations & positions1 x is necess>y to expla9 ! physiological ph5om5a att5d+ a natural labor1 & ! duties ( ! acc\*eur :5 conduct+ x1 & to %[ :at assi/ance he c r5d]1 & :5 he %\ld or %\ld n int]f]e4 ,,*apt] ,,xv4 ,,( ,,deliv]y ,,9 ,,g5]al4 ,,diff]5t ,,k9ds ,,( ,,deliv]y4 ,:5 ! *ild is br\ght into ! _w by ! unaid$ ef=ts ( nature1 & )\t any accid5t to itself or ! "m1 x is call$ a ,natural ,deliv]y4 ,:5 x occurs by ! ef=ts ( nature alone1 b n advantage\sly = bo?1 x is n call$ natural1 b simply ,spontane\s ,deliv]y4 ,& :5 assi/ance is requir$ x is call$ an ,artificial1 or difficult ,deliv]y4 ,x is also call$ precoci\s1 or t>dy1 accord+ z x comes be=e or aft] ! full t]m4 ,,causes ,,( ,,labor4 ,:at x is t causes labor to comm5ce1 & proce$1 is n fully kn[n4 ,at ! prop] "t ! ,ut]us prep>es to ca/ out ! ftus x has s long reta9$1 9 ! same mann] t ! tree ca/s (f its fruit1 & f "s effici5t cause :i* we h n yet discov]$4 ,x is probable t1 :5 ! ftus atta9s a c]ta9 size1 x presses ^u ! n]ves ( ! neck ( ! ,ut]us & irritates !m1 & !y react aga9 ^u ! muscul> fibres ( ! ,womb & cause !m to contract1 & s expel its cont5ts4 ,?is is mu* ! same action1 9 fact1 z vomit+4 ,:5 any body v repugnant to ! /oma* is swall[$1 x irritates ! n]ves ( t organ1 & !n !y excite its muscul> fibres1 :i*1 by =cible contractions1 expel ! (f5d]4 ,x is possible1 also1 t ! ftus itself may in/9ctively assi/ 9 br++ ab\t its own deliv]y1 z 0 suppos$ ( old by ,hippocrates1 & m lately by ,h>vey & o!rs4 ,x is c]ta9 t labor is bo? m difficult1 & m dang]\s1 :5 ! *ild is dead2 ?\gh x may take place z usual aft] ! dea? ( ! "m1 provid+ ! *ild be /ill alive4 ,sev]al in/ances ( ?is k9d h be5 kn[n1 :5 ! liv+ *ild 0 expell$ f ! ,womb1 by ! natural process1 sometime aft] ! "m _h ceas$ to brea!4 ,! contraction ( ! muscul> fibres ( ! ,womb h[ev]1 mu/ be reg>d$ z ! imm$iate or effici5t cause ( ftal expulsion1 let !m be br\ght on h[ !y may4 ,! muscles ( ! ,abdom51 & ! diaphragm1 also assi/1 9 ! la/ /age1 b are n ess5tial4 ,! "y ( "s ( ! l[] animals are obs]v$ to p]=m c]ta9 peculi> motions1 dur+ deliv]y1 by :i* x is mu* facilitat$2 & ?is is consid]$ a pro(1 by "s1 t volunt>y movem5ts ( ! ftus assi/ 9 ! process4 ,c]ta9ly if x be suppos$1 z we h %[n !re is good gr\nds = do+1 t ! *ild assi/s 9 plac+ itself 9 ! be/ position1 x is equally probable t x also assi/s 9 its own expulsion1 9 o!r ways4 ,,signs ,,( ,,deliv]y4 ,premonitory ,signs4--,a few days be=e deliv]y ! ,ut]us desc5ds mu* l[]1 s t ! diaphragm & /oma* are less press$ ^u1 & ! brea?+ & dige/ion becomes easi] 9 consequ5ce4 ,! ease :i* is ?us exp]i5c$ is sometimes s great t ! female becomes unusually animat$ & *e]ful1 & _c ?9k %e is s ne> h] travail4 ,?is is n always ! case h[ev]1 = "s on ! contr>y feel v uncom=table & melan*oly4 ,! lips ( ! ,vulva are also apt to swell & become pa9ful1 & ! l[] limbs numb$ & cramp$1 ow+ to ! *ild's head press+ on ! l>ge n]ves4 ,! neck ( ! bladd] is also v liable to be compress$1 s t a con/ant desire is felt to ur9ate1 & a simil> tr\ble may also be exp]i5c$ 9 ! ,rectum4 ,mo/ ( ^! inconv5i5ces1 b p>ticul>ly ! numbness & cramps 9 ! limbs1 are n likely to be exp]i5c$ except :5 ! head pres5ts1 because no o!r "p is s =m$ z to be able to desc5d suffici5tly l[2 :5 !y are felt !re=e1 ! female may console h]self by ! reflection t !y indicate1 ) tol]able c]ta9ty1 t ! *ild is pres5t+ 9 ! be/ position x c = a safe & spe$y deliv]y4 ,/&+1 or walk+1 usually become m difficult1 & swell+ ( ! ext]nal p>ts1 or piles1 are apt to occur4 ,) "s females also1 a sudd5 di>rha1 or vomit+1 takes place1 & tr\bles !m up to ! p]iod :5 labor comm5ces4 ,f9ally ! ,ut]us beg9s to contract1 ?\gh ins5sibly at fir/2 ! ,abdom5 becomes unusually h>d1 & fly+ pa9s are exp]i5c$1 p>ticul>ly ) fir/ *ildr54 ,?is cont9ues ) m or less ( int]mission1 up to ! actual p]iod ( labor1 :i* is usually divid$ into ?ree p]iods1 ea* ( :i* mu/ be consid]$ sep>ately4 ,,*apt] ,,xvi4 ,,! ,,progress1 ,,ph5om5a1 ,,& ,,duration ,,( ,,natural ,,labor4 ,,fir/ ,,p]iod4 ,on mak+ an exam9ation ! m\? ( ! ,womb w be f\nd to be dilat+1 & a dis*>ge ( mucus1 t+$ ) blood1 issu+ f x4 ,! membranes may also be felt protrud+ into ! ,vag9a1 & di/5d$1 l a bladd]4 ,! female compla9s ( be+ drawn p[]fully toge!r 9 ! inside2 %e trembles1 & gasps = brea?2 h] pulse s9ks1 & %e (t5 becomes sick & deadly fa9t2 %e compla9s ( great ?ir/1 & breaks out into pr(use p]spiration2 frequ5tly %e w weep1 & app>5tly suff] f "s t]rible appreh5sion1 :ile h] /r5g? w be completely exhau/$4 ,occasionally h[ev]1 %e w be p]fectly passive1 & almo/ immoveable1 appe>+ z if 9 a dream4 ,! pa9s h[ev]1 gradually become m & m acute1 & clos] toge!r2 ! pati5t is excit$ & irritable2 h] pulse becomes quick] aga91 ! ?ir/ increases1 & vomit+ frequ5tly ensues4 ,be=e ea* pa9 %e frequ5tly exp]i5ces a sev]e *ill1 ) *att]+ ( ! tee?1 & n unfrequ5tly becomes p]fectly deliri\s4 ,) ea* pa9 ! m\? ( ! ,womb exp&s m & m1 till at la/ x totally disappe>s1 & ! cavity ( ! ,ut]us & ! ,vag9a =m b "o uni=m passage1 :i* is completely occupi$ ) ! di/5d$ membranes1 or bag ( wat]s1 :i* may be felt l a s(t r\nd tumor4 ,?is is well repres5t$ 9 ! foll[+ ,plate3-- ,illu/ration3 ,,plate ,,xxxviii4--a4 ,fig4 #a4 ,fig4 #b4 ,fig4 #a %[s ! /ate ( ! p>ts at ! beg9n+ ( labor4 ,! m\? ( ! ,womb is consid]ably dilat$1 & ! ,membranes1 ,a1 are protrud+ slightly4 ,fig4 #b %[s ! /ate ( ! p>ts at ! end ( ! fir/ p]iod4 ,! neck ( ! ,womb is n[ s fully dilat$ t x =ms a cont9u\s passage ) ! ,vag9a1 :ile ! bag ( wat]s1 ,a1 projects f> d[n & occupies ! :ole wid? ( ! canal4 ,! fir/ p]iod may be mu* protract$1 & is g5]ally v exhau/+1 ?\gh n att5d$ ) any dang] or special difficulty4 ,,second ,,p]iod4 ,at ?is /age all ! previ\s symptoms become mu* exagg]at$4 ,! contractions are m p[]ful1 & ! pa9s m acute1 b ) a p]fect p]iod ( repose betwe5 !m1 dur+ :i* ! female w feel q easy1 & ev5 sometimes fall asleep1 b only to be ar\s$ by ! pa9s com+ on aga94 ,! muscles ( ! ,abdom51 & ! diaphragm1 are n[ call$ into play2 ! pati5t /ra9s1 or viol5tly be>s d[n1 & pants ) ex]tion1 :ile ! p]spiration /reams f e pore1 ! pulse quick5s1 & ! expression ( ! c\nt5ance betrays ! wilde/ anxiety & excitem5t4 ,! bag ( wat]s n[ desc5ds1 & enl>ges m & m1 until at la/1 be+ unable any long] to be> ! /ra9 to :i* x is subject1 x bur/s1 & ! wat]s fl[ away 9 a pr(use gu%4 ,imm$iately ?is takes place ! head desc5ds1 & closes up ! passage2 ! pa9s cease = a "t1 & ! pati5t aga9 has a respite1 :ile ! ut]us app>5tly ga9s fre% p[]4 ,v soon ! contractions recomm5ce1 m en]getically ev5 ?an be=e1 ! head passes ! m\? ( ! ,womb & ent]s ! ,vag9a1 :i* keeps enl>g+ z x desc5ds1 till x rea*es ! l[] "p1 or floor ( ! pelvis4 ,! pa9s n[ become m viol5t ?an ev]1 ! pati5t screams ) agony1 clut*es hold ( any object ne> h]1 ?r[s h]self back1 draws 9 h] brea?1 & be>s d[n ) all ! =ce %e c comm&4 ,! fe>ful cries :i* mo/ females emit at ?is "t appe> to assi/ ! deliv]y1 by ! convulsive ef=ts at brea?+ :i* !y necessitate1 & ! expulsive /ra9+ also does ! same4 ,^! natural ef=ts are mu* assi/$ by provid+ a firm support = ! pati5t's feet1 aga9/ :i* %e c pu%1 :i* %e w d ) trem5d\s =ce4 ,! head n[ presses1 at ea* pa91 aga9/ ! p]9eum1 :i* beg9s to project outw>ds1 z also does ! ,rectum4 ,! ,vulva beg9s to dilate1 ! lips sep>ate wid] & wid]1 & "p ( ! *ild's head becomes visible4 ,gradually ! lips become ?9n] & ?9n]1 & at la/ disappe> ne>ly altoge!r1 s t ! m\? ( ! ,vulva is only compos$ ( ?9 r+1 :i* seems ready to give way e mom5t4 ,! head h[ev] rec$es1 & ! p>ts aga9 assume some?+ l _! natural condition = a %ort "t1 :5 ! same process aga9 takes place1 & ! di/5sion proce$s /ill fur!r1 :ile ! head does n retire s f>4 ,?is alt]nate action is repeat$ p]haps _m times1 s t ! ext]nal m\? is op5$ gradually1 & )\t ! lips or p]9eum be+ torn1 :i* !y w\ld be if ! head 7 to pass sudd5ly1 be=e !y 7 s(t5$ & dilat$4 ,aft] ?is has be5 cont9u$ = a suffici5t p]iod a /rong expulsive pa9 is felt1 ! female screams1 ! head passes clean ?r\gh ! ext]nal op5+1 & ! lips close r\nd ! neck4 ,?is h[ev]1 is only = an in/ant1 ! re/ ( ! body spe$ily foll[+ ! head1 9 ! mann] h]eaft] to be expla9$4 ,mo/ usually1 9 fact1 ! :ole body foll[s ! head )\t any /oppage at all1 b sometimes !re is a delay ( a few seconds4 ,! ,?ird p]iod ( deliv]y comprises ! deliv]y ( ! ,plac5ta1 :i* w occupy our att5tion 9 ano!r place4 ,diff]5ces 9 ! process ( ,labor4--,al?\gh1 9 mo/ cases1 labor proce$s mu* 9 ! way ,i h j expla9$1 & is att5d$ ) simil> ph5om5a1 yet /ill we occasionally see m>k$ exceptions4 ,?is is p>ticul>ly ! case ) reg>d to pa94 ,mo/ females suff] sev]ely at ?is "t1 & "s ev5 ! mo/ tortur+ agony1 :ile o!rs aga9 exp]i5ce sc>cely any?+ to compla9 (1 & "s ev5 feel no?+ at all4 ,i am acqua9t$ ) a lady at ! pres5t "t1 ! "m ( sev]al *ildr51 :o assures me %e nev] felt any pa9 at all 9 h] labors1 nor 0 %e 9 any ways exhau/$ by !m4 ,i h kn[n h] rise f h] b$ 9 ! night1 f feel+ indications ( ! approa*+ ev5t1 make all h] arrangem5ts1 & s5d = ! nurse1 z if x 0 ! mo/ ord9>y affair imag9able4 ,on "o ( ^! occasions1 be=e h] husb& return$ ) ! assi/ants1 %e 0 deliv]$ :ile alone1 )\t any difficulty1 & !y f\nd h] sitt+ up 9 b$ nurs+ ! *ild4 ,%e _h cut x loose1 & ti$ up ! cord h]self1 hav+ he>d h[ to d s at "o ( my ,lectures1 & actually br\ght away ! ,plac5ta ) h] own h&4 ,9 two days aft] %e 0 ab\t z usual4 ,& yet ?is lady 0 by no means /rong1 nor rem>kably heal?y2 & :at is v s+ul>1 %e suff]$ sev]e pa9s at mo/ ( h] mon?ly p]iods2 mu* m1 z %e assur$ me1 ?an f all h] labors put toge!r4 ,m4 ,*ailly also m5tions an in/ance ( a "y girl ( sixte51 ) h] fir/ pregnancy1 ^: ,vag9a 0 also p>tly clos$ by an int]nal membrane1 ^: deliv]y nev]!less 0 almo/ pa9less4 ,%e woke up1 he tells u1 ab\t f\r o'clock 9 ! morn+1 ) "s v slight pa9s1 :i* sc>cely di/urb$ h]1 b :i* cont9u$ till ab\t six1 :5 ! *ild 0 born sudd5ly & safely1 )\t any assi/ance1 & ) sc>cely any increase ( pa9 to ! "m4 ,i h kn[n _m o!r su* cases z ^!1 & pl5ty ( !m c be f\nd record$2 b :at ?is =tunate exemption f suff]+1 9 su* cases1 dep5ds ^u1 is n kn[n4 ,! nature1 & ! seat ( ! pa9s1 is also v v>iable4 ,"s only feel a dull sort ( a*+1 ) p[]ful contraction1 or draw+ toge!r1 :ile o!rs call x gr9d+1 cutt+1 & burn+ pa94 ,"s feel x 9 ! back1 & "s at front1 :ile o!rs feel x mo/ 9 ! gro9s1 & o!rs aga9 exp]i5ce x 9 all ^! p>ts at once4 ,! peculi> %>p pa9 :i* results f ! extreme dilatation ( ! ext]nal m\?1 :5 ! head passes1 is p]haps ! mo/ con/antly felt1 & ! mo/ alike 9 all4 ,! mann] 9 :i* ! m\? ( ! ,womb op5s1 & ! "t requir$ = its dilatation1 diff] mu* 9 diff]5t cases4 ,9 females :o h previ\sly borne *ildr51 z be=e expla9$1 ! m\? is always consid]ably op5$ at ! full t]m1 :ile 9 a fir/ pregnancy x is ne>ly clos$1 ev5 till "s "t aft] ! labor actually comm5ces4 ,sometimes ! dilatation takes place rapidly1 & at o!rs v sl[ly2 x is especially liable to be delay$ if ! ,membranes break too soon1 because !n ! pressure ( ! bag ( wat]s is lo/1 & t is an important ag5t 9 exp&+ ! ,os ,ut]i4 ,9 "s cases ! neck ( ! ,womb is v h>d & rigid1 s t a long "t is requir$ to make x give way4 ,:5 any o!r "p ?an ! head pres5ts also1 ! op5+ ( ! m\? w n take place s soon1 because no o!r "p s completely fills up ! passage4 ,! break+ ( ! bag ( wat]s w sometimes occur v e>ly1 almo/ z soon z x protrudes2 :ile at o!r times x w be delay$ till ! :ole ,vag9a is fill$ up by x1 or ev5 till x appe>s ext]nally4 ,! quantity ( ! wat] dis*>g$ at ! "t ( ! rupture is also v>iable2 if ! pres5t+ "p ( ! ftus does n completely block up ! passage1 ! :ole may pass away :5 ! rupture takes place2 b if x does1 z is usually ! case :5 ! head pres5ts1 only a "p fl[s !n1 & ! re/ comes 9 gu%es1 z ! head is rais$1 & :5 ! *ild is born4 ,! too e>ly escape ( ! wat]s1 z already expla9$1 may ret>d ! deliv]y1 by delay+ ! expansion ( ! m\? ( ! ,womb2 & 9 ?is way unskilful acc\*eurs h caus$ l+]+ labors1 by break+ ! membranes too soon4 ,x is important to recollect also1 z ,i expla9$ be=e1 t a portion ( fluid sometimes exi/s betwe5 ! amnion & *orion1 :i* may pass fir/1 & induce ! belief t ! true wat]s h escap$1 :5 !y h n4 ,?is is call$ ! false wat]s1 or %[s1 & is n connect$ ) ! true wat]s at all4 ,! g5]al physiological ph5om5a ( a natural deliv]y hav+ ?us be5 expla9$1 we h n[ to /ate its duration1 & !n proce$ to its conduct or managem5t4 ,,duration ,,( ,,natural ,,labor4 ,! duration ( natural labor is n by any means con/antly ! same1 nor c x be pr$ict$ ) any?+ l c]ta9ty 9 any case2 b /ill by keep+ c>eful records1 & by duly obs]v+ a va/ numb] ( cases1 a tol]able approximation c be made4 ,!re are v>i\s circum/ances t t5d to l5g!n ! duration ( labor1 "s g5]al1 & o!rs belong+ to ! individual4 ,! mode ( life & e>ly habits ( ! female1 ! climate 9 :i* %e lives1 & ! mann] 9 :i* %e has conduct$ h]self dur+ ge/ation1 all h an important influ5ce4 ,z a g5]al rule1 ! p]iod becomes long] 9 proportion to ! civilization ( ! community 9 :i* %e lives4 ,! fir/ labor is g5]ally m t$i\s ?an ! succe$+ ones1 ow+ to ! sl[] dilatation ( ! p>ts4 ,x is also ?\ght by "s1 t ! labor is long] 9 proportion to ! age ( ! female1 p>ticul>ly ) ! fir/ *ild2 b ?is op9ion is n well f\nd$4 ,! av]age duration ( labor 9 our c\ntry1 is f eight to twelve h\rs4 ,9 "s p>ts x is long] ?an ?is1 & 9 o!rs aga9 x is mu* %ort]4 ,i h good reason also to ?9k1 t x is long] 9 cities ?an 9 ! c\ntry4 ,an exp]i5c$ practition] c sometimes pr$ict ) tol]able c]ta9ty1 :5 call$ to a labor1 h[ long x w be be=e x is ov]2 b ?is is seldom ! case1 & mo/ frequ5tly 8 success is ow+ m to *ance ?an to judgm5t4 ,if ! m\? ( ! womb be well dilat$1 ! contractions p[]ful1 & ! pati5t vigor\s1 ) ! pres5tation natural1 he is ( c\rse ju/ifi$ 9 pr$ict+ a spe$y deliv]y2 or ! rev]se1 if ^! favorable conditions d n exi/4 ,_m un=ese5 conditions may exi/1 h[ev]1 & _m accid5ts arise1 t may falsify an app>5tly safe conclusion4 ,no judici\s practition]1 except 9 a few r>e cases1 w haz>d 8 reputation by fix+ any "t1 & no well in=m$ pati5t w\ld ask him to d s1 because %e w\ld "k t x 0 out ( 8 p[]4 ,,*apt] ,,xvii4 ,,! ,,conduct ,,or ,,managem5t ,,( ,a ,,natural ,,labor4 ,,prelim9>y ,,requisites4 ,9 mo/ cases ( natural labor !re is n mu* assi/ance ne$$4 ,! assi/ant %\ld1 h[ev]1 possess a c]ta9 tact1 or mann]1 calculat$ to make a favorable impression on ! pati5t4 ,?is is especially ne$$ :5 a man (ficiates4 ,x mu/ be recollect$1 t ! situation ( ! female at su* times is a v peculi> "o1 & t ! pres5ce ( "o ( ! o!r sex1 h[ev] necess>y1 mu/ be m or less objectionable to h]4 ,he %\ld1 !re=e1 c>efully exhibit 9 8 behavior ! mo/ ref9$ delicacy1 comb9$ ) a w>m sympa?y & k9d consid]ation2 ?us soo?+ h] scruples & enli/+ h] gratitude4 ,he mu/ also appe> p]fectly self-possess$ "u all circum/ances1 & !n %e w h full confid5ce 9 8 skill & judgm5t4 ,x may seem sc>cely necess>y to /ate ^! ?+s1 b ,i h (t5 kn[n m5 (ficiate )\t su* qualifications1 & also be p]fectly unaw>e ( _! defici5cies4 ,su* acc\*eurs nev] (ficiate well2 !y may be skillful & att5tive1 b yet unsuccessful1 & unappreciat$4 ,!y are only tol]at$1 b n respect$1 & are nev] fully confid$ 94 ,:5 reque/$ to see a woman suppos$ to be 9 labor1 x is always advisable to be prompt 9 pay+ ! visit1 because deliv]y sometimes comes on sudd5ly & unexpect$ly1 & bo? "m & *ild may be 9 great dang] if no "o is ne> to assi/4 ,"s "t be=e ! ev5t is expect$1 x is advisable to provide c]ta9 articles1 :i* w or may be ne$$ at ! "t1 & :i* %\ld n h to be look$ = at ! la/ mom5t4 ,a pair ( %>p scissors1 ) a piece ( /rong ?read or cord1 are indisp5sable1 & a female ca!t] may be ne$$4 ,a quill ) ! fea!r "p on1 may also be useful2 & "s pure l>d or sweet oil is frequ5tly call$ =4 ,! pr(essional acc\*eur w also f9d x a good precaution to h 8 /e?oscope 9 8 pocket1 & a lancet1 if he ev] relies ^u ble$+ 9 any cont+5cy4 ,a small box ( extract ( ,belladonna also1 may (t5 be ( great & imm$iate s]vice4 ,,prelim9>y ,,proce$+s4 ,! fir/ ?+ requir$ :5 visit+ ! pati5t1 is ( c\rse to asc]ta9 positively :e!r %e be pregnant1 & :e!r labor is really comm5c$1 & if s h[ f> x has progress$4 ,?is necessitates an exam9ation1 ! proposal & mak+ ( :i* require ! mo/ delicate tact1 p>ticul>ly if x be ) a comp>ative /rang]1 or 9 a fir/ labor4 ,no allusion to x %\ld be made to ! pati5t h]self by ! assi/ant2 he %\ld conv]se ) h] ab\t indiff]5t matt]s1 or m]ely ^u h] heal?1 & /ate 8 wi%es to ! nurse or female fri5d1 & !n retire4 ,?is gives !m "t to in=m h] ( :at is requir$1 & to make ! necess>y prep>ation4 ,on ent]+ ! room aga91 he %\ld n proce$ abruptly1 b resume ! conv]sation1 & make "s ( ! necess>y arrangem5ts :ile c>ry+ x on4 ,he %\ld seat himself by ! side ( ! b$1 ) 8 "r h& next h]1 & 8 face opposite h]s4 ,!n pass+ 8 h& "u ! b$ clo!s1 aft] hav+ lubricat$ x ) l>d or oil1 he c proce$ ) ! exam9ation z if x 7 a simple ord9>y proce$+4 ,by exhibit+ no hurry1 & appe>+ to ?9k x no?+ unusual or 9 any way /range1 ! female h]self w cease to ?9k x s1 & w n be flurri$ or %ock$4 ,! h& mu/ be pass$ "u ! female's "r ?igh1 h] knees be+ elevat$4 ,%e %\ld1 ( c\rse1 lie on h] back1 & z ne> to ! edge ( ! b$ z conv5i5t4 ,n ! slighte/ exposure is necess>y1 nor all[able "u ord9>y circum/ances4 ,! =e-f+] be+ introduc$1 ballotm5t may be practis$1 to asc]ta9 if pregnancy really exi/s2 & if ! evid5ce f ?is s\rce is n suffici5t1 auscultation mu/ be resort$ to4 ,aft] be+ satisfi$ on ?is po9t1 ! m\? ( ! womb mu/ be c>efully exam9$1 & its degree ( dilatation notic$4 ,if ! female has pa9s1 _! "* & frequ5cy mu/ also be notic$1 & ! effects !y produce on ! p>ts4 ,x w g5]ally be possible by ^! means1 to discov] h[ f> ! labor has progress$1 & ev5 to =m an op9ion h[ long x is likely to la/4 ,! g5]al =m ( ! p>ts & _! size1 %\ld also be notic$2 p>ticul>ly ( ! pelvis1 s t any de=mity or defici5cy may be discov]$4 ,& la/ly1 ! pres5tation %\ld be asc]ta9$1 if possible1 s t x may be kn[n 9 "t :e!r nature w be suffici5t h]self or w require help+4 ,! position ne$ n be c>$ = at pres5t1 because x is ( little consequ5ce :5 ! pres5tation is favorable4 ,! "t requir$ to make ! exam9ation ne$ n be long1 & %\ld always be z %ort z possible4 ,:ile conv]s+ ) ! pati5t1 mu* useful in=mation may be ga9$4 ,! g5]al /ate ( h] heal?1 ! nature ( h] pa9s1 & ! "t !y fir/ comm5c$1 %\ld all be kn[n2 & if %e has _h *ildr5 be=e1 x w be highly useful to "k :at k9d ( a labor %e _h2 :e!r x 0 long or %ort1 easy or difficult1 & p>ticul>ly if att5d$ ) any accid5t likely to occur aga94 ,x ne$ sc>cely be rem>k$ t great caution is ne$$ 9 ^! cases1 _m em95t m5 hav+ be5 deceiv$ z to ! pati5t's condition1 z already /at$ 9 our *apt] on ! signs ( pregnancy4 ,& _m times ! doctor has be5 summon$ "u ! supposition t labor _h begun1 :ile x 0 yet f> (f4 ,! pa9s may be false ones1 su* z frequ5tly occur t[>ds ! end ( pregnancy1 & may all pass away4 ,^! false pa9s1 h[ev]1 c usually be di/+ui%$1 be+ cont9u\s & irregul>1 :ile ! true ones int]mit ) p]iods ( almo/ p]fect ease1 & are tol]ably regul>4 ,! false pa9s are also felt 9 v>i\s p>ts1 :ile ! true ones are *iefly fix$ 9 ! ut]us & vag9a4 ,sometimes1 h[ev]1 ! difficulty 9 di/+ui%+ !m is v great1 & ! acc\*eur has (t5 wait$ = sev]al h\rs & ev5 days2 ! labor mean:ile mak+ no progress2 & ev5tually all has pass$ (f1 & ! pati5t has ris5 aga9 f h] b$4 ,i "k "o case1 :]e a g5tleman att5d$ ne>ly ?ree days1 at ! end ( :i* "t ! pati5t rose & walk$ d[n /airs4 ,%e 0 n put to b$ till six weeks aft]4 ,i c sc>cely ?9k1 h[ev]1 t ^! mi/akes c happ5 v frequ5tly1 if ! exam9ation be prop]ly conduct$4 ,,prep>ations ,,= ,,! ,,deliv]y4 ,if x appe>s f ! exam9ation t labor has really comm5c$1 or is ab\t to d s1 ev]y?+ %\ld be at once prep>$4 ,all useless p]sons %\ld leave ! room1 & also ^? :o w\ld be likely to al>m or grieve ! pati5t by utt]+ cries1 or exhibit+ fe>2 b no objection %\ld be made to any "o be+ pres5t :om %e wi%es to see1 unless !y _c be dep5d$ ^u4 ,?us "s females always wi% to h _! husb&s ) !m1 b o!rs d n1 ?\gh !y are av]se to say+ s4 ,9 ^! cases ! acc\*eur1 if he be an att5tive obs]v]1 w soon see :at is really desir$ by 8 pati5t1 & w manage matt]s accord+ly4 ,! dress ( ! female %\ld be p]fectly loose1 consi/+ ( a wrapp] or night-g[n1 b suffici5tly complete & w>m to all[ ( h] gett+ up to walk 9 ! *amb]1 if %e desires x1 z "s d4 ,no corsets1 g>t]s1 or o!r tight b&ages1 h[ev]1 %\ld be all[$4 ,! b$ %\ld be prep>$ by plac+ ! mattress on ! top1 or by remov+ all f x2 & !n plac+ a ?ick lay] ( blankets or quilts1 ) a fold$ %eet ov] !m4 ,?is is to provide a firm level surface1 9 :i* ! body w n s9k1 & also to prev5t ! fluids soak+ ?r\gh4 ,x is an excell5t plan1 if ! mat]ial c be obta9$1 to place a ?9 oil-sk9 or ,india-rubb] clo? "u ! fold$ %eets1 z ?is keeps all p]fectly dry und]nea?4 ,"s p]sons also place ano!r fold$ %eet1 or a cu%ion1 "u ! pelvis1 to keep x elevat$2 b ?is is n necess>y1 unless ! b$ s9ks 9 v mu*4 ,x is also advisable to leave a foot-bo>d or o!r firm body1 aga9/ :i* ! female c press h] feet :5 be>+ d[n2 & a long t[el fold$ l5g?ways %\ld be pass$ "u ! back1 s t x c be rais$ up by a p]son lift+ at ea* end4 ,?is w (t5 be f\nd a bett] mode ( press+ ! back1 :i* ne>ly all pati5ts call =1 ?an by m]ely =c+ ! h& aga9/ x1 :i* is bo? tiresome & insuffici5t4 ,ano!r t[el may also be firmly fix$ to ! bottom ( ! b$1 s t %e c pull by x1 at ! same "t t %e pu%es ) h] feet4 ,"s p]sons are conf9$ on a cot1 b ?is is n a v good arrangem5t1 because x s9ks 9 too mu* 9 ! middle1 & is n suffici5tly l>ge & firm4 ,x is advantage\s 9 "o respect1 h[ev]1 z x c be plac$ by ! side ( ! b$1 into :i* ! pati5t c be lift$ :5 all is ov]1 & be comp>atively dry & com=table4 ,?is is ! mo/ frequ5t plan 9 ,france4 ,if ! b$ be prop]ly arrang$ h[ev]1 ! "u %eet c be )drawn1 & clean w>m napk9s !n pass$ "u ! body1 :i* w be equally z good4 ,! cov]+ %\ld consi/ ( a %eet1 ) blanket or cov]lid1 accord+ to temp]ature1 & %\ld1 ( c\rse1 nev] be remov$1 except "u peculi> circum/ances4 ,! *amb] itself %\ld be z quiet z possible1 well v5tilat$1 & n too w>m4 ,no?+ di/resses ! pati5t m ?an a close1 hot atmosph]e4 ,! acc\*eur ne$ n1 ( c\rse1 be pres5t :ile ^! arrangem5ts are be+ made2 & :5 he retires he %\ld sugge/ to ! nurse t ! female may att5d to ! b[els & bladd] dur+ 8 abs5ce4 ,?is precaution may bo? facilitate ! labor1 & prev5t mu* future annoyance4 ,x w\ld ev5 be advisable to adm9i/] an injection if necess>y1 ( ?9 />* & a little ca/or oil1 r ?an leave ! b[els unmov$4 ,9 reg>d to n\ri%m5t1 no?+ is ne$$ or prop] 9 ! %ape ( solid food2 because all ! en]gies ( ! sy/em are conc5trat$ 9 ! ut]us1 & z dige/ion _c !re=e g on1 x w\ld only be an evil4 ,if ! labor is mu* protract$ h[ev]1 "s bro? or s\p may be tak51 or a little milk4 ,z a g5]al rule1 no spiritu\s liquors or /imulat+ dr9ks ( any k9d %\ld be tak52 because !y imp>t no real /r5g?1 & may produce inflammation1 or conge/ion on ! bra94 ,"s females always pref] tea to dr9k1 o!rs lemonade1 toa/ wat]1 gruel1 or b>ley wat]1 & o!rs aga9 simple cold wat]1 :i* is p]haps ! be/ ( all4 ,9 cases ( great exhau/ion x is sometimes advisable1 & ev5 necess>y1 to give a little w9e1 or br&y & wat]1 b x %\ld always be cauti\sly adm9i/]$4 ,9 "s p>ts x is cu/om>y = ! female to lie on h] side dur+ deliv]y1 ) a pill[ betwe5 ! knees2 "s ev5 *oose ?is mode1 & o!rs w desire to /&1 or place !mselves on _! knees4 ,! mo/ frequ5t position h[ev]1 & c]ta9ly ! mo/ conv5i5t1 is on ! back1 ?\gh x may (t5 be *ang$ ) advantage "u peculi> circum/ances4 ,9 ! e>ly /ages ( labor %e c lie1 or move ab\t1 z %e *ooses1 or ev5 rise if m agreeable4 ,,att5dance ,,aft] ,,! ,,prep>ations ,,are ,,made1 ,,& ,,dur+ ,,! ,,deliv]y4 ,:5 ev]y?+ is arrang$ ! assi/ant %\ld take 8 seat on ! "r h& ( 8 pati5t & repeat ! exam9ation4 ,if ! head pres5ts1 he ne$ n conc]n himself mu* fur!r at pres5t1 b if x be any o!r "p1 he %\ld prep>e at once to *ange x1 or assi/1 z ! case may be4 ,at ?is second exam9ation ! p>ties pres5t1 & ! female h]self are usually anxi\s to "k if ! *ild is com+ "r1 & h[ long ! labor is likely to la/4 ,! answ] to ^! inquiries %\ld be gu>d$ & circumspect 9 reg>d to ! duration1 because ( its unc]ta9ty1 b if ! pres5tation is "r1 x is well to say s at once1 because ?is gives great com=t & enc\ragem5t4 ,if x be un=tunately wrong1 x is be/ n to say s abruptly1 b rem>k t x is r obscure1 or _c yet be fully di/+ui%$1 & s keep up ! spirits ( ! female :ile y await ! prop] "t1 or make ! necess>y arrangem5ts1 to int]f]e2 & !n tell h] !re is a little difficulty :i* requires to be right$1 b :i* w n be s]i\s1 nor cause mu* delay4 ,if ! labor /eadily progresses x is necess>y to rema9 ) ! female & att5d to x2 b if x be delay$1 & ev]y?+ rema9s natural1 %e may be left = a "t ) advantage4 ,:5 ! second /age is fairly comm5c$ h[ev]1 & especially aft] ! membranes are brok51 ! att5tion %\ld be unremitt+4 ,! /ate ( ! p>ts %\ld be asc]ta9$ frequ5tly1 s t ! actual progress may be kn[n1 & any necess>y assi/ance r5d]$4 ,! /ate ( ! bladd] especially %\ld be obs]v$1 & if x be full & ! female unable to ur9ate1 ! ca!t] %\ld be pass$4 ,neglect ( ?is precaution may lead to s]i\s accid5ts4 ,:ile mak+ ! exam9ations1 ! h& %\ld be introduc$ ) great c>e1 s z n to bruise or lac]ate ! p>ts1 & x %\ld n rema9 long] ?an absolutely necess>y4 ,_m females exhau/ !mselves unnecess>ily by be>+ d[n1 & /ra9+1 ) great =ce1 f ! v comm5cem5t ( labor1 "u ! mi/ak5 idea t x is necess>y to d s1 or w assi/4 ,!y %\ld be told n to d s h[ev]1 till aft] ! membranes are brok51 & n ev5 !n unless ! neck ( ! womb beg9s to dilate4 ,!y %\ld also be told n to make any ef=t except dur+ a pa91 z x w n assi/ at any o!r "t4 ,no attempt %\ld be made1 "u ord9>y circum/ances1 to rupture ! membranes1 or dilate ! m\? ( ! womb1 ev5 ?\gh nature may be sl[ 9 do+ s4 ,pati5ce mu/ be practis$1 bo? by ! female & by h] assi/ant1 & sometimes x is sev]ely tri$4 ,:5 ! wat]s h escap$1 & ! orifice is op5$1 an exam9ation mu/ be made1 to discov] :e!r ! cord has desc5d$1 or ei!r ( ! arms1 z is sometimes ! case1 & if s1 !y mu/ be return$ if possible4 ,z ! head desc5ds to ! bottom ( ! pelvis x compresses ! rectum1 & produces a feel+ z if ! b[els mu/ be mov$1 or ev5 causes !m to be s4 ,?is is apt to di/ress ! female1 & make h] wi% to rise1 :i* _c be p]mitt$4 ,if any?+ ( ! k9d occurs no notice %\ld be tak5 ( x1 or %e may ev5 be assur$ %e is mi/ak51 :ile a clean napk9 may be int]pos$4 ,?is1 z ,dr4 ,*ailly obs]ves1 w soo! h] delicacy4 ,su* an accid5t is v apt to occur t[>ds ! end ( ! labor4 ,:5 ! head has rotat$1 & pres5ts at ! ext]nal op5+1 or vulva1 & beg9s to di/5d x1 ! greate/ c>e is requir$4 ,?is is a critical p]iod1 dur+ :i* ! acc\*eur c r5d] m real assi/ance ?an at almo/ any o!r4 ,!re is dang] at ?is "t1 z =m]ly expla9$1 ( ! head pass+ ?r\gh too quickly1 be=e ! p>ts are suffici5tly relax$1 & s caus+ !m to rupture4 ,?is is p>ticul>ly ! case ) ! p]9eum1 aga9/ :i* ! head presses ) great =ce4 ,x is necess>y !re=e to support ! p]9eum1 z x is t]m$1 to prev5t ?is accid5t4 ,?is is done by pass+ ! "r arm "u ! pati5t's "r ?igh1 & plac+ ! palm ( ! h& flat aga9/ ! p]9eum1 ) ! ?umb encircl+ "o side ( ! vulva1 & ! =ef+] ! o!r4 ,! h& is !n g5tly1 b firmly1 press$ aga9/ ! "p dur+ e pa91 s z to prev5t ! head pass+ too quickly1 & also to elevate x1 & ?us relieve ! p]9eum ( "p ( ! /ra91 & ?r[ ! occiput "u ! pubes4 ,"s practition]s also pass ! left h& ov] ! ?igh1 at ! same "t1 & grasp ! back ( ! head ) x1 ?us hold+ ! head z x 7 betwe5 ! two h&s1 s z to direct x at pleasure4 ,! mann] ( do+ ?is is repres5t$ 9 plate ,,xxxix4 ,,plate ,,xxxix4 ,! mann] ( support+ ! p]9eum1 dur+ ! passage ( ! head4 ,! "r h& is plac$ und]nea?1 s z to pu% ! head g5tly back1 :5 x presses on ! p]9eum too =cibly1 be=e x is dilat$2 & also to elevate x t[>ds ! pubes4 ,! left h& is se5 above1 grasp+ ! top ( ! head1 to assi/4 ,?is may be done or n1 accord+ to ! necessities ( ! case1 or ! cu/om ( ! assi/ant4 ,illu/ration3 ,plate ,,xxxix4 ,! mann] ( support+ ! p]9eum1 dur+ ! passage ( ! head4 ,x is also necess>y to reque/ ! female at ?is "t to mod]ate h] ef=ts1 & n be> d[n too /rongly4 ,if h[ev] %e be too excit$1 & eag] to d s1 m c>e mu/ be us$1 & ! head press$ back /ill m =cibly1 till ! p>ts are fully relax$4 ,= want ( ^! precautions !re is (t5 s]i\s lac]ations ( ! p]9eum & vulva1 p>ticul>ly 9 fir/ labors1 & :5 ! p>ts are unusually rigid4 ,if prop] c>e be be/[$ h[ev]1 ^! accid5ts ought to occur b seldom1 ev5 9 ! wor/ cases1 & no?+ c be m hurtful to ! reputation ( an acc\*eur ?an = !m to happ54 ,sometimes x is necess>y to support ! p]9eum = h\rs1 & to be/[ con/ant att5tion ! :ole "t4 ,x is (t5 useful to keep apply+ a little simple o9tm5t1 or l>d1 9 ! int]vals ( ! pa9s1 mix$ ) ! extract ( ,belladonna1 :i* w s(t5 & relax ! p>ts4 ,dr4 ,lee also advises ! application ( a sponge1 dipp$ 9 w>m wat]1 & :i* w\ld probably d mu* good 9 _m cases4 ,x w ( c\rse be und]/ood t ! pressure only ne$s to be made dur+ ! pa9s2 :5 ! head draws back ! o9tm5t or w>m sponge may be appli$4 ,! knees ( ! female %\ld be held up by "s "o1 if %e be>s d[n too mu*1 s z to prev5t h] f do+ s too p[]fully4 ,:5 x is felt t ! p>ts are fully relax$1 & suffici5tly di/5d$1 ! head is left at lib]ty1 dur+ a /rong pa91 & x imm$iately passes ! out] r+1 or is born4 ,x %\ld !n be held up1 t[>ds ! pubes1 & ! mucus %\ld be clean$ f ! m\? ) "o ( ! f+]s1 s t ! *ild may brea!4 ,a c>eful exam9ation %\ld also be made r\nd ! neck1 to see if ! umbilical cord is ar\nd x4 ,if x be s1 b is n tight1 x may be left alone1 or pull$ a little ov] "o %\ld]1 or ev5 pass$ clean ov] ! head1 if x c be easily drawn out long en\gh4 ,:5 x is v tight1 & _c be eas$1 x mu/ be cut ?r\gh1 or x w /rangle ! *ild4 ,9 mo/ cases ! %\ld]s foll[ imm$iately aft] ! head1 ! ut]us re/+ only a few mom5ts2 b if !y d n ! head may be slightly drawn ^u1 or ! =e-f+] ( ! "r h& may be l9k$ "u ! arm1 & a little =ce employ$1 ?\gh v c>efully4 ,x is bett] h[ev] to wait ev5 two or ?ree m9utes1 & only resort to ^! means :5 !re is evid5tly a p>tial susp5sion ( ! natural ef=ts4 ,sometimes also ! contractions may be br\ght on aga9 by m]ely press+ ! h& ov] ! fundus ( ! ut]us1 & ?is %\ld !re=e be tri$ fir/4 ,9 all cases x be+ bett] to let ! ut]us expel ! *ild ?an to br+ x away by manual =ce4 ,dur+ ! passage ( ! %\ld]s ! p]9eum ne$s z mu* c>e z dur+ ! passage ( ! head1 & mu/ be support$ 9 ! same way4 ,inde$ "s au?ors are ( op9ion t mo/ cases ( lac]ation are caus$ by ! %\ld]s4 ,aft] ! %\ld]s are expell$ ! limbs & body spe$ily foll[4 ,! *ild %\ld be receiv$ 9 ! h&s ( ! acc\*eur1 & laid on its side1 at a little di/ance f ! vulva1 s t x may n be suffocat$ by ! dis*>g$ fluids4 ,he %\ld !n take a /rong ligature & pass x twice r\nd ! umbilical cord1 ab\t two in*es f ! navel1 & also at ab\t f\r in*es1 & !n cut ! cord ?r\gh1 betwe5 ! two b&s1 ) a pair ( %>p scissors4 ,! *ild may !n be h&$ to ! nurse4 ,! ty+ ( ! cord is by "s deem$ unnecess>y1 & 9 mo/ cases probably is s1 b z *ildr5 h be5 kn[n to ble$ to dea?1 :5 x 0 n done1 x %\ld nev] be neglect$4 ,"s practition]s only tie x once1 leav+ t "p op5 :i* is /ill atta*$ to ! plac5ta1 & !y suppose ?is is advantage\s1 inasmu* z x p>tly empties ! plac5ta ( its blood1 & s helps to deta* x4 ,!re is little or no fe>1 z "s suppose1 t ?is ble$+ c be ext5sive en\gh to hurt ! female1 or second *ild if !re be "o1 & ev5 if x 7 likely to be s x c\ld soon be /opp$2 x has ! inconv5i5ce h[ev] ( soil+ ! b$ m1 & ?is is probably "o great reason :y ! second ligature is appli$1 :i* c]ta9ly is n necess>y4 ,9 my directions ,i h said t ! cord may be ti$ ab\t two in*es f ! abdom51 & ?is w be suffici5t if ! *ild brea!s2 b if n x %\ld be left ab\t f\r in*es long1 s z to give room to cut x aga91 :i* is occasionally ne$$1 z w be se5 fur!r on4 ,! knot %\ld be drawn v tight1 & great c>e mu/ be tak5 nev] to tie x s ne> z to p9* ! sk9 ( ! abdom51 :i* passes a little di/ance up x4 ,a small portion ( ! inte/9e w ent] ! cord sometimes1 & swell x out = an in* or m2 ?is mu/ be press$ back ) ! ?umb & f+]1 & c>efully avoid$ by ! ligature4 ,"s practition]s cut ! cord fir/ & tie x aft]1 b ,i ?9k ! o!r plan is decid$ly ! safe/ & ! be/4 ,aft] ?is is accompli%$ ! acc\*eur %\ld place 8 h& aga9 ov] ! fundus ( ! ut]us1 to discov] :e!r x contracts1 & also to judge :e!r !re be ano!r ftus4 ,if ! womb is felt drawn up into a h>d r\nd ball1 9 ! middle ( ! abdom51 all is "r1 & no appreh5sion ne$ be felt2 b if x rema9s unalt]$ 9 size1 & is s(t1 flood+ is to be fe>$1 & ! h& %\ld be firmly press$1 or knead$1 ov] ! fundus1 to br+ on contraction4 ,if !re be ano!r ftus1 ! womb w rema9 mu* ! same z be=e labor1 & ! *ild may also be felt4 ,x is bett] h[ev] to make an exam9ation int]nally1 & !n1 9 mo/ cases1 ! membranes & pres5t+ "p ( ! second ftus w be f\nd at ! upp] /rait4 ,if !re be any d\bt aft] ?is x is ev5 bett] to c>ry ! h& a little way into ! womb1 ?an to rema9 9 ignorance on su* an important po9t4 ,! deliv]y ( ! second ftus usually foll[s close ^u ! fir/1 ?\gh sometimes !re w be a delay ( "s h\rs1 or ev5 days4 ,& 9 g5]al !re is little or no difficulty ) ! second1 ow+ to ! p>ts hav+ be5 already prep>$2 b ! long] x is delay$ ! less easy x becomes4 ,imm$iately ! bir? is fully effect$ ! female feels1 z mo/ ( !m express x1 9 heav52 !re is an almo/ in/antane\s *ange1 f ! mo/ agoniz+ pa9 to a /ate ( p]fect ease4 ,%e ceases h] cries1 & falls into a quiet & pleas+ languor1 /rik+ly at v>iance ) ! /ate ( int5se excitem5t %e 0 9 b a few mom5ts be=e4 ,?is repose h[ev]1 does n la/ long2 ! ,plac5ta yet rema9s1 & a new ef=t is requir$ to expel t4 ,,deliv]y ,,( ,,! ,,aft] ,,bir?1 ,,or ,,plac5ta ,,& ,,membranes4 ,unlike ! ,ftus ! ,plac5ta is fa/ to ! walls ( ! ,womb1 & c only become sep>at$ f !m by ! contraction ( _! sub/ance1 :i* usually comm5ces soon aft] ! bir? ( ! *ild1 & is indicat$ by new pa9s1 & a slight dis*>ge ( blood4 ,9 ab\t a qu>t] ( an h\r1 or tw5ty m9utes1 ! acc\*eur %\ld enquire ( ! pati5t :e!r %e has felt any ( ^! pa9s1 & he %\ld also exam9e :e!r ! ,plac5ta has rea*$ ! m\? ( ! ,womb1 or ,vag9a1 s t he may remove x4 ,if ! pa9s h n yet come on1 & ! ,plac5ta is n 9 ! passage1 he %\ld press "o h& on ! fundus ( ! ,womb1 to promote its contraction /ill fur!r1 & !n g5tly draw ^u ! cord ) ! o!r1 hold+ x z high up z possible1 ei!r by a piece ( l95 ar\nd x1 or by loop+ x ar\nd ! f+]4 ,x %\ld be pull$ v g5tly1 b /eadily1 d[nw>ds & backw>ds4 ,if x be snat*$1 or drawn too h>d1 x may break1 & cause great tr\ble2 or x may pull d[n ! ,womb1 & ei!r inv]t x or br+ on fall+ ( ! ,womb aft]w>ds4 ,! h& plac$ ov] ! fundus c detect ?is accid5t1 & if ! ut]us be felt to s9k d[n ! cord mu/ n be drawn ^u any long]4 ,pull+ away ! ,plac5ta too soon1 & ) rud5ess1 has (t5 l$ to deplorable accid5ts4 ,9 ne>ly e case x w gradually sep>ate itself1 & be deliv]$ 9 ab\t half an h\r1 & %\ld only be assi/$ by slight draw+ on ! cord1 & by press+ ! fundus4 ,:5 ! ,plac5ta is completely deta*$ !re is seldom any difficulty 9 its pass+ ! neck ( ! ,womb1 & d[n ! ,vag9a1 b x usually requires to be drawn ?r\gh ! ext]nal op5+ by ! h&4 ,9 do+ ?is ! membranes may be twi/$ r\nd ! cord1 s z to w9d !m altoge!r1 & /r5g!n ! cord4 ,9 case ! sep>ation does n take place we mu/ wait1 & cont9ue ! slight /ra9 on ! cord & ! friction ov] ! fundus4 ,x is n reckon$ safe h[ev]1 by mo/ au?ors1 to wait m ?an an h\r2 & if !re is no sign ( its com+ by t "t artificial deliv]y is resort$ to4 ,?is is accompli%$ by c>ry+ ! h& c>efully up into ! ,womb1 & sep>at+ ! ,plac5ta f its walls ) ! f+]s1 & !n br++ x d[n at once4 ,:5 ! aft]bir? has pass$ ! ,vulva1 a c>eful exam9ation %\ld be made ( x1 to see t no "p is left beh9d2 & = /ill great] security x is advisable to explore ! ,vag9a ?or\ghly1 s t any deta*$ portion may be remov$4 ,! membranes are v apt to become brok51 & fragm5ts ( !m left1 :i* ?\gh ev] s small may cause tr\ble4 ,! f+] %\ld also be pass$ into ! m\? ( ! ,womb1 s z to cle> x2 = sometimes a l>ge clot ( blood1 or a piece ( ! membranes1 w rema9 & keep x op51 & ?us cause sev]e flood+4 ,x is g5]ally consid]$1 by ^? :o h be/[$ att5tion on ! subject1 t assi/ance %\ld always be r5d]$1 if ! aft]bir? does n come v soon4 ,!re is dang]1 if x be left too long1 ( ! m\? ( ! ,womb contract+ & reta9+ x2 9 :i* case x becomes absolutely necess>y to ab/ract x1 b exce$+ly difficult1 & ev5 dang]\s1 to d s4 ,dr4 ,lee says x %\ld nev] be left m ?an an h\r at mo/1 & t x is be/ nev] to delay remov+ x ev5 s long z t4 ,:5 left purposely1 = obs]vation1 x is f\nd to be expell$ spontane\sly1 & soon1 only 9 a few cases2 usually x rema9s sev]al h\rs1 & mo/ frequ5tly x requires to be remov$ by h&4 ,no d\bt x is natural = x to be expell$ unaid$1 b x mu/ be borne 9 m9d t our females are usually too weak1 & defici5t 9 en]gy1 to p]=m any unusual natural function )\t assi/ance4 ,! acc\*eur mu/ use great caution1 s z nei!r to intrude 8 help :5 n requir$1 nor yet to refuse x :5 really ne$$2 & above all he mu/ n sub/itute viol5ce = skill4 ,:5 ! aft]bir? is br\ght away1 a b&age %\ld be pass$ r\nd ! body ( ! female1 made ( s(t l951 twelve or f\rte5 in*es wide4 ,x %\ld be drawn mod]ately tight1 & fa/5$ securely4 ,if x pass r\nd twice x w be all ! bett]1 & x %\ld be drawn d[n z ne> ! pubes z possible4 ,i "k _m ladies :o pref] ! ,india ,rubb] b&s1 rec5tly inv5t$1 z !y press m equally & firmly1 & are put on ) less tr\ble1 be+ all 9 "o piece & drawn ov] ! feet & limbs4 ,"s acc\*eurs put on ! wrapp] imm$iately ! *ild is born1 be=e ! aft]bir? passes away2 b ,i ?9k ?is is n ! be/ plan4 ,:5 prop]ly adju/$1 ! support+ b& gives great com=t to ! female1 & is v useful4 ,"s ladies provide a curi\s k9d ( corset to put on1 inv5t$ = ! purpose1 :i* h[ev]1 z a celebrat$ au?or rec5tly rem>k$1 ,are usually /iff & unyield+1 l ! prejudices ( _! patrons1 & (t5 prove injuri\s4 ,none ( !m are equal to ! simple contrivances above-m5tion$4 ,,att5tions ,,to ,,! ,,female ,,aft] ,,! ,,deliv]y ,,( ,,! ,,aft]bir?4 ,:5 ! aft]bir? is remov$ ! pati5t %\ld be left to repose h]self = ab\t a qu>t] ( an h\r1 dur+ :i* "t mo/ ( ! blood escapes1 & !n %e mu/ be made z com=table z possible4 ,9 ,france1 & ) _m p]sons "h1 x is cu/om>y to cleanse ! pati5t ) a sponge dipp$ 9 w>m wat]1 pass a clean w>m %eet "u h]1 & !n put on clean l951 aft] :i* %e is lift$ into ! clean b$1 previ\sly well w>m$2 ! acc\*eur himself c>ry+ h] !re4 ,mo/ frequ5tly h[ev]1 ! spong+ is disp5s$ ) till "s "t aft]1 & also ! *ang+ ( b$s--! "u %eet m]ely be+ )drawn1 & a w>m dry "o pass$ 9 its place1 :ile ! female's limbs are g5tly wip$4 ,9 ei!r case ! female %\ld be di/urb$ z little z possible1 p>ticul>ly if !re be dang] ( flood+1 & %e %\ld be c>efully gu>d$ f cold4 ,:5 ! soil$ & wet clo!s are remov$1 z completely z possible1 w>m napk9s %\ld be plac$ "u ! ,pelvis & betwe5 ! limbs1 to soak up ! dis*>ge1 & !y %\ld be c>efully *ang$ z (t5 z ne$$1 )\t uncov]+ ! pati5t4 ,if %e be dispos$ to sleep h[ev]1 & is mu* exhau/$1 ^! att5tions ne$ n be press$ too mu* till %e is recov]$ a little4 ,_m p]sons "h h a dread ( us+ ! sponge imm$iately1 & ( be+ c>ri$ to ano!r b$2 b !re is no dang] f ei!r practice1 9 ord9>y cases1 :5 c>efully p]=m$2 & x is s productive ( com=t1 t ,i nev] knew "o b :at 0 pleas$ ) & b5efitt$ by x1 & desir\s ( its be+ done 9 _! subsequ5t labors4 ,"s females w ev5 rise & take a cold ba?1 or be wrapp$ 9 a wet %eet1 n only )\t evil effect b ) positive advantage4 ,i w\ld n advise any "o to d ?is h[ev]1 p>ticul>ly if !y are ! lea/ timid at x1 or d\btful ( its propriety4 ,)\t ! m5tal /imulus ( fai? & hope x may be haz>d\s4 ,x %[s h[ev]1 t _m ( ! popul> notions1 z to ! requirem5ts & susceptibilities ( females1 9 ?is /ate1 are entirely unf\nd$4 ,! pati5t may ei!r exp]i5ce great com=t aft] be+ ?us att5d$ to1 or %e may compla9 v mu*4 ,"s w ev5 be attack$ ) a k9d ( *ill4 ,_! tee? w *att]1 & _! h&s & feet gr[ q cold4 ,?is h[ev] usually passes (f1 & %e falls asleep4 ,! acc\*eur ought to rema9 = an h\r or two1 ev5 ?\gh %e sleeps s\ndly1 & appe>s q well1 because %e may become sudd5ly worse1 or flood+ may set 9 ) su* viol5ce z to endang] life 9 a few m9utes1 :5 un*eck$4 ,if ! pati5t desires any n\ri%m5t %e may take a little simple s\p1 or gruel1 b no?+ /imulat+1 unless a little w9e be ne$$ f extreme exhau/ion4 ,,att5tions ,,to ,,! ,,*ild4 ,inspection :5 born4--,z soon z ! *ild is born its m\? & nose %\ld be cle>$ f mucus1 if t has n be5 done already2 & if x has n brea!d1 means %\ld be resort$ to imm$iately to make x d s4 ,sometimes ! :ole head is cov]$ ) a ?9 membrane1 call$ ! caul1 or veil1 :i* is mo/ probably only a portion ( ! ,amnion1 & :i* may cause suffocation4 ,i rememb] a case ( ?is k9d 9 my own practice1 9 :i* ! caul 0 unnotic$ at fir/1 & ! *ild came ne> dy+ f x4 ,no?+ c\ld be se51 & z x b5t be=e ! f+]1 :5 press$ into ! m\?1 x 0 totally unobs]v$4 ,! nurse h[ev]1 call$ out t ! *ild did n brea!1 & a close exam9ation z to ! cause soon reveal$ :y4 ,on pass+ ! f+] "u ! edge ( ! membrane1 :i* 0 r\nd ! neck1 x came (f l a cap1 & ! *ild cri$ imm$iately4 ,wa%+ ! *ild4--,! cleans+ ( ! *ild may usually be safely committ$ to ! nurse1 or o!r female att5dants1 ?\gh "s ( !m h v absurd & injuri\s practices 9 ?is respect4 ,?us ,i h kn[n !m rub ! :ole body ov] ) :iskey1 or raw spirits1 be=e wa%+ x1 :i* mu/ cause great coldness f its evaporation1 & also great irritation4 ,! only ?+ requir$ is p]fect cleanl9ess1 & ?is %\ld be effect$ 9 ! quicke/ & simple/ mann]4 ,"s v mild soap1 & mod]ately w>m wat]1 is all t is really ne$$1 ?\gh a little sweet oil1 or fre% l>d1 or butt]1 rubb$ on fir/1 appe>s to facilitate ! op]ation4 ,! dry+ %\ld be done z quickly z possible1 aft] all ! mucus is wa%$ (f1 & ) great c>e2 ! napk9 be+ z s(t z x c be1 & nev] rubb$ h>d1 = x takes b little =ce to remove ! sk94 ,_m p]sons take great tr\ble1 & are a long "t ov] ?is infantile wa% )\t succe$+ well ) x4 ,!y are deceiv$ by ! t\gh mucus slipp+ "u ! h&1 b /ill cl++ to ! body1 :]e !y leave x ev5 aft] us+ ! napk92 x !n dries on & =ms a h>d sk91 v difficult to remove1 & v irritat+4 ,?is c be avoid$ ) c>e1 & by us+ ! oil fir/1 :i* appe>s to s(t5 ! mucus4 ,"s p]sons use fl\r1 or ,indian meal1 & o!rs />*1 b none ( ^! are s good z ! simple means we h describ$4 ,dress+ ! *ild4--,aft] ! wa%+ & dry+ is complet$ ! *ild mu/ be dress$1 & ?is is a process 9 :i* com=t & utility is frequ5tly sacrific$ to m]e fa%ion & prejudice1 z x is 9 adults4 ,! article next ! sk9 %\ld be ( s(t l9e l951 :i* may be foll[$ by o!rs ( w>m] mat]ial1 accord+ to ! temp]ature4 ,!y %\ld all be p]fectly loose 9 _! make1 & q s(t to ! feel4 ,z f> z possible !y %\ld all be fa/5$ ) /r+s1 r ?an p9s4 ,^! metallic po9ts are tr\blesome to fix1 & (t5 injure ! *ild1 9 spite ( e precaution4 ,!y are also apt to be ref]r$ to z ! cause ( ! *ild cry+1 & ?us prev5ts o!r causes be+ s\ght =1 :i* frequ5tly exi/4 ,"s p put a ?ick flannel cap on ! head1 ov] a l95 "o1 b o!rs leave ?is "p altoge!r uncov]$1 :i* ,i ?9k is ! be/ plan4 ,at mo/ !re %\ld only be ! l95 cov]+2 ! head be+ bett] r cool ?an o!rwise4 ,! dress+ ( ! cord is ! next duty1 & ?is is done by tak+ sev]al pieces ( s(t l951 oil$ a little1 & cutt+ a small r\nd hole 9 ! middle ( ea*1 ?r\gh :i* ! cord is pass$4 ,! l95 !n lies flat on ! abdom5 ( ! *ild1 & ! cord on ! top ( t1 ! holes be+ j l>ge en\gh = x to pass easily ?r\gh4 ,five or six pieces are usually put on1 b v frequ5tly only "o is us$1 & is f\nd q suffici5t4 ,x %\ld be v f9e1 & s(t4 ,:5 ?is is done ano!r lay] is laid ov] ! cord1 & !n a b&age ( s(t l951 ab\t f\r or five in*es wide1 is pass$ two or ?ree times ov] x1 & r\nd ! body4 ,?is completes ! dress+1 & ! *ild may n[ be wrapp$ up w>mly & laid d[n to sleep--rememb]+1 z ,dr4 ,*ailly rem>ks1 t if x be laid on a *air1 or s(a1 x may be accid5tally sat ^u & kill$1 an accid5t :i* has happ5$4 ,,accid5ts ,,:i* ,,may ,,happ54 ,be=e ^! dress+s are ne$$ h[ev]1 !re are frequ5tly o!r ?+s ( m importance to be att5d$ to4 ,if ! labor has be5 long1 or ! pres5tation unfavorable1 ! *ild may be born apoplectic1 f ! pressure x has receiv$4 ,! face w be puff$ up1 & ( a blue color2 ! body w be swoll51 & ! limbs )\t motion1 :ile ! pulsation w sc>cely be felt1 ei!r ov] ! *ild's he>t or 9 ! cord4 ,x w feel w>m1 & ! limbs w be q flexible1 b /ill !re w be no signs ( life4 ,9 ?is case x %\ld be expos$ nak$ to ! cool air1 & ev5 bl[n ^u2 & if t does n resuscitate x ! cord may be cut ?r\gh bel[ ! ligature1 s z to let out two or ?ree tea-spoonfuls ( blood4 ,aft] ?is x g5]ally revives1 & beg9s to move1 :ile its face assumes a natural color1 & ! swell+ goes d[n4 ,! m\? & ?roat %\ld also be c>efully clean$ ) a quill fea!r1 ( all mucus4 ,a m frequ5t accid5t is ,asphyxia1 or want ( brea?+1 9 :i* case ! surface ( ! body is cold & pale1 & no brea? :atev] is drawn1 ?\gh ! he>t beats q naturally4 ,v weak *ildr51 or ^? born be=e _! "t1 are mo/ likely to become asphyxiat$1 or ^? deliv]$ by in/rum5ts4 ,! fir/ ?+ to be done is to c>ry ! *ild to ! op5 w9d[1 if x be n exce$+ly cold1 & expose its head & *e/ to ! air1 :ile ! re/ ( ! body is wrapp$ up w>m4 ,?is w (t5 make x gasp1 b if x does n a little cold wat] may be da%$ on its face & *e/1 & ! ?roat may be tickl$ ) a fea!r4 ,! bree* may also be sm>tly slapp$1 & ! *e/ well rubb$ ) ! cold h&4 ,:5 x beg9s to brea! a little x may be put into a w>m ba? up to ! middle1 & a w>m injection may be giv5 to x4 ,9 mo/ cases ^! means w spe$ily br+ x r\nd1 b if !y d n ! att5dant %\ld place 8 m\? close ov] t ( ! *ild & brea! into x1 s z to fill ! lungs1 & !n press d[n ! *e/ to empty !m aga91 repeat+ ! process sev]al times4 ,?is may be call$ artificial brea?+1 & if x succe$ once only !re is a probability ( its effect+ ! desir$ object4 ,! brea? h[ev]1 mu/ n be bl[n 9 too h>d1 or x may injure ! *ild's lungs1 nor too rapidly4 ,sometimes a tube is us$1 :i* is pass$ d[n into ! ?roat2 b x is tr\blesome1 & n mu* bett] ?an ! m\?1 if any at all4 ,^! ef=ts may be repeat$ tw5ty or ?irty times if necess>y1 or ev5 m4 ,9 "s cases x is requisite to cont9ue us+ "s1 or all ( ^! means1 = an h\r or two )\t int]mission1 be=e ! *ild beg9s to brea! freely4 ,i knew an in/ance ev51 :]e ! nurse cont9u$ to d s = five h\rs1 & at la/ fully recov]$ ! *ild1 ?\gh all pres5t1 includ+ ! doctor1 _h giv5 x up4 ,%e said %e did n despair :ile x cont9u$ w>m1 ?\gh x 0 d\btful :e!r ! he>t beat or n4 ,?is may %[ t ! attempt %\ld n be ab&on$ too soon4 ,9 cases ( asphyxia no blood %\ld be lo/ at all1 b on ! contr>y ! cord %\ld be c>efully exam9$ to see if x is ti$ fa/2 ! ble$+ f x frequ5tly aggravat+ ! evil4 ,cong5ital weakness4--,"s *ildr5 are born extremely weak1 & rema9 con/antly debilitat$ & cold4 ,?is is v apt to be ! case :5 !y are born be=e ! full t]m1 or :5 ! "m is diseas$4 ,!y %\ld be c>efully wrapp$ 9 cotton1 or v s(t flannel1 & kept w>m by bottles ( w>m wat]4 ,_m in/ances are on record ( ^! weak *ildr5 becom+ aft]w>ds extremely robu/1 s t !y ne$ n be reg>d$ ) unmix$ appreh5sion1 nor neglect$ f a supposition t !y mu/ die4 ,! *ild may be de=m$4--,! acc\*eur %\ld also c>efully exam9e ! *ild1 to see if x be de=m$ 9 any way1 or has met ) any accid5t1 because 9 "s ( ^! cases assi/ance is requir$ imm$iately1 & may be r5d]$ at once4 ,! *ild's capability ( endurance4--,! capability ( ! new-born infant to endure extremes ( cold is almo/ z great z t ( its "m1 & sometimes ev5 x is b5efitt$ by !m4 ,) _m p]sons x is cu/om>y to plunge x 9 cold wat]1 imm$iately :5 born2 & 9 ,russia1 we are told1 x is ev5 roll$ 9 ! sn[4 ,9 "s cases ^! extremes may be b5eficial1 b 9 o!rs ,i h no d\bt !y prove fatal4 ,a m$ium c\rse is be/1 9 mo/ in/ances1 leav+ ! extreme to be resort$ to :5 we wi% a sudd5 /imulus4 ,:5 all ^! matt]s are c>efully att5d$ to1 & bo? "m & *ild h rema9$ = an h\r or two )\t any unpleasant symptom1 !y may be left to ! c>e ( ! ord9>y att5dants1 giv+ !m /rict ord]s to s5d = prop] assi/ance imm$iately1 if any?+ unusual transpires4 ,,subsequ5t ,,att5tions ,,to ,,"m ,,& ,,*ild4 ,! ,bladd]4--,"o ( ! mo/ important po9ts to att5d to is ! ur9e4 ,a few h\rs aft] ! deliv]y is fully effect$1 unless ! female is repos+1 %e %\ld be ask$ :e!r %e has any desire to ur9ate2 &1 if %e has1 ! conv5i5ce %\ld be at once af=d$ to d s4 ,!re is always m or less dang] ( ret5tion ( ur9e1 f ! pressure t has be5 ex]t$ on ! bladd]2 & if x be all[$ to cont9ue too long its removal becomes exce$+ly difficult4 ,if on mak+ ! attempt ! ur9e does n fl[1 ! ca!t] mu/ be us$1 & ! soon] ! bett]4 ,! pa9 aris+ f ret5tion ( ! ur9e has (t5 be5 suppos$ to arise f inflammation ( ! womb1 or b[els--nei!r pati5t nor physician kn[+ its real s\rce1 till ! passage by ! ca!t] gave relief4 ,!re h ev5 be5 in/ances ( females dy+1 m]ely f an ov]*>g$ bladd]1 :ile _! att5dants 7 indu/ri\sly treat+ !m = ut]9e inflammation4 ,?is accid5t !re=e1 %\ld always be suspect$1 & a v little att5tion w prev5t any mi/ake 9 reg>d to x4 ,:5 all[$ to become too full ! swoll5 bladd] may be felt1 j above ! pubes1 h>d & t5d]1 s t ! lea/ pressure ^u x causes great pa94 ,if n reliev$ x w at la/ bur/4 ,! ,b[els4--,if ! b[els are n op5$ naturally1 x w be well1 ! foll[+ day1 to adm9i/] an injection ( ?9 />* & wat]1 or to prescribe a small dose ( ca/or oil1 or a seidlitz p[d]4 ,?is %\ld also be repeat$ = two or ?ree days1 till ! natural p[] is re/or$4 ,! ,food4--,b little solid food %\ld be tak51 & no?+ /imulat+4 ,gruel1 milk1 toa/ & wat]1 ,indian meal1 light pudd+s1 or bro?1 %\ld be ! *ief articles = "s "t4 ,roa/ apples are also v good1 be+ pleasant & relax+4 ,= refre%+ dr9ks1 if !re be any fev]1 lemonade or tam>9d tea may be tak54 ,! ,aft] ,pa9s4--,aft] ! expulsion ( ! aft]-bir? mo/ females exp]i5ce1 m or less1 sev]e pa9s1 almo/ l ^? ( labor1 aris+ app>5tly f ! fur!r contraction ( ! ut]9e walls to expel ! coagulat$ blood4 ,^! pa9s are seldom or nev] felt 9 fir/ labors1 b aft]w>ds !y are (t5 mo/ acute4 ,i h kn[n _m pati5ts suff] mu* m f !m ?an !y did dur+ labor4 ,!y sometimes la/ only a few h\rs1 or a day1 & sometimes ev5 ext5d to six or eight days4 ,no?+ t we "k ( c prev5t !m1 ?\gh _m means are kn[n ( mitigat+ _! sev]ity4 ,if !re be no t5d5cy to flood+1 a l>ge p\ltice may be plac$ ov] ! abdom51 or x may be fom5t$1 or cov]$ ) clo?s wrung out 9 hot wat]4 ,an injection may also be us$1 ei!r 9 ! ,vag9a or ,rectum1 consi/+ ( w>m ?9 />*1 ) ab\t tw5ty drops ( laudanum2 or ei!r ( ! foll[+ recipes may be us$ int]nally3--,pills ( ,gum ,camphor1 two1 ab\t ! size ( ord9>y pills1 to be repeat$1 if necess>y1 9 an h\r4--,or1 ,syrup ( ,poppies1 two dra*ms2 ,mucilage ( ,gum ,arabic1 two ounces2 & ,solution ( ,sulphate ( ,morphia1 t5 drops2 to be made into a mixture1 "o-half ( :i* may be tak5 at fir/1 & ! rema9d] 9 two h\rs1 if ! pati5t is n reliev$4 ,?is seldom fails4--,x is necess>y to be> 9 m9d t ! pa9s aris+ f inflammation h be5 mi/ak5 = ord9>y aft]-pa9s1 & s]i\s consequ5ces h result$ f ! error4 ,! aft]-pa9s h[ev]1 are conc5trat$1 & int]mitt5t1 :ile ! s5sations f inflammation are m diffus$ & con/ant1 & are also usually att5d$ by fev]4 ,! ,lo*ial ,dis*>ge4--,f ! "t ( deliv]y until ! ut]us has return$ to its ord9>y condition1 !re is p\r$ f x a dis*>ge1 at fir/ l blood1 & aft]w>ds ?9 & light color$1 call$ ! ,lo*ia4 ,! duration ( ?is dis*>ge v>ies f "o week to a mon?1 & its quantity f "o ounce to six or eight ounces1 daily4 ,x gradually dim9i%es h[ev]1 & frequ5tly /ops = a few days altoge!r4 ,9 wom5 :o d n nurse x is bo? m abundant1 & la/s long]1 ?an 9 ^? :o d4 ,! bloody color usually disappe>s aft] ! fir/ or second day1 ?\gh sometimes x w %[ itself aga91 ev5 :5 ! dis*>ge has ne>ly ceas$1 p>ticul>ly if ! female ex]t h]self too soon4 ,x appe>s t ?is dis*>ge is ess5tial to heal?1 & great att5tion %\ld !re=e be be/[$ on ! pati5t1 if x be too small1 or cease too soon1 or too sudd5ly4 ,9 mo/ cases x ceases naturally dur+ ! milk fev]1 & ( c\rse its disappe>ance !n ne$ n excite al>m4 ,sometimes also1 x does n atta9 its full quantity till "s days aft] its comm5cem5t4 ,if h[ev]1 x rema9s small pa/ ! ?ird day1 or does n appe> :5 ! milk fev] is ov]1 means %\ld be tak5 = increas+ x4 ,! be/ means = ?is purpose are w>m p\ltices & fom5tations ov] ! abdom51 & injections 9 ! rectum ( simple w>m wat]4 ,"s practition]s advise two dra*ms ( p[d]$ ,camphor to be spr9kl$ on ea* p\ltice1 & probably x is an excell5t addition4 ,occasionally ! lo*ia is v (f5sive1 & 9 t case a simple cleans+ injection may be frequ5tly us$ ( ?9 />*1 or ,*ammomile tea4 ,dur+ ! :ole p]iod ( ! ,lo*ia 9 fact1 ev5 9 ord9>y cases1 ! female w be all ! m com=table1 & bett]1 = an occasional injection1 & frequ5t wa%+4 ,?is is v mu* neglect$1 ?\gh x nev] ought to be s4 ,! only c>e requir$ is n to expose h] to cold1 :i* is q unnecess>y4 ,! ,milk ,fev]4--,ab\t ! second or ?ird day !re usually comm5ces a peculi> tempor>y excitem5t 9 ! sy/em1 call$ ! milk fev]1 :i* requires to be describ$ because x may be conf\nd$ ) some?+ m s]i\s4 ,x is g5]ally u%]$ 9 by heada*e1 flu%$ face1 & a hot dry sk92 ! pulse beats sl[ly1 & ! brea/s become h>d1 :ile ! ve9s ^u !m appe> v full4 ,9 a %ort "t h[ev]1 ! pulse becomes quick]1 a p]spiration breaks out1 & ! brea/s become /ill l>g] & full]1 s t ! female c sc>cely br+ h] arms to h] body4 ,^! symptoms la/ ab\t a day1 or two days at mo/1 & seldom become mu* aggravat$4 ,occasionally ! milk fev] is prec$$ by a slight *ill1 or by a furr$ tongue1 or sick /oma*1 b n v frequ5tly4 ,! precise causes ( ?is tempor>y fev] are unkn[n1 ?\gh probably x is connect$ ) ! full e/abli%m5t ( ! secretion ( milk1 & h5ce its "n4 ,x is seldom v sev]e 9 ^? :o nurse1 & frequ5tly does n appe> at all4 ,dur+ its cont9uance1 & = "s "t aft]1 ! female mu/ c>efully avoid exposure to cold1 & keep h]self quiet2 h] diet %\ld also be r re/rict$1 & light & un/imulat+4 ,an occasional seidlitz p[d] may also be ( s]vice1 or a simple injection4 ,mak+ ! ,b$4--,x is n cu/om>y to di/urb ! female1 = ! purpose ( mak+ h] b$1 till ! milk fev] is pass$2 or1 if t does n appe>1 till ! t5? or twelf? day2 & !n x %\ld be done ) c>e1 & s z n to expose h] unnecess>ily4 ,fir/ sitt+ up1 & ,go+ out4--,?is mu/ ( c\rse be det]m9$ m by ! condition ( ! pati5t1 & ! /ate ( ! wea!r1 ?an by any rules4 ,x may be z well to rem>k h[ev]1 no matt] h[ ! pati5t may feel1 t ! fir/ attempt %\ld always be made ) c>e4 ,v frequ5tly %e ?9ks h]self /rong]1 & m capable1 ?an %e really is1 & premature or undue ex]tion may d great injury4 ,9 mo/ cases ! female is all[$ to rise )9 ! fir/ week1 & sit = a %ort "t 9 an arm *air2 aft] :i* %e beg9s to walk sl[ly ab\t ! room4 ,! fir/ go+ out is fix$1 by fa%ion1 at "o mon?4 ,_m females h[ev]1 are unfit to leave ! h\se till long aft] t "t1 & o!rs %\ld by no means be conf9$ to x s long4 ,( c\rse ^! proce$+s %\ld dep5d1 z already rem>k$1 ^u ! pati5t's /r5g? & incl9ations1 & ^u ! /ate ( ! wea!r1 & n ^u any fa%ionable obs]vances4 ,"s females are q able to rise1 & ev5 walk out1 9 a few days1 ) b5efit to !mselves2 & x exhibits z great a want ( correct feel+1 or common s5se1 = any "o to make disp>ag+ rem>ks on !m = _! e>ly appe>ance1 z x w\ld if !y 7 to blame ! poor invalid = keep+ h] b$4 ,! ap>tm5t %\ld be kept con/antly well v5tilat$1 p>ticul>ly if ! female is conf9$ to x1 & all soil$ l951 or o!r s\rces ( f\l air1 %\ld be remov$ z quickly z possible4 ,!re is reason to believe t inatt5tion to ?is1 & to prop]ly cleans+ ! p]son ( ! female1 frequ5tly produces *ild-b$ fev]4 ,att5tions to ! ,*ild4--,if ! infant's b[els are n op5$ by ! end ( ! fir/ day x %\ld h a little sug>1 or molasses & wat]1 giv5 to x1 & if ?is does n succe$ ab\t half a tea-spoonful ( syrup ( ,rhub>b may be add$4 ,?is is h[ev] b seldom ne$$1 if x be put to ! brea/ )9 a few h\rs1 z ! fir/ secretion ( ! milk possesses suffici5t laxative p[] itself4 ,x %\ld also be obs]v$ :e!r x has ur9at$1 & if n x %\ld be plac$ 9 a w>m ba? imm$iately4 ,"s p]sons pref] to let ! *ild wait till ! milk fev] is e/abli%$1 be=e !y let x nurse1 b ?is is v improp]4 ,! e>ly fe$+ does x no good1 & ! purgatives x requires are injuri\s4 ,z soon z ! female is suffici5tly repos$1 if !re is no?+ special to =bid x1 ! *ild %\ld g to ! brea/4 ,sometimes ! *ild w rema9 sleepy & dull1 & n seem to require food at all1 = sev]al days1 & ev5 die at la/ ( />vation1 unless ar\s$4 ,if ?is le?>gy cont9ues x %\ld be put 9 a w>m ba?1 & aft]w>ds well rubb$1 :ile a little sug> & wat] is p\r$ d[n its ?roat4 ,^! att5tions may be requir$ to be repeat$ = "s "t4 ,ab\t ! f\r? or fif? day ! portion ( ! cord above ! knot usually sep>ates & falls (f1 if x has n already done s4 ,if ! navel is inflam$1 or suppurates1 a little simple o9tm5t may be rubb$ on1 & x %\ld be regul>ly & c>efully wa%$4 ,9 "s infants x swells out v mu*1 9 :i* case a pad %\ld be made ( s(t l951 & laid ^u x1 ov] :i* ! ord9>y b&age may be drawn4 ,! complete heal+ ( ! "p does n occur till ab\t ! twelf? day1 & ! b&age mu/ be c>efully worn till !n at lea/1 & is bett] cont9u$ a little long]1 p>ticul>ly if !re is any swell+1 or if ! *ild cries mu*1 or /ra9s4 ,,conclud+ ,,rem>ks4 ,f ! explanations giv5 above ( an ord9>y natural labor1 x w be evid5t t b little manual assi/ance is requir$1 ei!r to ! "m or ! *ild1 & also :at really is call$ = is ( s simple a "* z to be easily r5d]$4 ,x w\ld und\bt$ly be improp]1 & cruel1 to leave females at su* times )\t aid altoge!r2 b x is also equally improp] & injuri\s to int]f]e too mu*4 ,except+ 9 cases ( disease & de=mity1 or ( v unfavorable pres5tations ( ! ftus1 ,nature h]self w ne>ly always effect ! deliv]y2 & mu* bett]1 9 mo/ cases1 :5 left to h]self4 ,num]\s females & infants h be5 kill$1 & /ill m h be5 griev\sly injur$ = life1 by rude & uncall$ = manipulations2 s t x has be5 a "q ) "s acc\*eurs1 ( great exp]i5ce1 :e!r z _m w\ld die1 or s]i\sly suff]1 f receiv+ no assi/ance1 z d n[ f be+ improp]ly h&l$4 ,)\t go+ s f>1 x is und\bt$ly true t great mis*ief is done 9 ?is way1 :i* c only be prev5t$ by bo? acc\*eur & pati5t be>+ 9 m9d t ,nature h]self is usually compet5t1 & at mo/ only requires skillful & g5tle assi/ance4 ,"s practition]s seem to ?9k t labor is a m]e me*anical process1 l ! removal ( a block ( /one1 & h5ce !y dep5d altoge!r ^u =ce2 ov]look+ altoge!r ! wond]ful vital p[]s inh]5t 9 ! sy/em1 :i* op]ate ) su* c]ta9ty1 & yet s safely2 & :i* frequ5tly succe$ ( !mselves :5 brute =ce is completely foil$4 ,! nature ( ! assi/ance prop] to be giv51 9 any p>ticul> /age ( labor1 w be evid5t on inspect+ ! /ructure ( ^? p>ts1 ( bo? "m & *ild1 :i* are br\ght 9 connection at ! "t1 & by consid]+ h[ _! mutual relations require to be *ang$ & modifi$4 ,if ^? relations are already su* z are requir$1 & ! sy/em reta9s suffici5t =ce1 no?+ c be done ) any advantage--we mu/ wait1 & let ,nature op]ate h]self4 ,ev5 _m unfavorable conditions may be spontane\sly correct$1 & x %\ld always be a matt] ( consid]ation1 :5 ! means ( assi/ance are n v obvi\s1 :e!r x w n be bett] to rely ^u ! natural p[]s ?an to int]f]e4 ,great evil has result$ f tea*+ females t labor _c t]m9ate1 safely1 )\t a great deal ( assi/ance1 :i* c only be r5d]$ prop]ly by ^? :o possess a va/ am\nt ( skill & exp]i5ce4 ,!y are ?us l$ to ?9k !mselves totally dep5d5t ^u ! acc\*eur1 & _m ( !m actually seem to believe t he is z necess>y to deliv] ! *ild z a d5ti/ is to extract a bad too?4 ,if !y 7 bett] in=m$ !y w\ld feel m confid5ce 9 _! own natural p[]s1 & w\ld n be s unnecess>ily al>m$ :5 un=ese5 difficulties occur1 or :5 pr(essional aid _c be imm$iately procur$4 ,9 mo/ cases !re is m dang] aft] ! labor is ov]1 f pu]p]al fev]1 v>i\s local inflammations & o!r causes1 ?an !re 0 dur+ its progress4 ,inde$ ! real dang] may be said prop]ly to comm5ce sev]al days aft]1 & ! physician is really ne$$ !n m ?an at ! "t4 ,,section ,,vi4 ,,protract$ ,,& ,,difficult ,,labors4 ,! causes :i* may imp$e a labor1 & increase its difficulties1 are num]\s1 & !y are ( sev]al diff]5t k9ds--"s dep5d+ ^u ! "m1 & o!rs ^u ! *ild4 ,"s ( ^! may be easily remov$1 or modifi$1 b o!rs pres5t m s]i\s difficulty4 ,x is !re=e necess>y to enum]ate & expla9 !m sep>ately4 ,,*apt] ,,xviii4 ,,! ,,causes ,,& ,,consequ5ces ,,( ,,prolong$ ,,labor ,,to ,,bo? ,,"m ,,& ,,*ild4 ,,! ,,consequ5ces ,,( ,,prolong$ ,,labor4 ,a labor is usually call$ protract$ or difficult1 if ! head pres5ts1 :5 x is n complet$ 9 ab\t tw5ty-f\r h\rs f its actual comm5cem5t4 ,!re are _m labors h[ev]1 t la/ mu* long]1 & yet t]m9ate q favorably1 & _m t are ov] mu* soon] & yet are v difficult4 ,/ill1 g5]ally speak+1 ! dang] & difficulty increases z ! "t progresses1 & x is seldom prolong$ beyond tw5ty-f\r h\rs )\t s]i\s inconv5i5ce4 ,x appe>s1 f ! /ati/ics ( ! ,dubl9 ,ly+-9 ,hospital1 t 9 sev5ty-eight ?\s& deliv]ies1 "o out ( e n9ety-two ( ! mo!rs di$1 & "o out ( e eighte5 ( ! *ildr5 0 /illborn4 ,( ^? mo!rs :o 7 9 labor ) fir/ *ildr51 f ?irty to =ty h\rs1 "o 9 e ?irty-f\r di$1 & "o *ild 9 e five 0 /illborn4 ,( ^? :o 7 9 labor f =ty to fifty h\rs1 "o di$ 9 e ?irte54 ,( ^? :o 7 9 labor f fifty to sixty h\rs1 "o di$ 9 e elev54 ,& ( ^? :o 7 9 labor f sixty to sev5ty h\rs1 "o di$ 9 e eight1 & ne>ly "o-half ( ! *ildr54 ,x is evid5t !re=e t1 z a g5]al rule1 ! dang] increases ) ! l5g? ( "t4 ,,*apt] ,,xix4 ,,causes ,,connect$ ,,) ,,! ,,"m ,,:i* ,,may ,,imp$e ,,labor1 ,,or ,,make ,,x ,,difficult4 ,,in]tia1 ,,or ,,want ,,( ,,suffici5tly ,,p[]ful ,,contraction ,,9 ,,! ,,womb4 ,?is is mo/ likely to occur 9 delicate females1 & 9 ^? :o are debilitat$ by disease4 ,! contractions are v feeble1 &1 z ! nurses say d n tell2 ! m\? ( ! womb dilates b sl[ly1 & ! head desc5ds ) difficulty into ! passage4 ,9 _m cases 9 fact ! labor is s t$i\s1 f ?is cause1 t ! female becomes completely worn out1 & f9ally s9ks1 :ile ! *ild is expos$ to ! greate/ haz>d f ! delay4 ,x is 9 ^! cases t ! pati5t's /r5g? ne$s support+1 & t /imulants may be useful4 ,a little w9e1 or br&y & wat]1 w (t5 r\se ! fail+ en]gies1 & br+ on a s]ies ( /rong contractions t w end ! labor at once4 ,! mo/ usual resort h[ev] is to ! drug call$ ,ergot1 or ,secale ,cornutum1 a fungus gr[? :i* is sometimes f\nd on e>s ( rye4 ,?is possesses ! peculi> prop]ty ( excit+ ! womb to contract1 ! same z an emetic excites ! /oma* to vomit1 & x seldom fails 9 its effect2 b /ill !re are _m objections to its use4 ,x n unfrequ5tly causes delirium1 great re/lessness1 & anxiety1 sickness1 heada*e1 & convulsions1 or complete pro/ration1 f :i* ! female may be long 9 recov]+4 ,x is also suppos$ by "s to be n altoge!r free f dang] to ! *ild4 ,if h[ev] no o!r means 7 kn[n ( mak+ ! womb contract1 9 su* cases1 all ! probable evils %\ld be risk$1 because ! labor mu/ be complet$ at all haz>ds2 b o!r means are kn[n1 :i* succe$ ev5 m c]ta9ly ?an ergot1 & )\t any dang]4 ,! application ( ,galvanism1 expla9$ 9 my ,neuropa?y1 & ,practical ,facts1 w almo/ inv>iably cause ! womb to contract1 & spe$ily br+ ! labor to a safe t]m9ation1 )\t ! slighte/ risk or inconv5i5ce1 to ei!r "m or *ild4 ,simple friction ov] ! abdom5 w also succe$ 9 _m cases1 & g5tly rubb+ ! m\? ( ! womb ) ! f+] 9 o!rs4 ,^! simple means %\ld !re=e always be us$ 9 pref]5ce to ! ergot1 b 9 case !y _c be resort$ to1 or fail1 ! drug mu/ be adm9i/]$1 & ,i w !re=e expla9 ! mann] 9 :i* ?is is done4 ,:5 ga!r$ ! ergot is 9 l>ge irregul> lumps1 & %\ld be s kept4 ,:5 want$ = use a s+le dra*m %\ld be f9ely p[d]$1 & divid$ into ?ree p>ts2 "o ( ^! p>ts to be tak5 fir/ 9 a glass ( sug> & wat]1 & ! o!rs at int]vals ( t5 m9utes1 unless ! effects ( ! fir/ are v p[]ful4 ,x is (t5 ?r[n f ! /oma* h[ev] ev5 9 /ill small] quantities1 & is !n giv51 by "s1 z an injection by ! rectum1 9 :i* mode x seems m p[]ful1 s t a small] dose is suffici5t4 ,great caution %\ld always be obs]v$ 9 us+ ?is p[]ful drug1 z x w sometimes act s en]getically z to bur/ ! womb2 or expel ! *ild s sudd5ly z to lac]ate ! p]9eum & o!r p>ts4 ,! contractions produc$ by x are diff]5t f ! natural ones1 be+ almo/ con/ant1 )\t any int]val1 & gradually increas+ 9 =ce4 ,!y usually come on 9 ab\t t5 or fifte5 m9utes aft] ! la/ dose1 & cont9ue ab\t an h\r & a half4 ,"s practition]s dep5d almo/ altoge!r on ! ergot1 9 e protract$ case1 & ev5 use x to br+ on premature labor1 :5 t is requir$4 ,?us ,m4 ,p4 ,dubois 0 once call$ to a dw>f1 :om he deliv]$ ) in/rum5ts1 ! fir/ "t1 b ) great difficulty & risk4 ,! next "t %e became pregnant he det]m9$ to br+ on premature labor1 & accord+ly he adm9i/]$ ergot1 :5 %e 0 ab\t eight mon?s gone4 ,?is br\ght on natural labor1 & %e 0 deliv]$ )\t difficulty4 ,m4 ,*ailly says he believes x w br+ on ut]9e contraction at any "t1 & t he has nev] kn[n x to fail4 ,i consid] h[ev] t !re is always m or less risk 9 its use1 & ,i %\ld c]ta9ly pref] any ( ! o!r means1 p>ticul>ly ,galvanism4 ,x is ( ! fir/ importance h[ev] to be c]ta91 be=e us+ any =c+ means :atev]1 t !re is no physical imp$im5t4 ,if ! pelvis %\ld be de=m$ or small1 if ! *ild's head %\ld be unusually l>ge1 or dropsical1 or if ! s(t p>ts ( ! "m %\ld be undilat$ & rigid1 ! mo/ s]i\s consequ5ces mu/ ensue f viol5t ut]9e contractions4 ,9 l mann] if ! pres5tation be unfavorable1 p>ticul>ly if x be "o ( ! trunk1 ! dang] is equally great4 ,9 e case ! passage ( ! *ild mu/ be physically possible1 be=e x is attempt$ to =ce x away4 ,a neglect ( ?is rule has frequ5tly l$ to fatal results4 ,! ergot has be5 giv5 & ! ut]us =c$ to contract1 :ile ! pelvis 0 too small = ! *ild to pass ?r\gh2 & ! consequ5ce has be5 rupture ( ! ut]us1 or complete exhau/ion1 ) dea? to bo? "m & infant4 ,9 o!r cases ! deliv]y has result$ s sudd5ly1 f ! viol5ce ( ! expulsive ef=ts1 t ! vag9a & p]9eum h be5 lac]at$ 9 ! mo/ %ock+ mann]4 ,! ergot is also especially dang]\s to v n]v\s wom51 or to ^? :o are dispos$ to conge/ion1 apoplexy1 or inflammation4 ,among ! special causes :i* (t5 p>alyze ! action ( ! womb1 may be m5tion$ a full habit ( body1 great di/5tion ( ! ut]us f accumulations ( fluid1 & extreme ?ickness ( ! membranes4 ,9 "s cases 9 fact1 ! membranes w be s /rong t ! mo/ viol5t contractions fail to break !m1 & ! ut]us completely exhau/s itself to no purpose4 ,x is 9 su* cases z ^!1 :5 ! m\? ( ! womb is fully dilat$1 t ! acc\*eur %\ld rupture ! membranes artificially4 ,?is is usually done ) ! f+] nail by p9*+ !m4 ,"s practition]s h[ev] use a po9t$ in/rum5t1 or a %>p quill2 b !re is always m or less dang] ( injur+ ! *ild or ! "m by su* means4 ,! be/ "t = break+ !m is dur+ a /rong pa91 :5 !y are fully di/5d$4 ,! m]e scrat*+1 or pu%+ on !m w frequ5tly suffice4 ,i h kn[n cases h[ev] 9 :i* !y 7 s /rong t an in/rum5t 0 actually necess>y to op5 !m4 ,! dea? ( ! infant also seems sometimes to *eck ut]9e contraction1 ?\gh probably n f ! m]e circum/ance ( its be+ dead1 b because ! womb suff]s f ! same morbid cause :i* produc$ its dea?4 ,any /rong moral impression may also produce ! same /ate ( ?+s4 ,?us 9 "s females ! womb w in/antly cease its contractions1 & ! labor be arre/$1 f fright1 or f /rong repugnance to somebody1 or some?+1 9 ! room4 ,in/ances h be5 kn[n ( wom5 be+ s al>m$ on fir/ see+ ! acc\*eur1 or s displeas$ because he 0 n ! "o !y wi%$1 t ! ut]9e ef=ts imm$iately ceas$1 & c\ld n be aga9 br\ght on = a long "t4 ,! pres5ce ( "s p]son :o is a subject ( dislike may also h a v prejudicial effect1 & if ?is is kn[n !y %\ld be imm$iately remov$4 ,dr4 ,m]riman tells u ( a female :o 0 seiz$ ) a fit1 f :i* %e di$1 simply f see+ a /range doctor ent] ! room4 ,:atev] may be ! cause :i* p>alyzes ! action ( ! womb we %\ld endeavor1 if possible1 to discov] & remove x4 ,if h[ev] x be beyond our rea*1 ! pati5t's /r5g? mu/ be support$ z mu* z possible1 & ! simple/ means ( excit+ ! contractions tri$ fir/2 if ^! fail ! m p[]ful ones mu/ be tri$1 always pref]r+ ! safe/4 ,f9ally1 if all fail1 ! h& mu/ be introduc$ into ! womb1 ! *ild turn$1 & br\ght away by ! feet2 or ! =ceps mu/ be us$ if absolutely necess>y4 ,,rigidity ,,( ,,! ,,m\? ,,( ,,! ,,womb1 ,,vag9a ,,& ,,vulva4 ,sometimes ! m\? ( ! womb or o!r s(t p>ts1 w n give way1 b rema9 ob/9ately rigid1 s z to r5d] ! cont9u$ expulsive ef=ts ( ! womb ( no avail4 ,if ?is /ate cont9ues too long ! p>ts become swoll51 hot1 & dry1 & extremely pa9ful1 s t ! slighte/ t\* causes acute suff]+4 ,! abdom5 also becomes exquisitely t5d]1 fev] sets 91 ) cold sweats1 ! head beg9s to w&]1 ! features express great anxiety & suff]+1 & ! voice alt]s s t x c sc>cely be recogniz$4 ,^! symptoms w sometimes be e/abli%$1 & become rapidly worse 9 a rem>kably %ort "t1 s t ! pati5t w appe> to pass sudd5ly f a condition ( comp>ative ease & safety to "o ( extreme p]il & suff]+4 ,! *ild also suff]s 9 an equal degree1 ! cont9u$ pressure ^u its head hav+ a mo/ injuri\s effect4 ,! bones ov]lap to a great di/ance1 ! scalp is engorg$ ) fluid1 & all its blood-vessels are ready to bur/2 ! bra9 is sev]ely compress$2 ! circulation 9 x is susp5d$1 & apoplexy frequ5tly ensues4 ,ev5 :5 "o ( ^! protract$ cases ev5tually t]m9ates )\t imm$iate mis*ief1 !re is mu* subsequ5t evil to be fe>$4 ,! bruis$ p>ts frequ5tly sl\gh away1 s t fi/ulas are =m$1 & ! :ole rema9 s p]man5tly weak t !y c nev] aft]w>ds reta9 _! places4 ,! mo/ usual resort 9 ^! cases ( ob/9ate rigidity is blood-lett+4 ,?is frequ5tly induces relaxation imm$iately1 & also *ecks ! t5d5cy to inflammation & fev]4 ,9 _m cases h[ev]1 if n 9 all1 x may be disp5s$ )1 & %\ld always be s if possible4 ,v frequ5tly x produces z mu* evil z good1 by al>m+ ! pati5t1 & by creat+ a debility :i* _c aft]w>ds be remov$4 ,simple w>m fom5tations w (t5 make ! rigid p>ts give way2 & s w lubricat+ !m ) soo?+ o9tm5t1 or bett] /ill ano9t+ !m ) ! ,extract ( ,belladonna4 ,?is frequ5tly acts l a *>m1 & op5s ! rigid os t9c 9 a few m9utes4 ,injections ( ?9 />* & laudanum are also excell5t1 & may be advantage\sly adm9i/]$ be=e apply+ ! ,belladonna4 ,! ,galvanic ,batt]y may also be employ$1 x hav+ induc$ relaxation 9 _m cases1 :5 all o!r means fail$2 z w be se5 by ! cases quot$ 9 ,practical ,facts4 ,if ! labor really does progress ?\gh sl[ly1 x is g5]ally be/ to h pati5ce & let x take its c\rse4 ,if h[ev] ! pati5t is likely to s9k be=e x is complet$1 or if x is at a /& /ill1 & _c be accel]at$1 artificial deliv]y may be necess>y4 ,x is seldom h[ev] t all ( ! above m5tion$ means fail4 ,,obliquities ,,( ,,! ,,womb4 ,sometimes ! womb is s mu* incl9$ 9 a p>ticul> direction t its m\? does n pres5t to ! middle ( ! passage4 ,?us x may lean ov] s mu* to ! "r side t ! m\? may op5 aga9/ ! left wall ( ! ,pelvis2 or x may lean to ! left side1 or to ! front4 ,9 all ^! cases ! expulsion ( ! *ild may be totally prev5t$1 because x is =c$ aga9/ ! walls ( ! passage in/ead ( d[n its axis4 ,obliquity is sometimes right$ spontane\sly1 b m frequ5tly x requires ! int]f]5ce ( art4 ,! mode ( r5d]+ assi/ance is to support ! womb on ! side to :i* x falls1 p>ticul>ly dur+ ! pa9s1 s t its m\? may be direct$ t[>ds ! middle ( ! passage4 ,,prolapsus ,,ut]i4 ,fall+ ( ! womb may ret>d labor1 b is n likely to make x m ?an usually difficult1 nor dang]\s4 ,x is requisite1 h[ev] to be> 9 m9d t ! head ( ! *ild may1 by ?is displacem5t1 be f\nd 9 ! vag9a1 & ev5 at ! vulva1 be=e x has pass$ ?r\gh ! m\? ( ! womb1 because ! neck itself is already 9 ! passage4 ,! head may !re=e be felt l[ d[n1 & ! acc\*eur may ?9k ! labor w soon be complet$1 :5 9 reality x has sc>cely begun4 ,9 su* cases x m]ely requires pati5ce & non-int]f]5ce4 ,9 my "w on ! ,diseases ( ,wom51 w be f\nd _m curi\s cases ( pregnancy & deliv]y1 occurr+ dur+ p>tial or complete prolapsus ut]i2 & also mu* in=mation reg>d+ obliquity1 & o!r simil> d]angem5ts4 ,,smallness ,,or ,,de=mity ,,( ,,! ,,pelvis4 ,^! con/itute by f> ! mo/ s]i\s ob/acles to deliv]y1 & are mo/ to be dread$4 ,9 treat+ ^u !m x w be fir/ necess>y to expla9 ! *ief k9ds ( de=mities1 & ! cause f :i* !y arise1 aft] :i* x c be %[n h[ !y int]f]e ) ! progress ( labor1 & h[ !y c be be/ rem$i$4 ,de=mities ( ! pelvis may ei!r be cong5ital1 or !y may be produc$ by c]ta9 diseases 9 aft] life1 & also by bad physical education4 ,! pr9cipal causes h[ev] are two diseases1 ,ra*itis1 or ,rickets1 & ,malaco/eon1 call$ also ,mollites ,ossium1 or s(t5+ ( ! bones4 ,ra*itis usually attacks *ildr5 some:]e betwe5 n9e mon?s & two ye>s ( age1 & produces a v>iety ( well m>k$ symptoms2 su* z l>ge head & belly1 protrusion ( ! brea/-bone1 flatt5+ ( ! ribs1 emaciation ( ! limbs1 & v>i\s de=mities ( ! bones4 ,! pati5t may recov] f ! disease1 b ! de=mity ( ! bones (t5 rema9s1 & !re=e no female %\ld become pregnant1 :o has _h rickets1 till ! %ape & dim5sions ( h] pelvis are kn[n1 or x may co/ h] life4 ,malaco/eon or s(t5+ ( ! bones1 may come on at any p]iod ( life1 & frequ5tly occurs )\t any s]i\s con/itutional di/urbance4 ,x consi/s 9 a gradual absorption f ! bones ( all _! solid matt]1 s t !y become s(t1 & may be b5t or twi/$ l horn4 ,sometimes ?is /ate w be rea*$ v soon1 b at o!r times ! disease progresses v sl[ly4 ,! causes ( x are unkn[n1 & x is incurable4 ,i h se5 a pati5t :o c\ld b5d ! bone ( h] leg ne>ly d\ble1 z if x 7 a piece ( rope4 ,9 my "w on ! ,diseases ( ,woman1 ,i h spok5 ^u v>i\s o!r causes :i* may de=m ! bones 9 "y females1 su* z we>+ corsets1 improp] attitudes 9 sitt+1 & want ( suffici5t uncon/ra9$ ex]tion ( ! body 9 ! op5 air4 ,! de=mities may be ( v>i\s k9ds1 & may ei!r alt] ! g5]al appe>ance & ! walk1 or may n be discov]able except on exam9ation4 ,sometimes ! pelvis is too l>ge1 s t ! womb & o!r p>ts are cont9ually fall+ d[n into its cavity1 b ?is is v r>ely se52 m frequ5tly x is ei!r too small1 or irregul> 9 its =m4 ,9 all cases :]e ! irregul>ity 9 =m1 or dim9ution 9 size1 is su* z to prev5t ! passage ( ! *ild an op]ation becomes necess>y1 ei!r ^u ! "m or h] infant1 & great dang] is consequ5tly incurr$ by bo?4 ,x is !re=e ! duty ( e "m1 if %e has ! slighte/ suspicion t h] daught] is de=m$1 ?\gh x may n be app>5t1 to h h] exam9$ be=e %e is all[$ to m>ry4 ,_m h lo/ _! lives = want ( ?is precaution4 ,sev]e bl[s or falls 9 e>ly life may also create a pelvic de=mity1 & ?is1 z a possible consequ5ce ( su* accid5ts1 %\ld always be borne 9 m9d4 ,! means by :i* ! =m & size ( ! pelvis are asc]ta9$1 z be=e /at$1 are simple1 & su* z ne$ n 9 any way be fe>$4 ,to enum]ate all ! v>ieties ( de=m$ pelvis1 z describ$ by diff]5t au?ors1 is unnecess>y1 & w\ld n be useful "h4 ,i %all !re=e only ref] to !m g5]ally4 ,sometimes ! pelvis is regul> en\gh 9 its =m1 b s+ul>ly small altoge!r1 n l>g] p]haps ?an t ( a *ild eight or n9e ye>s ( age4 ,m frequ5tly1 h[ev] "o "p only is small1 :ile ! o!rs are full siz$1 or ! diff]5t p>ts are n 9 a prop] position 9 reg>d to ea* o!r4 ,?us sometimes ! pubic bones w be flatt5$ backw>d1 ne> to ! sacrum1 s z to n>r[ ! ant]o po/]ior diamet] ( ! upp] /rait2 at o!r times "o ( ! sides w be flatt5$ t[>ds ! o!r1 z if cru%$ 91 & ?us dim9i% all ! diamet]s2 & at o!r times "o side w s9k d[n l[] ?an ! o!r1 & ?us effect simil> *anges 9 ano!r way4 ,by ref]r+ to ! description ( ! p]fect pelvis1 giv5 9 ! e>ly "p ( ! "w1 ! nature ( ^! *anges w be readily und]/ood1 p>ticul>ly if ! plates giv5 !re are comp>$ ) ^? giv5 "h4 ,,plate ,,xl4 ,repres5ts ! /&>d =m1 ) :i* ! re/ mu/ be comp>$4 ,,plate ,,xli4 ,repres5ts a pelvis :i* resembles t ( ! male 9 its =m1 & is !re=e call$ mascul9e4 ,x is deep]1 & less capaci\s altoge!r ?an ! /&>d "o4 ,?is =m is occasionally met ) 9 females ( a peculi> g5]al con=mation1 & temp]am5t1 approa*+ t ( ! o!r sex4 ,x is n a suffici5t deviation f ! natural =m to create any great difficulty1 ?\gh x may cause delay4 ,illu/ration3 ,plate ,,xl4 ,repres5ts ! /&>d =m ( ! ,pelvis4 ,illu/ration3 ,plate ,,xli4 ,mascul9e ,pelvis4 ,,plate ,,xlii4 ,repres5ts ! peculi> de=mity mo/ frequ5tly produc$ by ,mollites ,ossium4 ,! diff]5t p>ts are /ret*$ out z x 71 & cru%$ inw>ds t[>d ea* o!r4 ,! size ( ea* /rait is dim9i%$ 9 ne>ly e diamet]1 & ! :ole =m is v unfavorable to deliv]y4 ,?is is sometimes call$ a cordi=m pelvis4 ,obs]ve ! diff]5ce betwe5 x & ! /&>d "o4 ,,plate ,,xliii4 ,?is is call$ an ,ovate ,pelvis4 ,x appe>s z if x _h be5 cru%$ by a heavy weight1 f above d[nw>d1 ! sacrum be+ depress$ bel[ ! plane ( ! pubes4 ,9 ?is case ! ant]o po/]ior diamet] ( ! upp] /rait is s mu* less5$ t ! two halves appe> ne>ly sep>at$1 & =m almo/ a figure ( eight 7#h74 ,illu/ration3 ,plate ,,xlii4 ,repres5ts ! peculi> de=mity mo/ frequ5tly produc$ by ,mollites ,ossium4 ,illu/ration3 ,plate ,,xliii4 ,?is is call$ an ,ovate ,pelvis4 ,,plate ,,xliv4 ,?is is ano!r k9d ( de=mity1 9 :i* "o side is sunk d[n bel[ ! o!r1 :ile bo? are twi/$ z x 7 r\nd ! sacrum4 ,,plate ,,xlv4 ,?is is a section ( a ,pelvis to %[ ! effect ( a corrod+ disease ( ano!r k9d4 ,! :ole ( ?is is su* a mass ( disease & de=mity z to preclude any p>ticul> description4 ,illu/ration3 ,plate ,,xliv4 ,?is is ano!r de=mity1 9 :i* "o side is sunk bel[ ! o!r1 & bo? twi/$ r\nd ! sacrum4 ,illu/ration3 ,plate ,,xlv4 ,! effect ( corrod+ disease4 ,curvature ( ! sp9e sometimes affects ! pelvis1 :5 l[ d[n1 & !re=e if any female is affect$ ) x %e %\ld n m>ry be=e be+ exam9$4 ,sev]al diseases & lesions ( ! hip-jo9t1 & ( ! ?igh1 may also d ! same1 & %\ld !re=e be suspect$4 ,9 ! great majority ( cases1 de=mities ( ! pelvis rema9 unkn[n1 till ! p]iod ( deliv]y1 & all t c be !n done is to combat 9 ! be/ possible way ! difficulties !y create4 ,x is evid5t t ! am\nt ( difficulty dep5ds entirely on ! disproportion betwe5 ! head ( ! *ild1 & ! passage ?r\gh :i* x has to be born4 ,if ! head be l>ge & ! passage small ! difficulty w be greate/1 b if ! head be small x may pass ?r\gh ! pelvis ?\gh "u its av]age size4 ,! developm5t ( ! head _c be asc]ta9$ h[ev]1 be=e bir?1 except :5 x is unusually l>ge f dropsy1 & x is !re=e always assum$ to be ( an av]age developm5t1 & ! pelvis is comp>$ accord+ly4 ,! k9d ( assi/ance requir$ 9 ^! cases dep5ds *iefly on ! measure ( ! pelvic diamet]s1 ?\gh x may be modifi$ some:at by o!r consid]ations4 ,:5 ! smalle/ diamet] ( ! pelvis measures f ?ree in*es & a half to ?ree in*es1 x is cu/om>y to leave ! expulsion ( ! ftus to nature1 & x is g5]ally effect$1 ?\gh sl[ly & ) difficulty4 ,if h[ev] ! pati5t becomes exhau/$1 or ! head be unusually l>ge1 ! =ceps are g5]ally us$ aft] wait+ five or six h\rs4 ,9 ^! cases ! head (t5 becomes firmly fix$ 9 ! upp] /rait1 s t great =ce is ne$$ to dislodge x4 ,! upp] "p passes ?r\gh1 ow+ to ! ov]lapp+ ( ! bones1 & ! scalp !n bulges out l a l>ge tumor1 f be+ engorg$ ) blood & s]um1 b ! l[] be+ m unyield+ rema9s beh9d4 ,x is !re=e impossible = ! head to move ei!r way1 z x is =m$ l a figure #h1 & held by ! n>r[ "p1 z w be se5 by ! foll[+ plate4 ,illu/ration3 ,,plate ,,xlvi4 ,?is ,plate repres5ts ! head fix$1 or impact$1 at ! upp] /rait ( a n>r[ pelvis4 ,:5 ! smalle/ diamet] is n m ?an f ?ree in*es to two & a half1 ! bir? is sometimes effect$ by nature1 b ) extreme difficulty4 ,! acc\*eur waits f\r or five h\rs1 z 9 ! =m] case1 & !n if no progress is made he applies ! =ceps1 us+ great c>e 9 do+ s4 ,if ! extraction is f\nd impossible1 ) reasonable =ce1 ! head mu/ be op5$ & made small]1 ev5 ?\gh ! *ild be liv+1 because x is m prop] to sacrifice x ?an to risk ! life ( ! "m4 ,9 a case l ?is h[ev]1 no "o p]son w\ld l to decide1 unless 9 a great em]g5cy2 !re %\ld always be a consultation if possible4 ,a dw>f1 nam$ ,lepratt1 :o us$ to p]=m at ! !atres1 0 deliv]$ ) ! =ceps by ,m4 ,dubois1 ?\gh ! pelvis only measur$ ?ree in*es4 ,%e p]fectly recov]$1 ?\gh ! *ild 0 born dead3 x 0 ( fair av]age size4 ,x is cont5d$ by "s t ! deliv]y may be effect$1 "u peculi>ly favorable circum/ances1 :5 ! passage measures only two & a half in*es1 & at all ev5ts ! ef=t %\ld be made2 b = ! sake ( ! "m su* cases %\ld n be left long1 z ! *ance is s small1 & ! risk ( delay s great4 ,:5 ! passage is less ?an two & a half in*es1 spontane\s or artificial deliv]y is all[$ to be impossible1 & ! only alt]natives !n are to dismemb] ! *ild or op5 ! "m4 ,:i* ( ^! %\ld be done dep5ds on circum/ances4 ,:5ev] ! *ild c be br\ght away by ! natural passages1 ?\gh x be piecemeal1 x always is s br\ght1 unless ! dang] to ! "m be great] ?an by ! ces>ian op]ation1 9 :i* case t op]ation is resort$ to4 ,by means ( an in/rum5t call$ ! ,cephalotribe1 :i* cru%es ! head1 ! *ild may be br\ght away1 unless v l>ge1 :5 ! pelvis only measures two in*es4 ,:5 ! passage is less ?an two in*es1 ! only resort is to ! ces>ean op]ation1 :i* sometimes succe$s1 & saves bo? "m & *ild1 ?\gh m frequ5tly ! "m s9ks4 ,! necessity = all ^! frightful op]ations is n[ mu* less ?an =m]ly1 & may be done away ) altoge!r4 ,?is important fact %\ld be kn[n univ]sally1 & also ! means to be resort$ to4 ,9 ! fir/ place1 e "y female %\ld be exam9$1 be=e m>riage1 by a compet5t p]son1 if !re be ! slighte/ reason to suspect de=mity2 & 9 case ! de=mity is f\nd to exi/1 ! consequ5ces if %e becomes pregnant1 mu/ be laid be=e h]4 ,if1 aft] be+ told ?is1 %e w m>ry1 or has already done s1 ! means ( avoid+ conception %\ld be plac$ at h] disposal1 s t %e may n be made1 ( necessity1 a helpless victim4 ,^! means ne$ n be describ$ "h1 ?\gh ,i h no hesitation 9 ref]r+ to !m4 ,:5 ,i "k t ! life1 or life-long heal?1 ( a female1 dep5ds on h] n becom+ pregnant1 ,i consid] x my duty to put su* means at h] disposal1 if %e desires x4 ,9 _m in/ances ,i h kn[n females suff]1 sev]al times1 ! mo/ frightful tortures1 m]ely to br+ into ! _w ! mangl$ fragm5ts ( a dismemb]$ *ild1 ) ! greate/ risk to _! own lives2 & 9 o!rs ,i h kn[n !m 9 con/ant dread ( becom+ pregnant1 because !y 7 consci\s x w\ld be _! dea? w>rant4 ,9 su* cases ,i leave x to humanity1 & common s5se1 z to :e!r su* in=mation %\ld be )held8 ,i c\ld n reconcile x ) my notions ( duty to )hold x4 ,9 case pregnancy has occurr$ be=e ! de=mity is discov]$1 & x is !n f\nd t a full gr[n *ild _c be born1 premature deliv]y mu/ be br\ght on2 or1 9 o!r words1 ! ,ut]us mu/ be made to expel ! *ild be=e ! full t]m1 :ile x is yet small en\gh to pass ?r\gh ! ,pelvis4 ,?is op]ation is ( c\rse only all[able :5 ne$$ to pres]ve life1 or to escape great suff]+ & dang]4 ,x mu/ always be decid$ ^u by ! m$ical man1 & p]=m$ by him1 s t a description ( x is uncall$ = "h4 ,9 ,europe x is q common1 & no?+ has t5d$ s mu* to d away ) ^? disgu/+ & horrid op]ations1 on "m & *ild1 :i* 7 =m]ly absolutely necess>y 9 cases ( de=mity4 ,if x is f\nd at ! fir/ deliv]y ( a female1 or be=e1 t %e _c be> a liv+ *ild at full t]m1 artificial deliv]y is accompli%$ at sev5 or eight mon?s1 ?us avoid+ all ! dang] to ! "m1 & frequ5tly pres]v+ ! *ild4 ,9 ! case ( ! dw>f be=e ref]r$ to1 :5 %e became pregnant ! second "t1 ,m4 ,dubois br\ght on premature deliv]y1 & ! *ild 0 born alive1 ) b little difficulty4 ,accord+ to /ati/ics x appe>s t1 :5 artificial premature deliv]y has be5 induc$1 9 "o hundr$ & sixty-"o cases only eight mo!rs h di$1 & all b =ty-six ( ! infants 7 born alive4 ,( ! :ole numb] ( *ildr5 sev5ty-?ree cont9u$ to live2 & ( ! eight mo!rs five di$ f o!r causes1 leav+ b ?ree ^: dea? result$ f ! op]ation4 ,n[ :5 ! fe>ful numb] ( dea?s f in/rum5ts1 & o!r op]ations1 necess>y at full t]m1 is recollect$1 ! advantage ( ?is practice w be evid5t4 ,9 ! ,ces>ian op]ation = in/ance1 :i* is (t5 ! only rema9+ resort1 b "o female out ( six recov]s4 ,! deliv]y %\ld be po/pon$ z long z possible1 s z to give ! be/ *ance = ! *ild liv+4 ,?is mu/ ( c\rse be decid$ ^u aft] ! size ( ! pelvis is asc]ta9$4 ,sev5 mon?s is ! e>lie/ "t at :i* ! ftus is viable1 & x is mu* bett] left till eight1 if ! size ( ! p>ts w all[ ( its bir? !n4 ,9 case !y are s small t x _c be born ev5 at sev5 mon?s1 we h our *oice1 z ,m4 ,*ailly rem>ks1 betwe5 ! dreadful ,ces>ian op]ation at full t]m1 & produc+ e>ly misc>riage4 ,m4 ,dubois seems to recomm5d premature deliv]y 9 ne>ly all cases1 if ! smalle/ diamet] is "u ?ree in*es2 because1 z he rem>ks1 spontane\s deliv]y at full t]m is !n a v r>e exception1 & ! dang] & suff]+ to ! "m is s great4 ,he also recomm5ds x :5 !re are tumors1 & ev5 :5 ! female is afflict$ ) any acute disease4 ,( c\rse x is always necess>y1 be=e op]at+1 to be sure t ! *ild is alive4 ,i knew a lady myself :o _h giv5 bir?1 at full t]m1 to sev5 *ildr51 all ( :i* 7 torn f h] ) in/rum5ts1 dead1 ow+ to ! smallness ( ! pelvis4 ,:5 pregnant ) ! eigh?1 premature deliv]y 0 br\ght on1 at my sugge/ion1 at ab\t sev5 mon?s & a half4 ,! ftus 0 born ) comp>ative ease1 & liv$4 ,b = ?is op]ation %e probably w\ld nev] h be5 bless$ ) a liv+ *ild at all4 ,s9ce !n %e has avoid$ conception4 ,,tumors ,,9 ,,! ,,pelvis4 ,tumors ( v>i\s k9ds are met )1 bo? 9 ! bones ( ! pelvis & atta*$ to ! s(t p>ts4 ,!y frequ5tly (f] ! mo/ s]i\s imp$im5ts to deliv]y1 & baffle ! skill ( ! mo/ exp]i5c$ ob/etricians4 ,9 fact !y diff] s mu* 9 _! /ructure1 _! size1 & _! situation1 t b few g5]al directions c be giv5 z to _! managem5t4 ,9 e case :]e "o exi/s pregnancy %\ld nev] occur1 if possible to be prev5t$1 be=e x is remov$2 = ?\gh x may cause no inconv5i5ce at o!r times1 yet dur+ deliv]y x may necessitate v s]i\s op]ations1 or ev5 cause dea?4 ,"s ( ^! tumors are m]e vesicles1 or bags1 fill$ ) fluid1 & may be punctur$ & _! cont5ts let out1 s z to make !m less4 ,o!rs are m or less solid b moveable1 & may (t5 be support$ above ! upp] /rait till aft] ! *ild is born4 ,:5 !y are s l>ge z to block up ! passage1 & are ei!r fix$ or _c be c>ri$ up into ! ,womb1 !re is (t5 no o!r *oice ?an to ei!r cut !m out or op5 ! *ild's head2 ! practice be+ det]m9$ by ! circum/ances ( ! case4 ,9 "s in/ances ! bladd] itself1 di/5d$ ) ur9e1 has imp$$ deliv]y1 & be5 mi/ak5 = a tumor2 & 9 o!r in/ances /ones 9 ! bladd] h caus$ ! same error4 ,a specim5 ( "o ( ^! tumors is repres5t$ 9 ,plate ,,xlvii1 & "o ( a ,polypus 9 ,plate ,,xlviii4 ,,plate ,,xlvii4 ,?is repres5ts an ,ov>ian ,tumor1 :i* has desc5d$ be=e ! head ( ! *ild1 & completely block$ up ! passage4 ,! deliv]y1 x w be se51 is utt]ly impossible 9 su* a case1 unless ! ,tumor c ei!r be pu%$ away1 or r$uc$ 9 size4 ,illu/ration3 ,plate ,,xlvii4 ,case ( ,tumor4 ,,plate ,,xlviii4 ,?is ,plate repres5ts a case :i* occurr$ 9 ! practice ( ,dr4 ,ramsbo?am1 & :i* t]m9at$ favorably4 ,! polypus _h a v long neck1 & 0 =c$ out ( ! ext]nal op5+ by ! *ild1 :i* 0 !n born ) ease4 ,i once saw a case myself1 9 :i* ! labor 0 completely arre/$ by a l>ge h>d tumor ab\t ! middle ( ! ,vag9a2 x c\ld n be mov$1 & deliv]y 0 evid5tly impossible :ile x rema9$4 ,9 consultation x 0 decid$ to cut x out1 z !re seem$ b little circulation ( blood 9 x1 & its situation 0 favorable = ! op]ation4 ,?is 0 accord+ly done ) b little tr\ble1 & ! *ild 0 born )\t difficulty 9 ab\t tw5ty m9utes aft]4 ,! "m p]fectly recov]$4 ,illu/ration3 ,plate ,,xlviii4 ,case ( ,polypus4 ,,tumors ,,ext]nally4 ,sometimes tumors exi/ ext]nally1 on ! lips1 or 9 ! ,vulva1 b z !y seldom (f] mu* ob/ruction1 & are easily detect$ & manag$1 b little ne$ be said ab\t !m4 ,!y %\ld always h[ev] be att5d$ to1 if discov]$1 be=e labor comes on1 or bett] /ill be=e pregnancy4 ,9 "s in/ances ! ve9s ar\nd ! ,vulva become mu* enl>g$1 & resemble tumors1 & sometimes ev5 imp$e deliv]y4 ,x is usual !n to op5 !m1 & let out ! blood1 b n till ! head is suffici5tly l[ to press ^u x & prev5t dang]\s ble$+4 ,,ob/ructions ,,9 ,,! ,,vag9a1 ,,& ,,n>r[ness ,,or ,,ob/9ate ,,resi/ance ,,( ,,! ,,vulva ,,& ,,p]9eum4 ,! ,vag9a may be p>tly clos$ by its sides gr[+ toge!r1 or x may be unit$ by b&s & membranes /ret*+ across2 & ^! ob/ructions may be suffici5t to imp$e or prev5t deliv]y4 ,mo/ usually !y give way1 & are gradually brok5 d[n by ! pressure ( ! *ild's head2 b if !y prove too /rong1 aft] wait+ a reasonable "t1 !y mu/ be cut ?r\gh4 ,cases h ev5 be5 kn[n 9 :i* ! hym5 has be5 f\nd p]fect at deliv]y1 & ev5 (f]$ consid]able resi/ance1 s z to necessitate its be+ cut ?r\gh be=e ! *ild c\ld be born4 ,9 su* cases ?is membrane is unusually /rong1 & conception occurs )\t its be+ brok54 ,:5 ! p]9eum or ,vulva rema9s rigid & h>d1 s t ! op5+ _c be enl>g$ suffici5tly = ! *ild to pass1 x may also be necess>y to op]ate ) ! knife4 ,b ?is %\ld nev] be done till aft] e means ( relaxation has be5 tri$1 & ! head has be5 kept back z long z prud5t4 ,x is h[ev]1 always bett] to op5 a passage ?an to let "o be torn1 because x may be made 9 ! mo/ favorable place4 ,:5 ! p]9eum is all[$ to be torn1 ! mo/ s]i\s consequ5ces (t5 ensue1 & ! pati5t is made a mis]able suff]] = life4 ,! ,vag9a & ,rectum may be torn into "o1 or ! p[] ( reta9+ ! cont5ts ( ! inte/9e1 or bladd]1 may be = ev] lo/4 ,:5 an incision is made none ( ^! evils foll[2 ! w\nd spe$ily heals1 & 9 a little "t no trace ( x c be se54 ,x has ev5 be5 necess>y to cut ! neck ( ! ,womb1 :5 x w\ld n op51 to prev5t ! organ f be+ ruptur$2 & ?is has be5 done ) p]fect safety4 ,a celebrat$ practition] 9 ?is city _h to p]=m su* an op]ation v rec5tly1 on a female :o _h injur$ h]self1 & made ! m\? ( ! ,womb gr[ toge!r1 by viol5t attempts to produce abortion4 ,! deliv]y took place ) comp>ative ease1 & no unpleasant results :atev] foll[$1 ei!r to ! "m or ! *ild4 ,,*apt] ,,xx4 ,,causes ,,connect$ ,,) ,,! ,,*ild1 ,,or ,,*ildr51 ,,:i* ,,may ,,imp$e ,,deliv]y1 ,,or ,,make ,,x ,,difficult ,,& ,,dang]\s4 ,,procid5tia ,,( ,,! ,,umbilical ,,cord4 ,?is means ! escape ( a portion ( ! cord be=e ! *ild itself4 ,x is mo/ frequ5t 9 ! irregul> pres5tations1 z !y d n s fully close up ! m\? ( ! ,womb1 & x is mo/ likely to occur at ! comm5cem5t ( labor1 ?\gh n impossible at a lat] /age4 ,v (t5 ! cord desc5ds :5 ! membranes break1 be+ c>ri$ d[n by ! ru% ( ! wat]s2 & sometimes x is already 9 ! sack1 or bag1 be=e ! rupture takes place4 ,?is accid5t is comp>atively frequ5t1 be+ f\nd to occur z (t5 z once 9 ab\t ?ree hundr$ cases4 ,! causes :i* produce procid5tia ( ! cord1 are mo/ likely ^!3--,a l>ge quantity ( liquor amnii1 & its sudd5 dis*>ge1--,unnatural pres5tations1--,de=mities ( ! sup]ior /rait ( ! ,pelvis1--,a v long cord1--& ruptur+ ! membranes too e>ly4 ,b x may also happ5 f o!r causes ) :i* we are unacqua9t$4 ,!re is seldom mu* difficulty 9 detect+ ?is accid5t1 because if ! membranes are brok5 x protrudes into ! ,vag9a1 & if !y rema9 :ole x c be felt )9 ! sack1 & its pulsation w be q di/9ct4 ,sometimes1 x is true1 x may be s firmly compress$1 betwe5 ! ftus & ! walls ( ! pelvis1 t its pulsation may be v indi/9ct1 or ev5 totally susp5d$ = a "t2 b ?is only necessitates a little extra c>e4 ,procid5tia ( ! cord may be v s]i\s = ! *ild2 9 fact1 x is a frequ5t cause ( its dea?4 ,! reason ( ?is w be evid5t :5 ! functions ( ! cord are borne 9 m9d4 ,! circulation 9 x is z necess>y = ! life ( ! *ild be=e bir?1 z brea?+ is aft]1 & :5 protrud$ fir/ x c seldom escape be+ s press$ ^u z to /op its circulation1 & h5ce ! dang]4 ,to ! "m x makes no diff]5ce :atev]1 unless x be told & al>m h]2 or unless viol5t ef=ts are made to correct x4 ,%e _h !re=e bett] n "k if x occurs4 ,if assi/ance is n r5d]$ 9 ?is accid5t ! consequ5ces are almo/ always fatal to ! *ild1 ?\gh 9 "s in/ances ! cord has rema9$ hang+ f ! ,vulva sev]al in*es1 = an h\r or m1 & /ill ! infant has be5 sav$4 ,if ! fall5 cord is detect$ be=e ! membranes are brok51 x may frequ5tly be put back into ! ,womb )\t mu* difficulty4 ,! acc\*eur mu/ wait till ! m\? ( ! ,womb is fully dilat$1 & !n wat* 8 opportunity1 9 an int]val betwe5 two contractions1 to pu% ! cord upw>ds1 betwe5 ! ftus & ! ut]9e walls4 ,if he succe$s 9 ?is1 z is usually ! case1 he mu/ !n break ! membranes dur+ ! next pa91 & ?is w br+ ! pres5t+ "p at once into ! upp] /rait1 & s block up ! passage4 ,to effect ?is manuvre x is requisite to introduce two or ?ree f+]s1 & sometimes ev5 ! :ole h&4 ,x mu/ nev] be attempt$ till ! m\? is fully dilat$1 o!rwise ! membranes may be ruptur$ too soon1 & ! deliv]y be delay$1 ?us increas+ ! dang]4 ,aft] ! rupture ( ! membranes ! replac+ ( ! cord becomes a mu* m difficult matt]1 & frequ5tly _c be effect$ at all2 p>ticul>ly if ! head be desc5d$ f> d[n4 ,e ef=t h[ev] mu/ be made1 & if unsuccessful ! deliv]y %\ld be ha/5$ z mu* z possible4 ,9 _m su* cases ! =ceps are appli$1 & ! *ild br\ght away at once1 because e mom5t's delay increases ! risk to its life4 ,sev]al diff]5t k9ds ( in/rum5ts h be5 inv5t$ to return ! cord1 b !y are seldom at h& :5 ne$$1 & none ( !m are s good z ! h& itself4 ,if ! return ( ! cord _c be effect$1 & ! progress ( ! labor w all[ ( x1 ! h& is introduc$ & ! *ild turn$1 unless ! position ( ! head w all[ ( ! advantage\s application ( ! =ceps1 9 :i* case !y are mo/ly resort$ to4 ,! only g5]al rule is1 to t]m9ate ! labor z spe$ily z possible1 consi/5t ) ! welf>e ( ! "m4 ,9 spite ( all t c be done ! pulsation is (t5 f\nd to cease1 & :5 ! *ild is born x is ei!r q dead or brea!s b a few times4 ,a v frequ5t indication t ! ftus suff]s f compression ( ! cord1 is a gre5i% color ( ! wat] dis*>g$1 ow+ to ! dis*>ge ( ,meconium f ! *ild's b[els4 ,?is is br\ght ab\t1 mo/ probably1 by its /ra9+1 & its ef=ts to relieve itself4 ,,%ortness ,,( ,,! ,,cord4 ,! cord is sometimes too %ort1 & ?is may op]ate v unfavorably 9 _m ways4 ,x may keep ! ftus up 9 ! ,womb1 & prev5t x f desc5d+ to ! bottom ( ! ,vag9a1--x may cause ! plac5ta to be torn away too soon1 & s lead to s]i\s flood+1--x may pull d[n & inv]t ! ,womb1--or x may make ! labor v t$i\s1 & cause ! dea? ( ! *ild4 ,un=tunately !re are b few signs ( ?is accid5t1 ev5 aft] ! rupture ( ! membranes1 & none at all be=e1 t c be dep5d$ ^u4 ,if ! head has desc5d$ prop]ly1 & ! p>ts be fully relax$1 b /ill ! expulsion is delay$ f no obvi\s cause1 x may reasonably be suppos$ t %ortness ( ! cord exi/s2 & if s !re is v soon giv5 a pro( ( x by a dis*>ge ( blood4 ,?is is ow+ ei!r to ! break+ ( ! cord1 or to ! sep>ation ( ! plac5ta1 & is frequ5tly ! fir/ intimation ! assi/ant has ( ! accid5t4 ,all t c be !n done is1 to conclude ! deliv]y z soon z possible1 & 9 ! be/ way t circum/ances w all[4 ,9 "s cases ! cord is n too %ort absolutely1 b is made s by be+ tw9$ r\nd ! body or limbs ( ! *ild1 :i* are (t5 cut (f by x4 ,m4 ,tasil saw a case :]e ! cord r\nd ! neck _h ne>ly sev]$ ! head2 & ,montgom]y gives sev]al in/ances 9 :i* ! limbs _h be5 amputat$ 9 ?is way4 ,two ( ^! are repres5t$ bel[3-- ,illu/ration3 ,,plate ,,xlix4 ,fig4 #a4 ,fig4 #b4 ,limbs cut (f by ! ,cord4 ,occasionally ! cord c be slipp$ ov] ! head1 or limbs1 :5 w\nd r\nd !m1 & ! /ra9 ^u x be ?us remov$4 ,if ?is _c be done h[ev]1 & ! dang] increases1 relief may be obta9$ by cutt+ ! cord1 p>ticul>ly if x be absolutely %ort4 ,b ?is mu/ n be done till ev]y?+ indicates t ! labor w probably soon t]m9ate2 & ! end connect$ ) ! *ild mu/ be c>efully held1 or ti$4 ,,desc5t ,,( ,,o!r ,,p>ts ,,) ,,! ,,head4 ,"o ,arm4--,! desc5t ( "o arm along ) ! head may cause "s delay & difficulty1 b ,nature ne>ly always ov]comes ! imp$im5t4 ,x is seldom t ! arm c be r$uc$1 & !re=e b little c be done at fir/2 if ! deliv]y be evid5tly arre/$ by x ! acc\*eur mu/ at la/ assi/ 9 ! mo/ feasible mann]4 ,sometimes ev5 x is necess>y = him to apply ! =ceps4 ,! ,two ,arms4--,ev5 ?is difficulty is (t5 ov]come spontane\sly1 ?\gh mu* m r>ely ?an ! =m] "o4 ,z soon z x is detect$1 ! acc\*eur mu/ endeavor to return "o or bo? ( ! limbs1 if ! labor has n proce$$ too f>2 & if he _c succe$ ! deliv]y mu/ be accompli%$ z soon z possible1 ei!r by turn+ or ) ! =ceps1 unless !re be reasonable gr\nd = delay4 ,! ,feet4--,ei!r "o or bo? ( ! feet may also desc5d ) ! head1 at fir/1 ?\gh !y usually rec$e & all[ ! head to be born alone4 ,:5 !y are s impact$ z to prev5t ! deliv]y be+ complet$1 ! acc\*eur mu/ int]f]e4 ,9 mo/ cases he w f9d x q easy to pu% ! feet above ! head1 & all[ t to desc5d alone2 b if ?is is n possible he mu/ introduce "o h&1 grasp ! feet ) x1 & pull !m d[n1 :ile ! o!r pu%es ! head up4 ,?is w turn ! *ild1 & if x be 9 no imm$iate dang]1 & ! "m is n suff]+1 ! re/ may be left to nature2 b if ! contr>y is ! case1 ! deliv]y mu/ be f9i%$ z spe$ily z possible4 ,:5 ! head is v l[ d[n x may be necess>y to use ! =ceps1 b great c>e mu/ be obs]v$ n to grasp ! feet along ) ! head :5 us+ !m4 ,a ,foot & ,arm4--,! proce$+ is ! same z ) ! foot alone4 ,if ! limbs _c be return$ ! head & arm mu/ be pu%$ up1 :ile ! foot is br\ght d[n4 ,,tw9s ,,& ,,triplets4 ,9 mo/ cases :]e !re are two or m *ildr5 ! deliv]y is easi] ?an ) "o1 because !y are g5]ally small1 & ! fir/ "o s prep>es ! way t ! re/ are born )\t difficulty4 ,x is also a fact t tw9s are ne>ly always born be=e full t]m1 & consequ5tly are n q gr[n4 ,! expulsion ( ! second ftus usually takes place1 imm$iately aft] ! fir/1 ?\gh sometimes ! ,womb /ops contract+1 & x is n born = half an h\r or m1 & x may ev5 rema9 = h\rs or days4 ,x is a "q :e!r1 9 su* a case1 ! second deliv]y %\ld be left = ,nature to f9i%1 or :e!r ! acc\*eur %\ld t]m9ate x soon] artificially4 ,! mo/ g5]al practice is to wait only ab\t half an h\r1 & !n1 if ! ,womb is /ill in]t1 use friction1 or o!r necess>y means1 to excite x1 & accompli% ! second deliv]y z soon z possible4 ,if !re be m ?an two ! proce$+ is /ill ! same4 ,"s difficulties may arise h[ev] ) tw9s1 :i* x is necess>y to be prep>$ =4 ,?us ! two heads may come toge!r1 & mutually imp$e ea* o!r4 ,9 ?is case ! "o :i* moves ! easie/ mu/ be pu%$ up till ! o!r is desc5d$ suffici5tly l[4 ,"o head may also desc5d ) "o or two feet2 9 :i* case1 if ! feet _c be return$1 ! head mu/ be pu%$ up1 & !y mu/ be br\ght d[n4 ,! =ce ex]t$ h[ev]1 mu/ n be v great at fir/1 because "o may belong to ea* ( ! *ildr51 & mu* injury may be done2 a little g5tle traction w soon detect ?is h[ev]1 ) ord9>y c>e4 ,if two arms1 or "o arm & a foot desc5d1 ! same c>e is also requir$1 be=e pull+ ^u !m1 to asc]ta9 t !y are n p>ts ( ! two *ildr54 ,sometimes :5 ! head ( "o tw9 desc5ds along ) ! feet ( ! o!r !y may1 if small1 desc5d toge!r4 ,b if ?is is impossible1 & int]f]5ce is ne$$1 we mu/ fir/ try to pu% up ! head2 & if ?is _c be done1 x mu/ be drawn ^u1 n ! feet2 because if ! feet 7 drawn d[n ! two *ildr5 w\ld soon occupy ! passage toge!r1 body & head1 & w\ld p]haps become firmly w$g$4 ,9 ne>ly e case "o ( ! tw9s pres5ts by ! head & ! o!r by ! feet1 z =m]ly %[n4 ,,excessive ,,size ,,( ,,! ,f,,tus1 ,,or ,,! ,,diseas$ ,,developm5t ,,( ,,c]ta9 ,,p>ts4 ,ftus too l>ge4--,x is v r>ely ! case t ! ,ftus is s l>ge z n to pass easily ?r\gh a well-=m$ ,pelvis1 ?\gh su* cases h be5 kn[n4 ,! mode ( proce$+ is ( c\rse precisely ! same z if ! pelvis 7 too small4 ,if no means w succe$ 9 ab/ract+ ! ,ftus :ole1 x mu/ be made less2 b ,nature %\ld be fir/ all[$ full "t to act ) all h] =ce4 ,hydrocephalus4--,?is consi/s ( an accumulation ( wat] 9 ! head ( ! *ild1 & is usually t]m$ wat]y head4 ,! bones ( ! cranium w sometimes be widely sep>at$ by x1 & ! head be made s l>ge t x _c possibly be born till made less4 ,! causes :i* produce ?is disease be=e bir? are unkn[n4 ,9 cases ( hydrocephalus ! head does n desc5d into ! /raits1 ow+ to its size1 & is felt to be full & firm1 dur+ a pa91 b s(t & yield+ dur+ ! int]vals1 especially at ! fontanelles & sutures1 :i* are also v l>ge4 ,! bones are usually v wide asund]1 or ev5 totally sep>at$1 z if float+ 9 ! fluid4 ,9 "s cases1 :5 ! quantity ( fluid is b small1 ! deliv]y may t]m9ate spontane\sly2 ! head l5g!n+1 f be+ s s(t1 & ?us adapt+ itself to ! size & =m ( ! /rait4 ,mo/ frequ5tly h[ev]1 assi/ance is r5d]$ 9 su* cases1 ei!r by ! =ceps1 :i* w sometimes succe$1 or by punctur+ ! head1 & lett+ out ! fluid4 ,?is op]ation has be5 p]=m$ & ! *ild sav$1 ?\gh su* an occurr5ce c nev] be reasonably anticipat$4 ,su* in/ances h[ev]1 %[ t great c>e %\ld be tak5 n to injure ! bra91 z t w\ld de/roy ! small *ance !re is4 ,dropsy may also occur 9 ! *e/1 or abdom5 ( ! *ild1 caus+ simil> difficulty ) dropsy ( ! head4 ,if ! natural or artificial expulsion ( ! *ild _c be effect$ )\t1 ! "p mu/ be c>efully punctur$1 & ! fluid evacuat$4 ,tumors on ! ,ftus4--,sometimes v>i\s k9ds ( tumors =m on ! *ild's body1 b !y are r>ely s l>ge z to prev5t deliv]y1 ?\gh !y may delay x4 ,if !y %\ld be too l>ge h[ev]1 x w be necess>y to remove !m1 z 9 ! case ( tumors 9 ! ,pelvis4 ,,ossification ,,( ,,! ,,head4 ,occasionally ! bones ( ! head w be s h>d1 & s closely unit$1 t !y w n ov]lap1 9 :i* case ! labor may be v difficult1 unless ! head is small1 or ! pelvis v l>ge4 ,if aft] wait+ a reasonable "t1 !re be no prospect ( ! labor t]m9at+ naturally1 & ! female is exhau/$1 x mu/ be t]m9at$ artificially1 z if x 7 a case ( de=m$ pelvis4 ,x is seldom h[ev]1 t ! head does n ev5tually give way4 ,,v>i\s ,,pres5tations ,,& ,,positions ,,( ,,! ,f,,tus1 ,,f ,,:i* ,,! ,,labor ,,may ,,be ,,difficult ,,or ,,protract$4 ,pres5tations ( ! ,face4--,^! are usually m difficult1 & long]1 ?an ^? ( ! head4 ,!y w ne>ly always h[ev]1 t]m9ate spontane\sly1 or ) ord9>y assi/ance2 b1 if !y %\ld n1 artificial deliv]y mu/ be practis$1 ei!r by turn+1 if ! case be n too f> advanc$1 or ) ! =ceps4 ,"s ( ! mo/ celebrat$ au?ors recomm5d t all ^! cases %\ld be treat$ l cases ( natural labor4 ,dr4 ,m]riman says t 9 "s v favorable in/ances turn+ may be practis$ ) safety & advantage2 b ,dr4 ,lee says1 ,my firm belief is1 t ! *ild1 ev5 "u su* favorable circum/ances1 w\ld h a f> bett] *ance to be born alive if ! labor 7 left :olly to ,nature2 or1 if ! natural p[]s 7 inadequate1 to be extract$ ) ! =ceps4 ,9 su* cases !re is (t5 too little pati5ce1 & too mu* int]f]5ce4 ,! =ehead incl9$ aga9/ ! ,pubes4--,9 ?is position ! labor may be long delay$1 & difficult1 & mo/ practition]s endeavor to turn ! head r\nd1 if !y _c br+ d[n ! feet1 or else apply ! =ceps at once4 ,dr4 ,lee h[ev] rem>ks1 & v prop]ly1 ,f all t ,i h se5 ( ^! cases1 ,i am dispos$ to believe t x is be/ to leave !m to ! natural ef=ts1 & to avoid all int]f]5ce1 all attempts to *ange ! position1 :ile ! pa9s cont9ue regul>1 & ! head advances1 h[ev] sl[ly4 ,if ! labor does n progress at all1 or ! female becomes exhau/$1 ( c\rse artificial deliv]y is necess>y4 ,sev]al v>ieties ( head & face pres5tations may also ret>d labor consid]ably1 b ,nature ne>ly always ov]comes ! difficulty2 or if %e _c d s m]e ord9>y assi/ance is requir$4 ,,pres5tations ,,( ,,! ,,l[] ,,extremities4 ,x has already be5 rem>k$1 9 ano!r place1 t bree* pres5tations mo/ly t]m9ate spontane\sly1 & t b few ( !m require int]f]5ce4 ,9 "s ( !m ev51 :5 ! pelvis is l>ge1 or ! ftus small1 ! deliv]y is effect$ q rapidly4 ,/ill su* pres5tation occasionally causes delay & difficulty1 & necessitate m or less assi/ance4 ,z soon z ! m\? ( ! ,womb is op5$ suffici5tly1 unless ! labor is rapidly progress+ )\t x1 "o ( ! f+]s may be introduc$ & hook$ ov] ! gro91 & a little g5tle =ce ex]t$ ^u x4 ,?is w assi/ v mu*1 & w (t5 be all suffici5t4 ,if ! pelvis is too small1 or ! ftus too l>ge1 & ! deliv]y is evid5tly arre/$1 ! bree* mu/ be pu%$ up1 if possible1 & ! feet be br\ght d[n1 z 9 turn+4 ,! rem>ks ( ,dr4 ,lee on ?is pres5tation are s pla9 & practical1 & m>k$ ) su* good s5se1 t ,i ?9k a bett] explanation ( :at %\ld be done 9 su* cases-c\ld h>dly be giv51 ,i w !re=e quote 8 rem>ks 9 full3-- ,hav+ asc]ta9$ t ! nates pres5t1 :atev] ! position ( ! ftus may be1 :e!r ! abdom5 look backw>d or =w>d1 we _c alt] x ) safety1 & no *ange c be requir$ to be made till ! nates & l[] extremities are expell$4 ,! os ut]i dilates sl[ly 9 mo/ cases ( nates pres5tation1 b we _c employ any means ) advantage to accel]ate ! deliv]y1 & 9 mo/ cases1 if we d n int]f]e1 b wait pati5tly1 !y are gradually press$ l[] & l[] into ! pelvis1 & at la/ escape f ! vag9a )\t any assi/ance4 ,if ! os ut]i & vag9a are imp]fectly dilat$1 & ! nates are drawn d[n or pass rapidly ?r\gh ! pelvis1 ! *ild is (t5 lo/4 ,! membranes %\ld n be ruptur$1 & ! expulsion ( ! nates %\ld be left entirely to ! natural ef=ts1 unless ! labor is protract$ & exhau/ion takes place4 ,except support+ ! p]9eum1 no?+ is requir$ 9 a great proportion ( ^! cases be=e ! nates & l[] extremities h be5 expell$1 :5 x becomes necess>y to asc]ta9 precisely ! relative position ( ! *ild to ! pelvis1 to rectify ?is if x is unfavorable1 & artificially extract ! sup]ior extremities & head1 to prev5t ! fatal compression ( ! umbilical cord4 ,if we f9d1 aft] ! expulsion ( ! nates & l[] extremities1 t ! toes are direct$ =w>d1 or t ! *ild is 9 ! position repres5t$ 9 ! second figure1 ) its abdom5 appli$ to ! ant]ior "p ( ! ut]us1 & t its back lies along ! sp9e ( ! "m1 we %\ld wrap ! nates & sides 9 a s(t napk91 & turn ! *ild v g5tly r\nd dur+ a pa91 obs]v+ to :i* side ! feet are incl9$ to turn1 till its abdom5 is to ! sp9e ( ! "m1 & ! toes are direct$ backw>d to ! holl[ ( ! sacrum1 or to ! side ( ! pelvis4 ,9 _m cases ! nates turn r\nd 9 ! passage spontane\sly1 s t x is n requir$ artificially to alt] ! position4 ,x is necess>y always to recollect t x is possible to turn ! body ( ! *ild r\nd )\t turn+ ! face r\nd into ! holl[ ( ! sacrum1 & t ! *9 may be ov] ! symphysis pubis :5 ! front ( ! *e/ & abdom5 are turn$ backw>d4 ,aft] ! l[] extremities & body ( ! *ild h be5 expell$1 & plac$ 9 ! mo/ favorable position = ! extraction ( ! sup]ior extremities & head1 x is necess>y to proce$ )\t loss ( "t to draw ^! ?r\gh ! pelvis1 t ! *ild may n be de/roy$ by compression ( ! umbilical cord4 ,z pressure ^u ! cord = a v %ort "t w 9 "s cases kill ! *ild1 x is prop] to wat* closely ! pulsations ( its art]ies4 ,draw ! body ( ! *ild =w>d z f> z ! arm-pits1 & place x ov] ! palm ( y\r "r h& & =e-arm1 & g5tly draw ! body t[>ds ! left ?igh ( ! "m2 !n pass ! =e & middle f+]s ( y\r left h& along ! back "p ( ! left arm ( ! *ild to ! elb[-jo9t1 & press d[n ! arm ) y\r l+]s along ! ?orax ( ! *ild1 & extract x4 ,!n transf] ! body ( ! *ild & left arm to y\r left h& & =e-arm = support1 & ) ! =e & middle f+]s ( y\r "r h& dis5gage & br+ d[n1 9 ! same way1 ! "r arm ( ! *ild2 !n pass ! =e & middle f+]s ( y\r left h& into ! m\? ( ! *ild1 or r ov] ! l[] & upp] jaw1 & at ! same "t place ! =e & middle f+]s ( y\r "r h& ov] ! back "p ( ! neck & occiput1 & ) ! f+]s ( ! two h&s ?us appli$ extract ! head1 9 ! l9e ( ! axis ( ! pelvis4 ,! p]9eum is v rigid 9 "s cases ( nates pres5tation1 :]e x is ! fir/ *ild1 & x w be torn if ! head is extract$ ha/ily1 & n drawn =w>d to ! symphysis pubis4 ,:5 y feel ! pulsations ( ! cord beg9n+ to cease1 y may be tempt$ to employ great] extract+ =ce ?an ! neck ( ! *ild & p]9eum c be>1 & bo? may be de/roy$4 ,! only me?od ( obviat+ ?is is to press back ! edge ( ! p]9eum1 t ! air may ga9 admission into ! m\? ( ! *ild1 & ! respiration g on1 :5 ! circulation 9 ! cord has be5 arre/$1 until ! p]9eum is suffici5tly dilat$ to slide back ov] ! face1 & all[ ! head to pass4 ,i h se5 f tw5ty m9utes to half an h\r elapse 9 "s cases1 aft] ! cord _h ceas$ to pulsate1 be=e ! p]9eum w\ld all[ ! head to escape1 dur+ :i* "t ! respiration 0 regul>ly p]=m$4 ,?is is n a new practice2 x has be5 allud$ to by "s ( ! old] acc\*eurs1 & "s o!rs2 & ! advantages to be d]iv$ f x 7 fully po9t$ out "s ye>s ago by ,dr4 ,bigel[1 9 a pap] publi%$ 9 ! ,am]ican ,j\rnal ( ! ,m$ical ,sci5ces1 ',on ! means ( af=d+ ,respiration to ,*ildr5 9 ,rev]s$ ,pres5tations4' ,! object ( ,dr4 ,bigel[ 9 ?is pap] is to %[ t 9 _m cases ! life ( ! *ild may be sav$ by =m+ a communication betwe5 ! m\? & atmosph]e previ\s to ! deliv]y ( ! head4 ,if ! head be l[ d[n1 ! f+]s alone c give ! necess>y assi/ance2 b if x is high 9 ! pelvis1 & is rea*$ ) difficulty1 ! assi/ance ( a tube may be necess>y4 ,he recomm5ds a flat tube1 :i* is to be gu>d$1 & kept )9 ! f+]s ( ! ins]t$ h&4 ,:]e ! pelvis ( ! "m is small or di/ort$1 & ! *ild l>ge & unfavorably situat$1 ! ef=ts ( nature may be insuffici5t to expel ! *ild1 ei!r alive or dead4 ,! nates may become s firmly impact$ 9 ! pelvis1 t !y _c advance )\t artificial assi/ance4 ,a f+] %\ld be pass$ up to "o ( ! gro9s1 & :5 a pa9 comes on a consid]able extract+ =ce may be ex]t$ ) x1 )\t injur+ ! *ild2 or a s(t h&k]*ief may be pass$ betwe5 ! ?igh & abdom51 & ! nates drawn d[n2 b ?is _c be done unless !y h desc5d$ l[ into ! cavity ( ! pelvis4 ,:]e ^! means fail1 & x is impossible to extract ! *ild alive1 ! blunt hook or crot*et mu/ be employ$4 ,9 cases ( nates pres5tation1 :]e ! pelvis is di/ort$1 aft] ! extraction ( ! trunk & extremities1 x is necess>y to p]=ate ! back "p ( ! head1 & complete ! deliv]y ) ! crot*et4 ,9 pres5tations ( ! feet & knees ! treatm5t does n ess5tially diff] f t requir$ 9 pres5tations ( ! nates4 ,,pres5tations ,,( ,,! ,,%\ld]4 ,^! are ! mo/ dang]\s ( all ! pres5tations1 & mo/ frequ5tly require assi/ance2 9 fact ! deliv]y c seldom be t]m9at$ naturally :5 ! %\ld] pres5ts4 ,sometimes ! *ild w pass d\bl$ up1 z =m]ly expla9$1 b ?is mu/ n be too confid5tly expect$4 ,dr4 ,lee says-- ,x is n[ a g5]al rule1 e/abli%$ 9 all c\ntries :]e midwif]y is und]/ood1 t 9 cases ( pret]natural labor1 :]e ! %\ld] & sup]ior extremities ( ! *ild pres5t1 ! op]ation ( turn+ ought to be p]=m$4 ,b ! h& mu/ n be =c$ into ! ut]us1 if ! orifice is rigid & undilatable2 x %\ld be dilat$ ne>ly to ! size ( half-a-doll> piece or m1 or ! m>g9 ought to be v ?91 s(t1 & yield+1 if x is exp&$ to a small] ext5t ?an ?is :5 turn+ is attempt$4 ,if ! os ut]i w n admit ! extremities ( ! f+]s & ?umb 9 a conical =m to be introduc$ )\t mu* =ce1 if x is ?ick1 h>d1 & unyield+1 "s delay is necess>y1 t ! p>ts may relax1 dea? be+ almo/ always ! consequ5ce ( ?ru/+ ! h& ) viol5ce ?r\gh ! orifice ( ! ut]us 9 a rigid & undilatable condition1 :e!r ! membranes be ruptur$ or n4 ,b z soon z x w admit ( ! safe introduction ( ! h&1 :]e y h asc]ta9$ t an arm pres5ts1 no "t %\ld be lo/ 9 complet+ ! deliv]y1 o!rwise ! membranes may give way1 ! liquor amnii be evacuat$1 & a case ( little difficulty & dang] be sudd5ly conv]t$ into "o equally haz>d\s to ! "m & *ild4 ,9 all cases ( labor1 :]e ! fir/ /age is f> advanc$ )\t ! nature ( ! pres5tation be+ positively det]m9$1 or a sup]ior extremity is felt ?r\gh ! membranes1 ! pati5t %\ld be kept 9 ! horizontal position1 t !y may n be ruptur$2 & y %\ld rema9 9 con/ant att5dance ^u ! pati5t1 & be prep>$ to int]f]e ! in/ant ! necessity arises4 ,speak+ ( ! op]ation ( turn+ 9 ^! cases he rem>ks z foll[s3-- ,9 "s favorable cases ( %\ld] & arm pres5tation1 ! ut]us is widely dilat$ be=e ! membranes are ruptur$ & ! liquor amnii dis*>g$2 & no difficulty is exp]i5c$ 9 pass+ ! h& into ! ut]us1 lay+ hold ( ! feet1 & extract+ ! *ild by ! op]ation ( turn+4 ,if ! ut]us is n contract+ /rongly & at %ort int]vals1 little resi/ance is (f]$ to ! introduction ( ! h&1 & ! deliv]y may be spe$ily accompli%$ ) safety bo? to ! "m & *ild4 ,b if ! membranes h bur/1 ! liquor amnii escap$1 & ! ut]us has be5 contract+ firmly ^u ! *ild _m h\rs be=e ! op]ation ( turn+ is attempt$1 ! *ild is (t5 de/roy$ by ! pressure1 & ! coats ( ! ut]us expos$ to great dang] f contusion & lac]ation 9 pass+ up ! h& & br++ d[n ! feet4 ,! %\ld] & ?orax become s /rongly impact$ 9 ! pelvis1 t great =ce is requir$ to introduce ! h& to grasp ! feet1 & mu* ex]tion necess>y be=e ! position c be *ang$4 ,9 o!r cases ( %\ld] & arm pres5tation1 ! membranes bur/ & ! liquor amnii escapes at ! comm5cem5t ( labor1 & ! os ut]i is rigid & undilat$1 s t ! h& _c be pass$ into ! ut]us aft] ! labor has cont9u$ _m h\rs4 ,! difficulty & dang] ( ^! cases is greatly increas$ :5 ! ut]us is contract+ ) viol5ce1 & ! pelvis is di/ort$1 or a disproportion exi/s betwe5 ! *ild & pelvis f any o!r cause4 ,! great] numb] ( wom51 if ab&on$ to ! ef=ts ( nature "u ^! circum/ances--! ut]us hav+ no p[] to alt] ! position ( ! ftus--w\ld ultimately die undeliv]$1 f exhau/ion or rupture ( ! ut]us & vag9a4 ,=tunately ^! cases are v r>e1 & :5 assi/ance is r5d]$ e>ly1 ! difficulty is readily ov]come4 ,?is is a /rong reason :y all wom5 especially %\ld "k :at to d1 because a little timely help may save mu* suff]+1 or ev5 life4 ,,section ,,vii4 ,,accid5ts ,,dur+ ,,labor ,,:i* ,,may ,,compromise ,,! ,,"m',s ,,life4 ,,*apt] ,,xxi4 ,,ut]9e ,,hemorrhage1 ,,or ,,flood+1 ,,dur+ ,,labor4 ,?is is always a tr\blesome1 & frequ5tly a fatal accid5t4 ,x %\ld be always wat*$ =1 & att5d$ to z e>ly z possible--a few m9utes frequ5tly det]m9+ ! recov]y or dea? ( ! pati5t4 ,! *ief causes ( flood+ are1 ! too e>ly or viol5t1 sep>ation ( ! plac5ta2 ins]tion ( ! plac5ta ov] ! m\? or on ! neck ( ! womb2 lac]ation ( ! womb or vag9a2 ! bur/+ ( a swell$ ve92 rupture ( "o or m ( ! blood vessels ( ! ut]us2 & break+ ( ! cord4 ,probably ! mo/ frequ5t ( ^! causes are ! premature or viol5t sep>ation ( ! cord1 & ! bur/+ ( ! blood vessels4 ,! ins]tion ( ! plac5ta ov] ! m\? ( ! womb1 in/ead ( on ! fundus1 occurs v seldom1 b :5 x does sev]e flood+ is ne>ly c]ta9 to foll[1 because ! plac5ta has !n to be torn1 by ! expansion ( ! p>ts1 at ! v comm5cem5t ( ! labor1 & probably cont9ues to p\r out blood = a long "t be=e ! *ild is deliv]$1 & x c be expell$4 ,9 fact ?is occurr5ce1 unless ! labor t]m9ates v spe$ily1 is ne>ly always fatal to ! "m1 & frequ5tly to ! *ild also4 ,9 mo/ cases !re is m or less hemorrhage f ?is cause dur+ ge/ation1 p>ticul>ly aft] ! six? mon?1 :5 ! neck ( ! ut]us beg9s to enl>ge m ?an ! plac5ta1 & consequ5tly te>s away f x4 ,abortion frequ5tly results also1 if ! flood+ be n /opp$4 ,madame ,boiv9 tells u t 9 tw5ty ?\s& ?ree hundr$ & fifty-sev5 deliv]ies !re 7 b eight cases 9 :i* ! plac5ta grew ov] ! m\? ( ! womb2 :i* is equal to "o case 9 e two ?\s& five hundr$ & fifty-f\r4 ,dr4 ,*ur*ill has collect$ ! acc\nts ( "o hundr$ & sev5ty-f\r cases ( ?is k9d1 & he f9ds t out ( ^! =ty-eight t]m9at$ fatally2 or ne>ly "o out ( e ?ree4 ,! rupture ( ! blood vessels may occur :5 !y are too mu* engorg$ ) blood1 or :5 _! coats are weak5$ & corrod$ by disease4 ,%ortness ( ! cord may also produce a rupture ( ! vessels1 by ! /ra9 x causes on !m & on ! membranes4 ,9 _m cases ! flood+ comes on sudd5ly1 )\t any w>n+ :atev]1 ?\gh mo/ usually x is prec$$ by a s5sation ( weight1 heat1 & flutt]+ 9 ! pelvis1 pa9s 9 ! ?ighs & back1 flu%$ face1 heada*e1 & dizz9ess4 ,! pulse also becomes irregul>1 ! h&s & feet gr[ cold1 & ! e>s (t5 r+1 or buzz4 ,! only c]ta9 sign t ! hemorrhage has really comm5c$ is ! appe>ance ( ! blood itself1 & ?is (t5 occurs1 z previ\sly rem>k$1 )\t any premonitory sign :atev]4 ,! dang] f hemorrhage dur+ labor is greate/ :5 x comm5ces ! e>lie/1 because x has !n ! longe/ to la/4 ,f any ( ! causes m5tion$ x is evid5t t x mu/ cont9ue till deliv]y is accompli%$1 & !re=e if x appe>s at ! comm5cem5t ( ! labor x may cause ! dea? ( bo? "m & *ild1 be=e ! labor c be t]m9at$4 ,! dang] is greate/ h[ev] to ! *ild1 unless ! fl[ be v pr(use inde$1 & !n x is equally s to bo?4 ,aft] deliv]y ! dang] is ( c\rse only to ! "m2 & ! rapidity ) :i* x may compromise h] life is 9 "s cases fe>ful4 ,dr4 ,lee ?us speaks ( su* cases4 ,b "o ( ! mo/ dang]\s v>ieties ( ut]9e hemorrhage is t :i* foll[s ! expulsion ( ! plac5ta1 or its removal f ! ut]us by art4 ,sometimes ! blood escapes 9 great quantities f ! ut]us imm$iately aft] ! removal ( ! plac5ta1 & ! pulse ceases at ! wri/1 & consci\sness is entirely lo/ 9 a few seconds4 ,!re is no symptom be=e labor has comm5c$1 or dur+ its progress1 to w>n y ( :at is ab\t to take place4 ,! *ild has be5 safely deliv]$1 ! plac5ta has come away 9 a %ort "t1 & :ile y are p]haps congratulat+ y\rself on ! happy t]m9ation ( ! labor ! blood beg9s to trickle ov] ! b$ ^u ! floor1 or ! pati5t sudd5ly compla9s ( great fa9tness4 ,9 su* cases !re may be ei!r a want ( ut]9e contraction1 or ! contractions may n be p]man5t1 b be foll[$ by relaxation & ! effusion ( a l>ge quantity ( blood1 :i* may ei!r appe> ext]nally1 or rema9 to become coagulat$1 & di/5d ! ut]us4 ,= sev]al h\rs aft] deliv]y1 9 "s cases1 ?is alt]nate relaxation & contraction goes on1 to ! great haz>d ( ! pati5t1 & if h] condition be n cle>ly asc]ta9$1 & ! prop] rem$ies be employ$1 dea? may unexpect$ly take place4 ,9 reg>d to ! treatm5t1 he gives su* excell5t & practical rules1 t ,i _c d bett] ?an quote !m4 ,by f> ! mo/ important rem$ies 9 ^! cases ( ut]9e hemorrhage are con/ant & p[]ful pressure ov] ! fundus ut]i1 ! application ( cold ar\nd ! pelvis1 & ! free adm9i/ration ( w9e1 br&y1 & o!r /imulants3 ergot is indicat$1 b x mo/ frequ5tly produces no effect4 ,! pressure & cold are always )9 our rea*1 h[ev] sudd5 ! attack may be4 ,! hypoga/rium %\ld be /rongly compress$ ) ! b9d]1 & a pad ( fold$ napk9s plac$ "u x1 & 9 addition ! h& %\ld be firmly appli$ ov] ! fundus ut]i4 ,i d n "k :o x 0 t fir/ employ$ compression ( ! fundus ut]i 9 cases ( flood+ aft] ! bir? ( ! *ild2 b x has be5 (t5 recomm5d$1 & !re are few practition]s 9 ?is c\ntry :o are n fully aw>e ( ! importance ( ! b9d] & pad1 9 excit+ p]man5t & regul> ut]9e contractions4 ,dr4 ,m',keevor /ates1 t 9 #ahae x 0 recomm5d$ by ,dr4 ,labatt 9 8 lectures1 & = a numb] ( ye>s be=e ?is ,dr4 ,labatt 0 accu/om$ to recomm5d a ?ick firm pad1 or compress ov] ! pubes1 previ\s to ! application ( ! ord9>y b9d]1 :]e1 9 =m] labors1 ut]9e hemorrhage _h tak5 place4 ,dr4 ,m',keevor /ates1 t ( #fffe wom5 deliv]$ dur+ ! ye>s #ahai & #ahbj1 only #be 7 attack$ ) hemorrhage aft] ! bir? ( ! *ild4 ,( ^!1 #ae occurr$ be=e ! expulsion ( ! plac5ta1 t5 aft]w>ds1 & 9 all ! results 0 favorable4 ,he saw only two fatal cases dur+ ! "t he 0 9 ! ,dubl9 ,ly+-9 ,hospital1 & he attributes ?is small mortality p>tly to ! process ( p>turition be+ left entirely to ! unassi/$ gradual ef=ts ( ! ut]us2 p>tly to ! pati5t hav+ be5 kept cool & quiet1 free f all s\rces ( di/urbance & irritation2 b1 above all1 to ! c>eful application ( ! b9d] imm$iately aft] deliv]y1 by :i* means ! expulsion ( ! plac5ta1 & p]man5t contractions ( ! ut]us1 are mo/ effectually secur$1 & :5ev] any t5d5cy to hemorrhage did occur be=e ! removal ( ! plac5ta1 ! fir/ po9t inv>iably att5d$ to 0 to tight5 ! b9d]1 & 9 ! ev5t ( ?is n succe$+1 a ?ick firm compress1 made by fold+ a c\ple ( l>ge co>se napk9s into a squ>e =m1 0 plac$ ov] ! region ( ! ut]us1 & ! b9d] aga9 adju/$4 ,9 ! great majority ( in/ances1 ^!1 ) ! admission ( cool air1 *eck$ ! dis*>ge2 if n suffici5t1 additional pressure 0 made ) ! h&s4 ,at ! same "t t y effici5tly compress ! fundus ut]i ) ! b9d] & pad1 cold %\ld be vigor\sly appli$ to excite ! contractions ( ! ut]us4 ,! be/ mode ( do+ ?is is to plunge a l>ge napk9 9 a pit*] ( cold wat]1 & da% x sudd5ly aga9/ ! ext]nal p>ts1 ! nates & ?ighs2 & ?is %\ld be repeat$ till ! ut]us contracts1 & ! viol5ce ( ! hemorrhage is controll$4 ,i am satisfi$ t ?is is ! mo/ efficaci\s me?od ( apply+ cold to excite ut]9e contractions2 x is f> less =midable ?an p\r+ wat] f a height ov] ! nak$ abdom51 b x is n less efficaci\s1 & x possesses ^! decid$ advantages ov] ! o!r me?od1 t :ile ! application is made to ! ext]nal p>ts1 nates1 & ?ighs1 ! pressure ( ! b9d] & pad is n )drawn f ! hypoga/rium1 ! position ( ! pati5t is n *ang$ f ! side to ! back1 ! b$ is n inundat$ ) wat]1 & ! application c be repeat$ z (t51 & cont9u$ z long1 z ! urg5cy ( ! symptoms may require4 ,! abdom5 may be expos$ once1 & cold wat] p\r$ ov] x f a height1 & ! ut]us made to contract1 & ! fl[ ( blood be arre/$ = a "t1 b relaxation ( ! ut]us may foll[ aft] a %ort int]val1 & ! hemorrhage be r5ew$ aga9 ) equal viol5ce z at fir/2 b we _c ) propriety expose ! abdom5 a second "t1 & empty ov] x f a height ! cont5ts ( a great decant] or kettle4 ,besides1 by adopt+ ?is practice1 we sacrifice ! :ole ( ! effects d]iv$ f pressure on ! fundus ut]i4 ,! application ( a napk9 soak$ 9 v9eg> & wat] to ! p>ts is (t5 suffici5t1 along ) ! b9d]1 to re/ra9 ! hemorrhage :]e x is n v pr(use4 ,i h v seldom introduc$ a plug ( any k9d into ! vag9a 9 ^! cases1 b :5 !re has be5 a dra9+ ( blood f ! ut]us1 aft] ! practice n[ describ$ has be5 employ$1 a l>ge s(t sponge pass$ into ! vag9a1 & press$ up aga9/ ! os ut]i1 has appe>$ 9 "s cases to promote ! coagulation ( ! blood4 ,! sponge1 h[ev]1 _c be employ$ ) safety aft] ! expulsion ( ! *ild & plac5ta1 unless ! ut]us be firmly compress$ above ! brim ( ! pelvis to prev5t its becom+ di/5d$ ) blood4 ,m frequ5tly ,i h _h rec\rse ) good effect1 to ! introduction ( sev]al pieces ( smoo? ice into ! upp] "p ( ! vag9a1 & all[+ !m to rema9 !re1 9 contact ) ! os ut]i1 & be dissolv$1 or pieces ( ice h be5 inclos$ 9 a bladd] & laid ov] ! pubes4 ,o!r means besides ^? n[ describ$ h be5 recomm5d$ 9 cases ( flood+ aft] ! expulsion ( ! plac5ta4 ,x has be5 propos$ to inject cold wat] into ! cavity ( ! ut]us by means ( ! /oma* pump1 & favorable reports h be5 giv5 ( ! practice4 ,! effect1 ,i ?9k1 w\ld be simil> to direct+ =cibly a /ream ( cold wat] aga9/ a /ump soon aft] amputation2 ! coagula 9 ! cavity ( ! ut]us & 9 ! orifices ( ! vessels w\ld be all wa%$ away3 nev]!less1 x might p]haps be advantage\s 9 "s desp]ate cases4 ,port w9e & wat]1 z cold z possible1 ,dr4 ,coll9s says1 inject$ into ! rectum1 has be5 ( s]vice4 ,"s ( ! e>li] writ]s on midwif]y1 & _m 9 ! pres5t c5tury1 h /rongly recomm5d$ ! introduction ( ! h& )9 ! ut]us = ! purpose ( remov+ ! coagula accumulat$ )9 ! cavity1 & to excite ! ut]us to contract4 ,b x is n necess>y to pass ! h& into ! ut]us = ! removal ( coagula1 because if ! b9d] has be5 prop]ly appli$1 & /rong pressure made ov] ! fundus ut]i1 clots _c accumulate )9 ! ut]us1 & if !y h be5 p]mitt$ to collect 9 consequ5ce ( neglect1 !n expulsion w imm$iately foll[ ! use ( prop] compression ( ! hypoga/rium1 )\t ! introduction ( ! h&4 ,nor d ,i consid] x necess>y1 to excite ut]9e contractions1 t ! h& %\ld ev] be introduc$ into ! cavity ( ! ut]us aft] ! removal ( ! plac5ta4 ,i am fully conv9c$1 f repeat$ obs]vation1 t ?is practice1 :i* is s common z to be almo/ univ]sal 9 ?is c\ntry at ! pres5t "t1 is (t5 n only ineffectual = ! purpose1 9 ! wor/ cases ( flood+1 b t x is (t5 foll[$ by ! mo/ p]nici\s effects2 ! coagula :i* nature has =m$ h be5 displac$ by ! h&1 & ! ut]us has n be5 excit$ by ! /imulus ( x to secure a p]man5t contraction4 ,9 ! great] numb] ( fatal cases ( ut]9e hemorrhage aft] ! expulsion ( ! plac5ta1 :i* h come "u my obs]vation1 ! h& _h be5 introduc$ into ! cavity1 & ! clos$ fi/ _h be5 press$ = a long] or %ort] "t r\nd & r\nd aga9/ ! l9+ membrane1 to make ! ut]us contract4 ,i d n recollect a s+le fatal case1 :]e ! un=tunate result c\ld be fairly attribut$ to ! want ( ! introduction ( ! h& into ! cavity ( ! ut]us1 & ! friction ( ! knuckles aga9/ ! l9+ membrane4 ,i h repeat$ly pass$ ! h& into ! ut]us to produce contraction1 b x has refus$ to obey ! /imulus ( ! h&2 x has rema9$ l a s(t flaccid bag1 m l a piece ( inte/9e ?an ut]us1 & ! blood has cont9u$ to p\r d[n ! arm1 until ! h& has be5 )drawn1 & m effici5t rem$ies employ$4 ,l]\x 0 well aw>e t ! /imulus ( ! h& w\ld n 9 all cases excite ! ut]us to contract1 = he obs]ves1 :]e ! os ut]i is contract$1 ! means indicat$ by ,levret are v efficaci\s1 & remove ! hemorrhage z if by a *>m4 ,b x is n s 9 complete in]tia ( ! ut]us2 (t5 x is widely dilat$1 & (f]s no resi/ance to ! introduction ( ! h&4 ,! introduction ev5 ( ! :ole h& excites little s5sation1 & ! woman w promptly p]i% f hemorrhage if o!r means m active & c]ta9 are n employ$ to prev5t x4 ,! tampon or plug is ! rem$y ,l]\x recomm5ds 9 cases ( flood+ aft] deliv]y1 & he affirms t x w (t5 succe$ 9 /opp+ ! fl[ ( blood :5 all o!r means fail4 ,dr4 ,dewees obs]ves1 t he has n f\nd x necess>y to introduce ! h& = ! purpose ( /opp+ an hemorrhage aft] ! expulsion ( ! plac5ta1 dur+ ! la/ five-&-?irty ye>s1 z he reg>d$ ! practice z always frightful1 & (t5times unnecess>y & p]nici\s4 ,b x is difficult to subv]t an e/abli%$ mode ( practice1 h[ev] uns\nd1 & probably "s ( y1 )\t mu* reflection1 because y h he>d ?is recomm5d$1 w pass up ! h& into ! cavity ( ! ut]us aft] ! expulsion ( ! plac5ta1 on ! v fir/ occasion t y h an opportunity ( do+ s1 remove all ! coagula1 & rub ! inn] surface ) ! fi/ till y are tir$1 )\t effect4 ,i h se5 cases repeat$ly :]e ?is has be5 dilig5tly p]=m$ by ^? :o _h neglect$ to apply ! pad & b9d]1 & all ! o!r means n[ describ$4 ,if y pass ! h& at all )9 ! p>ts1 :i* ,i /rongly suspect y w d1 let me entreat y to c>ry x no f>!r ?an ! os ut]i1 :i* y may1 ) mu* less risk & ) great] effect1 press & rub ) ! f+]s & irritate ?an ! inn] surface ( ! body & fundus ( ! ut]us4 ,mauriceau recomm5ds t wom5 :o are subject to flood+ aft] deliv]y %\ld be bl$ twice or ?rice f ! arm dur+ pregnancy1 & once1 or (t5]1 aft] labor has comm5c$4 ,!re are cases ( ut]9e hemorrhage aft] ! deliv]y ( ! *ild & expulsion ( ! plac5ta unconnect$ altoge!r ) ! ple?ora1 or an excit$ /ate ( ! he>t & art]ies1 & :]e ble$+ & l[ diet d n prev5t ! accid5t4 ,ruptur+ ! membranes at ! v comm5cem5t ( labor is by f> ! be/ rem$y1 ! only ?+ inde$ ^u :i* any dep5dance c be plac$4 ,aft] attacks ( ut]9e hemorrhage1 ! pati5t %\ld n be rais$ f ! horizontal position = sev]al h\rs1 & ! /r5g? %\ld be support$ by w9e1 beef-tea1 & light n\ri%m5t4 ,br&y 9 gruel sometimes agrees :5 w9e is reject$4 ,a good l>ge dose ( ! liquor opii s$ativus (t5 produces ! mo/ decid$ b5efit aft] ! hemorrhage has ceas$2 !re are few cases be=e ?is 9 :i* opium does good1 ?\gh x is con/antly giv5 9 all ! v>ieties ( flood+1 ev5 :5 ! great object is to excite ut]9e action4 ,:]e recov]y is to take place aft] ut]9e hemorrhage1 says ,dr4 ,m4 ,hall1 ! pallor ( ! c\nt5ance1 ! disposition to syncope1 ! coldness ( ! extremities1 ! feeble /ate ( ! pulse1 & un9t]rupt$ respiration1 pass gradually away4 ,:]e ! case is to t]m9ate fatally1 ! symptoms gradually assume a m al>m+ aspect1 ! c\nt5ance becomes pale & sunk1 ! respiration /]tor\s1 & ! pulse _c be felt at ! wri/4 ,!re is great re/lessness1 & be=e dea? "o or m fits ( convulsions sometimes occur4 ,:]e recov]y takes place1 9 "s wom5 x is a/oni%+ h[ little p]man5t inconv5i5ce is felt f ! great loss ( blood :i* !y h su/a9$4 ,9 ! c\rse ( t5 days or a =tnight ! effects h entirely disappe>$2 & ?is is ! mo/ common result4 ,9 "s wom51 a viol5t det]m9ation ( blood takes place to ! bra91 m>k$ by heat1 /rong pulsations ( ! c>otid & temporal art]ies1 intol]ance ( light1 & all ! symptoms ( inflammation ( ! bra9 or its membranes4 ,a /rong febrile attack is also sometimes exp]i5c$1 )\t an increas$ det]m9ation ( blood to any p>ticul> organ4 ,^! affections ( ! bra9 & n]v\s sy/em are aggravat$ by depletion4 ,! pati5t %\ld be kept 9 a cool1 d>k room1 & mild ca?>tics1 anodynes1 & antispasmodics1 occasionally giv54 ,:]e !re is mu* heada*e & ?robb+1 a few lee*es %\ld be appli$ to ! temples1 & a cold lotion to ! scalp4 ,^! rem>ks ( ,dr4 ,lee1 z to ble$+ frequ5tly mak+ ! aft] symptoms worse1 %\ld be c>efully borne 9 m9d4 ,!re is no d\bt b t too copi\s1 or too frequ5t ble$+1 dur+ pregnancy or labor1 disposes ! female to _m s]i\s dang]s aft]w>ds4 ,i h kn[n "s suff] con/ant heada*e1 dizz9ess1 & loss ( memory1 = weeks aft] f x2 & o!rs h ev5 be5 made light head$4 ,to ! above rem$ies ,i w\ld only app5d "o o!r1 :i* has1 on _m occasions succe$$1 :5 all o!rs h fail$1 namely ,galvanism4 ,?is has1 at ! la/ mom5t1 :5 ! female 0 s9k+1 br\ght on ut]9e contractions1 /opp$ ! flood+1 & sav$ h] life4 ,! application is v simple2 "o pole be+ plac$ on ! back1 imm$iately betwe5 ! hips1 & ! o!r ov] ! ut]us4 ,or "o ( ! poles may be coat$ ) wax1 all b ! end1 & introduc$ into ! vag9a1 s t ! unwax$ "p may t\* ! m\? ( ! womb1 :ile ! o!r is plac$ ov] ! fundus1 or on ! back1 z f\nd mo/ effici5t4 ,! p[] %\ld be suffici5tly /rong to produce contraction1 & ! application mu/ be cont9u$ till ! contraction rema9s aft] ! pole is )drawn4 ,no m$ical man %\ld give any female up :o is flood+1 no matt] h[ sev]ely1 till he has tri$ ,galvanism4 ,9 my ,neuropa?y & ,practical ,facts w be f\nd _m cases1 ) su* pla9 directions t any "o c\ld foll[ !m & apply x4 ,! pres5tation ( ! plac5ta1 or its gr[? ov] ! m\? ( ! womb1 is ! mo/ s]i\s cause ( flood+1 & g5]ally makes any attempt to *eck x ( no avail1 except deliv]y4 ,! dis*>ge h[ev] ne>ly always occurs be=e ! full p]iod1 & ei!r causes misc>riage or necessitates premature deliv]y4 ,dr4 ,lee rem>ks3 ,9 ! great] numb] ( cases ( plac5tal pres5tation ! dis*>ge ( blood takes place spontane\sly 9 ! sev5? & eigh? mon?s ( pregnancy1 & _c be ref]r$ ei!r to bodily ex]tion1 ext]nal viol5ce1 nor to any unusual det]m9ation to ! ut]9e organs1 or conge/ion ( _! vessels4 ,! hemorrhage g5]ally comes on sudd5ly1 :5 ! woman is 9 a /ate ( re/1 & ! blood cont9ues to fl[ until fa9tness or ev5 syncope takes place4 ,x (t5 ceases entirely1 & ! pati5t resumes h] usual occupations1 & has no dread ( ano!r attack4 ,b aft] an int]val ( sev]al days1 & sometimes n be=e two or ?ree weeks1 ! flood+ is r5ew$1 & p]haps ) increas$ viol5ce1 or a con/ant pr(use dis*>ge takes place1 & a decid$ effect is produc$ ^u ! con/itution1--! pulse becomes rapid & feeble1 & ! c\nt5ance pale4 ,simil> attacks return at long] or %ort] int]vals1 & if deliv]y be n accompli%$ by art1 soon] or lat] dea? takes place4 ,! fir/ attack ( flood+ seldom proves fatal1 b x sometimes does s2 = 9 ! second case relat$ 9 ! table1 :i* occurr$ 9 ! ,briti% ,ly+-9 ,hospital1 ! life ( ! pati5t 0 at once ext+ui%$ by a s+le gu% ( blood f ! ut]us4 ,i exam9$ ! body aft] dea?4 ,! c5tre ( ! plac5ta 0 ov] ! c5tre ( ! os ut]i4 ,:5 flood+ takes place to an al>m+ ext5t 9 ! sev5? or eigh? mon?s ( ge/ation1 y ought fir/ to asc]ta91 by a c>eful int]nal exam9ation1 :e!r or n ! plac5ta be situat$ at ! os ut]i4 ,x is impossible1 f ! mann] 9 :i* ! dis*>ge ( blood takes place1 to be c]ta9 ( ! fact2 = !re are "s cases ( hemorrhage f deta*m5t ( ! plac5ta f ! upp] "p ( ! ut]us1 :]e ! flood+ occurs spontane\sly1 & to z great an ext5t z 9 cases :]e ! plac5ta pres5ts4 ,9 "s cases ,i h be5 induc$1 f ! symptoms1 to believe t ! plac5ta 0 at ! os ut]i :5 x 0 n4 ,z ! treatm5t & ! successful or fatal result ( ! case w1 9 a great measure1 dep5d on ! correctness ( ! diagnosis1 ! exam9ation %\ld be conduct$ ) s mu* c>e & circumspection z to leave no room = d\bt on ! subject4 ,an ord9>y exam9ation1 ) ! =e & middle f+]s1 is g5]ally suffici5t to enable u to asc]ta9 ! true /ate ( ! case1 b :]e ! os ut]i is v high up1 & direct$ backw>ds1 x becomes requisite to introduce ! :ole h& )9 ! vag9a4 ,! f+] %\ld !n be pass$ g5tly ?r\gh ! os ut]i1 &1 if ! plac5ta adh]es to ! c]vix1 x w be di/+ui%$ f coagulat$ blood1 ! only sub/ance ) :i* x c be conf\nd$1 by its firm]1 fibr\s1 vascul> /ructure1 &1 above all1 by its adh]+ at "o "p to ! ut]us1 & be+ sep>at$ at ano!r4 ,if y w take ! tr\ble to pass ! f+] c>efully & repeat$ly ov] ! ut]9e surface ( a rec5tly expell$ plac5ta1 y w nev]1 9 actual practice1 mi/ake a plac5ta at ! os ut]i = a clot ( blood1 h[ev] firm4 ,9 all cases x is requisite to proce$ at once to det]m9e by an exam9ation1 s c>efully conduct$ z to r5d] a mi/ake impossible1 :e!r or n ! plac5ta pres5ts--ev5 ?\gh ! hemorrhage %\ld be slightly r5ew$ by ! displacem5t ( ! coagula2 y _c be too e>ly acqua9t$ ) ! precise condition ( ! pati5t4 ,y ought1 at ! same "t1 to asc]ta9 :e!r ! plac5ta adh]es p>tially or completely to ! c]vix ut]i1 & :e!r ! os ut]i is 9 a condition to admit ( ! op]ation ( turn+ be+ p]=m$4 ,! op]ation ( turn+1 :i* is requir$ 9 all cases ( complete plac5tal pres5tation1 is n necess>y 9 ! great] numb] ( cases 9 :i* ! edge ( ! plac5ta pass+ into ! membranes c be di/9ctly felt ?r\gh ! os ut]i4 ,sometimes !re is pr(use & dang]\s hemorrhage :]e ! plac5ta does n adh]e all r\nd to ! neck ( ! ut]us1 b only p>tially4 ,if ! os ut]i is n mu* dilat$ or dilatable1 ! be/ practice 9 ^! cases is to rupture ! membranes1 to excite ! ut]us to contract vigor\sly1 by ! b9d]1 ergot1 & all o!r means1 & to leave ! case to nature3 by adopt+ ?is treatm5t ! op]ation ( turn+ may be avoid$ ) advantage 9 ! great] numb] ( cases ( p>tial plac5tal pres5tation4 ,b1 if ! hemorrhage is pr(use1 has return$ at diff]5t int]vals1 & a great quantity has be5 lo/1 & ! con/itution is really affect$1 x is ! safe/ practice at once1 if ! orifice ( ! ut]us is 9 a condition to all[ ! h& to pass )\t difficulty1 to deliv] by turn+ ! *ild4 ,:]e ! plac5tal pres5tation is complete1 ! op]ation ( turn+ %\ld be p]=m$1 9 all cases1 z soon z ! orifice ( ! ut]us is s mu* dilat$ or dilatable z to all[ ! h& to be introduc$ )\t ! employm5t ( mu* =ce4 ,x is seldom safe to attempt to deliv] by turn+ be=e ! os ut]i is s f> dilat$ t y c easily introduce ! po9ts ( ! f\r f+]s & ?umb )9 x3 h[ev] s(t & relax$ x may be1 until dilatation has comm5c$1 & proce$$ s f>1 ,i am conv9c$ !re are v few cases 9 :i* ! op]ation ( turn+ w be requir$1 or complet$ )\t ! risk ( inflict+ "s injury on ! os ut]i4 ,?is is a po9t ( ! greate/ practical importance1 b ,i d n "k 9 :at mann] to communicate to y1 9 words1 a m cle> & def9ite idea ( ! gr\nds ^u :i* y ought to proce$4 ,9 e case1 be=e attempt+ to turn1 make a mo/ c>eful exam9ation ( ! os ut]i1 & endeavor1 f ! degree ( dilatation1 & ! ?9ness & s(tness ( ! orifice1 to =m a correct judgm5t ^u ?is po9t1 be=e int]f]+1 = ! hemorrhage w be r5ew$ if ! attempt is unsuccessful1 & ! pati5t w be plac$ 9 a worse condition ?an %e 0 be=e4 ,:5 y h resolv$ to turn1 let ! pati5t lie on ! left side1 ) ! pelvis close to ! edge ( ! b$1 & introduce ! "r h& into ! vag9a z be=e describ$1 & !n pass ! f+]s & h& g5tly & sl[ly 9 a conical =m ?r\gh ! os ut]i1 giv+ x "t to dilate1 & onw>d into ! cavity betwe5 ! deta*$ portion ( ! plac5ta & ! ut]us3 !n =ce ! f+]s ?r\gh ! membranes1 grasp bo? feet1 & br+ !m d[n into ! vag9a1 & sl[ly extract ! *ild z 9 ! cases ( nates pres5tation1 & d n aft]w>ds be 9 a hurry to remove ! plac5ta1 unless x is :olly deta*$ & ly+ 9 ! upp] "p ( ! vag9a4 ,?is op]ation is easily & spe$ily p]=m$ :5 ! os ut]i is widely dilat$ & dilatable4 ,x is1 h[ev]1 a great exagg]ation ( ! facility ) :i* turn+ may be accompli%$ 9 ^! cases1 to repres5t x z a v simple process--l putt+ ! h& into ! coat-pocket & pull+ out y\r h&k]*ief4 ,at ! be/ x is a dang]\s op]ation1 & y c nev] tell ) c]ta9ty :e!r or n ! pati5t w recov] aft] its p]=mance1 h[ev] easily x may h be5 effect$4 ,b !re is n unfrequ5tly mo/ pr(use & al>m+ flood+ f complete plac5tal pres5tation1 :]e ! os ut]i is s ?ick1 rigid1 & undilatable1 t x is impossible to introduce ! h& into ! ut]us )\t produc+ c]ta9 mis*ief4 ,9 ?irte5 out ( ?irty-six record$ cases ! os ut]i 0 rigid & undilatable4 ,! tampon or plug has no p[] to re/ra9 ! hemorrhage 9 su* cases1 nor d ,i "k ( any o!r means--ei!r cold1 quietness1 or opium--:i* effectually h1 & x is sometimes absolutely necess>y "u su* circum/ances to deliv] by turn+1 be=e ! h& c possibly be introduc$ into ! ut]us )\t produc+ fatal contusion or lac]ation ( ! "p4 ,i h f\nd 9 sev]al ( ^! cases1 h[ev]1 t ! deliv]y may be safely accompli%$ by m]ely pass+ ! h& into ! vag9a1 & aft]w>ds ! =e & middle f+]s betwe5 ! ut]us & deta*$ portion ( ! plac5ta1 grasp+ ) !m ! feet1 :i* are g5]ally situat$ ne> ! os ut]i1 & draw+ d[n ! inf]ior extremities into ! vag9a1 & deliv]+4 ,i "k t ! inf]ior extremities may (t5 be br\ght d[n 9 ?is way :]e x is impossible to pass ! :ole h& ?r\gh ! os ut]i4 ,! same /ate ( ?+s may h[ev] result f o!r causes1 & a v diff]5t mode ( proce$+ may !n be ne$$1 z ! doctor v cle>ly %[s4 ,flood+ may take place 9 ! latt] mon?s ( pregnancy1 & dur+ labor1 :]e ! plac5ta does n adh]e to ! neck ( ! ut]us1 b to ! body or ! fundus1 & is deta*$ by "s ext]nal or int]nal cause4 ,! sep>ation ( ! plac5ta f ! upp] "p ( ! ut]us may be produc$ by viol5ce1 z bl[s1 falls1 pressure ov] ! hypoga/rium1 & %ocks ( v>i\s k9ds2 b x arises mu* m frequ5tly f int]nal causes1 ( :i* morbid /ates ( ! plac5ta1 & twi/+ ( ! umbilical cord once or (t5] r\nd ! neck ( ! *ild1 are ! mo/ common & obvi\s4 ,?is v>iety ( hemorrhage1 ?\gh usually t]m$ accid5tal1 c r>ely1 h[ev]1 be ref]r$ to accid5t4 ,sometimes ! flood+ occurs to a great ext5t )\t any assignable cause2 a l>ge portion ( ! :ole ( ! plac5ta1 :5 9 a heal?y condition1 be+ sudd5ly deta*$ f ! ut]us1 :5 ! pati5t has be5 expos$ to no ext]nal accid5t1 or injury ( any k9d1 & :5 no symptoms ( increas$ det]m9ation ( blood to ! ut]us h prec$$ ! attack4 ,:5 ?is happ5s a l>ge quantity ( blood is p\r$ out betwe5 ! plac5ta & ut]us1 a small portion ( :i* only at ! "t usually escapes f ! vag9a1 to indicate :at is go+ on )9 ! ut]us4 ,!re may be a great int]nal hemorrhage1 accompani$ ) ! ord9>y con/itutional effects result+ f loss ( blood--z fa9tness1 sickness1 or vomit+1 coldness ( ! extremities1 rapid feeble pulse1 hurri$ brea?+2 :5 !re is little or no dis*>ge f ! vag9a to excite al>m1 or to po9t out ! s\rce ( dang]1 :5 x is extreme4 ,x is f ! g5]al symptoms ( exhau/ion1 & by ! disagreeable s5se ( uneas9ess1 weight1 or di/5sion ( ! ut]us1 exp]i5c$1 & n f ! quantity ( blood :i* appe>s ext]nally 9 ^! cases1 t we are l$ to discov] ! true /ate ( ! pati5t--to suspect t int]nal hemorrhage is go+ on4 ,b mu* m frequ5tly only a small portion ( ! plac5ta is at fir/ deta*$1 & ! great] "p ( ! blood :i* is extravasat$ betwe5 x & ! ut]us sep>ates ! membranes1 & desc5ds by its weight to ! orifice1 & escapes ?r\gh ! vag9a4 ,9 all cases1 h[ev]1 ( ut]9e hemorrhage 9 ! latt] mon?s1 ! dang] _c be s accurately e/imat$ by ! quantity ( blood :i* appe>s ext]nally1 z by ! g5]al symptoms4 ,! portion ( plac5ta :i* is deta*$1 nev] re-unites to ! ut]us1 b :5 expell$ x is usually se5 cov]$ ) a d>k coagulum adh]+ to ! ut]9e surface4 ,:5 ! blood escapes 9 small quantity1 & !re are no labor pa9s pres5t1 & no disposition 9 ! os ut]i to dilate1 & ! con/itutional p[]s are n impair$1 an attempt %\ld be made to prev5t a return ( ! dis*>ge1 & ! occurr5ce ( labor pa9s4 ,= ?is purpose1 if ! pulse is full & frequ5t1 "s blood may be tak5 f ! arm1 & ! pati5t %\ld be kept 9 ! horizontal position1 surr\nd$ by cool air1 cold applications made ov] ! hypoga/rium1 & acetate ( lead & opium1 m9]al acids1 & o!r rem$ies t dim9i% ! =ce ( ! circulation & promote ! coagulation ( ! blood1 %\ld be tak5 int]nally4 ,! plug is "h totally inadmissible2 x c only conv]t an ext]nal into an int]nal hemorrhage4 ,b :]e ! flood+ occurs at fir/ pr(usely1 & is r5ew$ ev5 9 a mod]ate degree1 9 spite ( our ef=ts to *eck x1 ! cont9uance ( pregnancy to ! full p]iod _c be expect$2 x w be ( no avail to ble$ & adm9i/] int]nal rem$ies1 except = ! purpose ( *eck+ ! dis*>ge1 & ?us av]t+ ! imm$iate dang] until ! ut]us is empti$ ( its cont5ts4 ,! op]ation ( turn+1 :i* is requir$ 9 all cases ( complete plac5tal pres5tation1 is r>ely necess>y 9 ut]9e hemorrhage :]e ! membranes are felt at ! orifice4 ,9 a great proportion ( ^! cases1 :]e1 on mak+ an exam9ation1 y c feel ! smoo? membranes ext5d+ across ! neck ( ! ut]us1 ! flood+ w be arre/$1 & ! labor safely complet$1 if ! membranes are ruptur$1 ! liquor amnii dis*>g$1 & contractions ( ! ut]us excit$ by g5tle dilatation ( ! orifice1 & o!r appropriate means4 ,! only cases 9 :i* ?is treatm5t fails are ^? 9 :i* x has n be5 _h rec\rse to suffici5tly e>ly1 or :]e ! :ole or a l>ge portion ( ! plac5ta has be5 sudd5ly sep>at$ f ! ut]us1 & a great int]nal hemorrhage has tak5 place4 ,! ut]us w n contract effectually 9 ^! cases aft] ! membranes h be5 ruptur$2 ! pa9s1 in/ead ( becom+ /rong]1 become m & m feeble1 return at long] int]vals1 & dur+ ^! ! blood fl[s m pr(usely1 & dea? w\ld take place be=e deliv]y1 if ! *ild 7 n extract$ by ! =ceps1 crot*et1 or by ! op]ation ( turn+4 ,9 all cases1 !n1 ( ut]9e hemorrhage 9 ! latt] mon?s ( pregnancy1 & 9 ! fir/ /age ( labor1 :]e ! plac5ta does n pres5t1 & ! quantity ( blood dis*>g$ is s great z to r5d] deliv]y necess>y1 :]e x appe>s improbable t ! pregnancy c g on long] ) safety1 or to ! end ( ! n9? mon?1 rupture ( ! membrane ) ! nail ( ! =ef+] ( ! "r h&1 evacuate ! liquor amnii by hold+ up ! head ( ! *ild1 dilate v g5tly ! os ut]i ) ! =e & middle f+]s exp&$1 & occasionally make pressure ) ! f+]s ar\nd ! :ole orifice2 apply ! b9d]1 give ergot & /imulants1 & ! ut]us w1 9 all probability1 contract ^u its cont5ts1 & expel !m )\t fur!r tr\ble4 ,if ! hemorrhage %\ld1 h[ev]1 cont9ue aft] ! employm5t ( ^! means1 deliv]y mu/ be accompli%$ by ! =ceps1 craniotomy1 or by turn+1 accord+ to ! peculi>ities ( ! case4 ,9 wom5 :o are liable to attacks ( flood+ aft] ! expulsion ( ! *ild or plac5ta1 rupture ! membranes at ! comm5cem5t ( labor1 ev5 be=e ! os ut]i is mu* dilat$1 if ! pres5tation is natural1 & y w (t5 succe$ 9 entirely prev5t+ hemorrhage4 ,! recomm5dation to ble$ may be ) good reason object$ to1 at lea/ 9 ! great majority ( su* cases2 & ,i _c b ?9k t a timely & p]sev]+ use ( ! ord9>y rem$ies1 namely1 keep+ quiet1 us+ acid dr9ks1 & cold fom5tations to ! abdom51 w\ld d away ) any necessity = x at all4 ,i "q v mu* if ev] ble$+ really prev5t$ abortion f flood+1 & ,i _c b ?9k t x has (t5 br\ght x on soon]4 ,nev]!less1 if all o!r means fail to arre/ ! dis*>ge1 & !re are no decid$ objections to ! contr>y1 x might be cauti\sly tri$2 ?\gh ! policy ( tak+ m blood f a p]son :o is already los+ too mu*1 is n v evid5t4 ,i h (t5 kn[n ! mo/ sev]e flood+ /opp$1 m]ely by ! female ly+ on h] back1 dr9k+ pl5tifully ( lemonade1 & apply+ cold wet clo?s ov] ! abdom54 ,a small dose ( laudanum occasionally is also useful2 & complete re/ & tranquillity ( m9d is z indisp5sable z re/ ( ! body4 ,_m females flood & misc>ry m]ely f worry+ & frett+ !mselves1 & f passion1 or /rong excitem5t1 p>ticul>ly ( a c]ta9 k9d4 ,?is 9 %ort mu/ be c>efully avoid$1 & ! pati5t mu/ live /rictly z if a wid[4 ,?is accid5t is likely to occur 9 subsequ5t pregnancies1 at ne>ly ! same "t1 & %\ld !re=e be gu>d$ aga9/ by a c>eful avoidance ( all excitem5t1 or viol5t bodily ex]tion1 dur+ ! :ole "t4 ,keep+ ! b[els g5tly op51 & practis+ a regul> diet1 are also requisite4 ,a good support+ b&age is also ( frequ5t s]vice4 ,= mu* m valuable in=mation on ?is subject h[ev]1 ,i ref] to my "w on ,! ,diseases ( ,wom51 9 :i* x is fully treat$4 ,,*apt] ,,xxii4 ,,eclampsia1 ,,or ,,convulsions ,,dur+ ,,labor4 ,convulsions are to be look$ ^u z v s]i\s indications ( d]angem5t1 dur+ ei!r pregnancy or labor1 & are frequ5tly foll[$ by fatal results to bo? "m & *ild4 ,!y may be ( sev]al diff]5t k9ds1 epileptic1 hy/]ic1 or cataleptic1 ?\gh ! epileptic =m is mo/ common4 ,!y (t5 occur dur+ pregnancy1 b n usually be=e ! sev5? mon?1 ?\gh occasionally met ) mu* e>li]4 ,accord+ to obs]vations x appe>s t !re is n above "o case ( convulsions 9 six hundr$ deliv]ies4 ,! pr9cipal cause ( ?is disease appe>s to be ! /rong sympa?y betwe5 ! womb & o!r organs1 ow+ to :i* !y are cont9ually di/urb$ by ! *anges x und]goes4 ,c]ta9 temp]am5ts also dispose to x1 p>ticul>ly ! lymphatic1 & also dropsy1 rickets1 & o!r diseases4 ,/rong moral impressions may also h a pr$ispos+ effect1 su* z sudd5 frights1 joy or ang]1 & also acute pa91 or ! dread ( x4 ,9 mo/ cases1 & p>ticul>ly dur+ pregnancy1 ! convulsions are prec$$1 & indicat$1 by sev]e heada*e1 & spasm at ! /oma*1 ) dimness ( sight1 bright sp>ks be=e ! eyes1 buzz+ 9 ! e>s1 & p>tial difficulty 9 speak+4 ,occasionally h[ev] ! fit comes on q sudd5ly1 )\t any w>n+ :atev]4 ,!re are few exhibitions ( suff]+ m frightful ?an "o ( ^! attacks1 & none t call = m prompt & decid$ action4 ,9 g5]al females are p]fectly helpless :5 "o is attack$ 9 ?is way1 & in/ead ( be+ able & dispos$ to r5d] prop] assi/ance1 !y ei!r run away al>m$1 or fall into hy/]ics !mselves4 ,x is h[ev] ( ! utmo/ consequ5ce t ! suff]] %\ld be att5d$ to in/antly1 & !re=e e female %\ld "k :at to d 9 su* an em]g5cy1 at lea/ till bett] aid c arrive4 ,at ! fir/ comm5cem5t ( convulsions ! features become gradually fix$1 ! eyes are exp&$ & di/ort$1 ! brea? is drawn ) difficulty1 & all consci\sness appe>s to cease4 ,! body !n beg9s to twit*1 ! m\? op5s1 usually on "o side1 ! tongue protrudes1 ! head turns on "o side1 & ! blood ru%es to x & ! face 9 great quantities4 ,9 a %ort "t ! jaws close aga9 ) great =ce1 & ! tongue is bitt5 if prop] c>e has n be5 tak5 to prev5t x4 ,at la/ ! eyes began to tw9kle1 ! m\? moves z if ! pati5t 7 mutt]+1 & ! no/rils exp&2 ! arms are ?ru/ /raight d[n by ! sides ( ! body1 ) ! h&s firmly clos$2 ! legs are /iff5$ /raight out1 & ! body is b5t back l a b[4 ,9 %ort e muscle is affect$ ) spasms1 :i* are sometimes fe>fully viol5t1 & may endure = a consid]able "t4 ,:5 !y subside1 ! fit gradually t]m9ates & passes (f4 ,dur+ ! :ole "t ! brea?+ is difficult1 ! m\? fro?s v mu*1 & ! he>t palpitates quickly1 b irregul>ly4 ,:5 ! spasm is ov] ! pati5t falls into a p]fect /upor1 dur+ :i* %e rema9s unconsci\s1 b ) all ! limbs s(t & moveable1 except ! f+]s1 :i* appe> to grasp4 ,! jaws g5]ally rema9 clos$1 & s d ! eyes1 b !y may be easily op5$1 & w sometimes rema9 op52 ! brea?+ becomes p[]ful & l\d1 & ! pulse beats ) rapidity4 ,at la/ slight motions are obs]v$1 & consci\sness gradually returns1 b ! memory is g5]ally gone = "s "t4 ,?is /ate ( /upor usually la/s f t5 m9utes to half an h\r1 b has be5 kn[n to cont9ue = _m h\rs1 or ev5 a :ole day4 ,! spasm seldom cont9ues m ?an f "o to t5 m9utes1 ?\gh x has la/$ = an h\r or m4 ,^! convulsions might be mi/ak5 = ord9>y hy/]ia by ^? n acqua9t$ ) ! diff]5ce4 ,9 hy/]ia h[ev] ! female moves ab\t & /ruggles m2 %e also cries out1 & reta9s bo? s5sibility & consci\sness1 s p]fectly ev5 sometimes t %e reque/s ^? ar\nd to hold h]1 :i* is nev] ! case 9 convulsions4 ,dur+ ! /upor x might be suppos$1 by any "o n aw>e ( ! previ\s fit1 t ! pati5t 0 suff]+ f apoplexy1 or intoxication1 ! appe>ance be+ s simil> to t exhibit$ 9 ^? /ates4 ,?is %[s ! necessity = c>eful inquiries z to :at has previ\sly occurr$4 ,dur+ pregnancy convulsions g5]ally cause abortion1 ei!r by br++ on ut]9e contractions or by caus+ ! dea? ( ! *ild4 ,"s few pati5ts h suff]$ f !m h[ev]1 & yet gone _! full "t1 b ?is mu/ nev] be expect$4 ,a gradual ext9ction ( ! vital sp>k1 dur+ ! /upor is ! ord9>y t]m9ation1 ?\gh sudd5 dea? is n unfrequ5t1 dur+ ! fit4 ,gradual recov]y is occasionally witness$1 b seldom )\t p>tial loss ( memory1 or "s o!r affliction4 ,madame ,la*apelle says t "o-half ( ! females attack$ ) convulsions die1 & ( _! *ildr5 _m m4 ,!re is no d\bt b t ! t5d5cy to ?is fe>ful affliction may be v mu* less5$ 9 _m females1 by prop] att5tion to diet & regim54 ,^? :o are ( a full habit1 & dispos$ to heada*e1 & ru% ( blood to ! head1 %\ld live l[1 & c>efully avoid ev]y?+ ( a heat+ or /imulat+ "*1 & also e k9d ( excitem5t or agitation4 ,! b[els %\ld be kept free1 & ! sk9 well rubb$ & kept w>m1 & ! head cool4 ,treatm5t4--,:ile ! pati5t is 9 ! fit1 c>e mu/ be tak5 t %e does n fall (f ! b$1 or bite h] tongue1 to prev5t :i* ! jaws mu/ be kept ap>t1 by putt+ some?+ betwe51 z a piece ( s(t wood1 or ! h&le ( a spoon cov]$ ) clo?1 or ev5 a knott$ napk94 ,! face %\ld be spr9kl$ ) cold wat]1 & ! :ole body well *af$1 p>ticul>ly ! h&s & feet1 :i* %\ld also be made w>m z soon z possible4 ,z soon z ! spasm is ov] x is cu/om>y to ble$1 ei!r at ! arm1 or by lee*es to ! temples & beh9d ! e>s4 ,mu/>d p\ltices %\ld also be appli$ to ! feet1 & inside ! ?ighs1 & an enema %\ld be giv5 ( w>m wat] & a table-spoonful ( salt4 ,ice1 or cold wat]1 %\ld be appli$ to ! head con/antly1 & if possible ! body %\ld be imm]s$ 9 a hot ba?1 :i* w1 9 _m in/ances1 br+ ! pati5t r\nd imm$iately )\t any o!r treatm5t4 ,! bladd] %\ld be also look$ to1 z well z ! b[els1 & if necess>y ! ca!t] %\ld be us$4 ,z soon z %e c swall[ a few drops ( laudanum may be giv51 or a little e!r1 b n a full dose by any means4 ,! propriety ( ble$+1 ev5 9 ^! cases1 is d5i$ by _m1 & ,i am almo/ incl9$ to ?9k myself1 t a prompt & p]sev]+ use ( ! o!r rem$ies m5tion$1 w\ld be fully z successful )\t x4 ,at all ev5ts1 ! fe>ful mortality 9 spite ( x proves t x has n mu* p[]1 & may well raise a d\bt ( its utility4 ,convulsions h[ev] are s fe>ful & viol5t1 t few practition]s c resi/ ! temptation to ble$1 because x seems s well calculat$ to give prompt relief2 & besides x has popul> prejudice 9 its favor4 ,"s au?ors h[ev] ass]t t x makes ! dang] great] ( p>alysis1 & loss ( memory1 aft]w>ds4 ,:5 convulsions occur dur+ pregnancy !y seldom cease entirely till ! ut]us is empti$ ( its cont5ts4 ,x is !re=e necess>y to br+ on labor1 & t]m9ate x z soon z possible1 aft] ! p>ts are 9 a prop] condition4 ,:5 !y occur dur+ labor x mu/ also be f9i%$ 9 ! %orte/ "t possible1 to af=d ! be/ *ance ( sav+ ! *ild1 & also because no treatm5t w prev5t ! attack :ile ! pati5t rema9s undeliv]$4 ,all means ( br++ on dilatation ( ! m\? ( ! womb1 m5tion$ 9 ! article on ,rigidity1 may be resort$ to1 except+ ,ergot1 :i* %\ld nev] be us$ 9 ^! cases4 ,m4 ,*ailly tells u1 t 9 ?irte5 cases ( convulsions n9e 7 fir/ pregnancies1 & sev5 ( ! females 7 dropsical4 ,only "o 0 attack$ dur+ pregnancy1 t5 :ile 9 labor1 & two aft]4 ,only two di$1 & t5 ( ! *ildr54 ,x is wor?y ( rem>k t :]e pregnant females h _h convulsions1 app>5tly f liv+ too high1 ! *ildr5 h also _h !m aft] deliv]y4 ,,*apt] ,,xxiii4 ,,rupture ,,( ,,! ,,womb ,,or ,,vag9a4 ,rupture ( ! womb arises f v>i\s causes1 b mo/ usually f p[]ful contractions :5 ! pelvis is small1 or ! ftus l>ge1 or :5 x pres5ts unfavorably4 ,x n unfrequ5tly results also f =ce be+ us$1 p>ticul>ly ) in/rum5ts4 ,9 fact !re is no d\bt b t num]\s females die f ?is accid5t1 br\ght on by ! viol5ce1 ha/e1 & want ( skill ( _! att5dants4 ,few injuries are m s]i\s1 or m beyond ! rea* ( any rem$y ?an ?is1 ?\gh x is sometimes suff]$ ) impunity4 ,! symptoms ( rupture ( ! womb are /rongly m>k$1 & fe>fully evid5t4 ,:5 x occurs1 :i* is mo/ usually dur+ a p[]ful contraction1 ! female %rieks1 & in/antly compla9s ( an agoniz+ pa9 ov] ! seat ( ! rupture2 h] face gr[s deadly pale1 h] pulse falls1 & %e fa9ts4 ,9 g5]al dea? is almo/ in/antane\s1 ?\gh sometimes life may be pres]v$ = an h\r or two1 b v seldom4 ,!re h ev5 be5 cases ( recov]y1 b !y are v few1 & reg>d$ almo/ z miracles4 ,9 mo/ cases1 directly ! rupture happ5s ! ftus escapes ?r\gh ! r5t into ! abdom51 & mo/ ( ! fluid ) x2 b sometimes x /ill rema9s 9 ! womb1 & !n if ! liquor amnii is dis*>g$ !re may little or no?+ pass ?r\gh ! op5+1 & ! dang] w be mu* less5$ 9 consequ5ce4 ,9 all cases ! only proce$+ :i* (f]s any *ance ( recov]y is1 to deliv] z soon z possible1 because :5 ! ftus is expell$ ! ut]us beg9s to contract1 s z to close ! w\nd1 & :5 t is effect$1 if b little fluid has pass$ into ! cavity ( ! abdom51 all may yet g well4 ,x may frequ5tly happ51 :5 ! h& is pass$ into ! womb1 to turn & deliv]1 t no?+ c be f\nd1 ! ftus hav+ pass$ ?r\gh ! op5+ into ! abdom9al cavity1 9 :i* case ! h& mu/ be pass$ ?r\gh ! op5+ also1 & ! ftus be br\ght back if possible4 ,if h[ev] ! r5t is too mu* clos$1 or ! *ild _c be rea*$1 ! ,ces>ean op]ation is ! only resort4 ,m4 ,p4 ,dubois tells u ( a case ( ?is k9d :i* occurr$ 9 8 own practice4 ,! female _h only be5 9 labor ab\t an h\r :5 %e utt]$ a pi]c+ cry1 & sank z if sudd5ly mortally w\nd$4 ,! head ( ! *ild1 :i* 0 previ\sly at ! m\? ( ! womb1 c\ld n be felt1 & on introduc+ 8 h& ,m4 ,dubois f\nd its feet 7 pass$ ?r\gh ! op5+ into ! "m's abdom52 he br\ght !m back h[ev]1 & effect$ deliv]y by turn+ ) comp>ative ease4 ,/range to say ?is woman 0 dis*>g$ cur$1 9 fifte5 days aft]1 ?\gh ! ut]us 0 s torn t ! inte/9es _h =c$ !mselves ?r\gh ! op5+ into its cavity1 & ,m4 ,d4 put !m back ) 8 h&1 :i* also pass$ cle> into ! p]itoneal cavity4 ,9 all cases1 aft] ! deliv]y is effect$1 ! womb %\ld be aga9 explor$1 s t if any p>ts h come ?r\gh !y may be return$ be=e ! op5+ closes1 :i* x may d v soon4 ,cases are ev5 m5tion$ :]e ! *ild pass$ cle> out ( ! womb into ! abdom9al cavity1 & rema9$ !re till absorb$1 or escap$ ?r\gh a fi/ul\s op5+ _m ye>s aft]2 :ile ! w\nd heal$ up1 & o!rwise ! pati5t p]fectly recov]$4 ,recov]y h[ev]1 9 any way1 is a r>e occurr5ce4 ,"s females seem m dispos$ to ?is accid5t ?an o!rs2 possibly f a peculi> t5d]ness 9 ! sub/ance ( ! womb4 ,all are h[ev] liable to x1 & ?is liability %\ld beget a prop] caution 9 all manipulations1 & =bid uncall$ = viol5ce 9 any way4 ,rupture ( ! vag9a is mu* less s]i\s ?an rupture ( ! womb1 unless x occurs at ! upp] "p1 :5 x may give rise to simil> symptoms & results4 ,at ! l[] "p ! dang] is mu* less1 ?\gh /ill suffici5t to excite appreh5sion4 ,! treatm5t is ! same z 9 ! =m] case4 ,deliv]y mu/ be effect$ z soon z possible1 & ! pati5t kept /ill & cool to avoid inflammation4 ,x is g5]ally ?\ght t ! great] "p ( ^! accid5ts result f improp] treatm5t1 & p>ticul>ly f us+ in/rum5ts4 ,,section ,,viii4 ,,op]ations ,,) ,,! ,,h& ,,& ,,) ,,in/rum5ts4 ,,*apt] ,,xxiv4 ,,op]ations ,,) ,,in/rum5ts4 ,! use ( in/rum5ts 9 effect+ deliv]y is a la/ resort to save life1 & ought to be intru/$ only to p]sons ( skill2 x may !re=e be ?\ght unnecess>y to treat ( !m 9 ! pres5t "w1 & inde$ ,i %\ld n h done s b = ! purpose ( satisfy+ ! natural curiosity ( females !mselves4 ,! great] "p ( ! dread !y n[ exp]i5ce :]e in/rum5ts are ne$$1 arises f ignorance ( _! nature & mode ( action4 ,at ! pres5t "t ne>ly all ! in/rum5ts us$1 9 compet5t h&s1 are comp>atively safe & h>mless1 & if females g5]ally und]/ood h[ !y op]at$1 mu* less fe> w\ld be excit$ by _! use4 ,ye>s ago1 :5 cutt+ & te>+ in/rum5ts 7 employ$1 9 ne>ly e case ( difficulty1 ! lam5table results :i* foll[$ fully ju/ifi$ ! fe>s exp]i5c$1 b at ! pres5t day su* ?+s are seldom se51 except 9 m$ical museums1 ! same purpose be+ mu* bett] effect$ by simpl] & m h>mless app>atus4 ,i wi% !re=e simply to give a brief explanation ( ! /ructure1 & mode ( action1 ( ! in/rum5ts n[ *iefly employ$1 & to %[ ! ext5t ( _! application & ! results :i* h foll[$ f x4 ,,! ,,=ceps4 ,! =ceps are int5d$ to take hold ( ! ftus1 & assi/ u to draw x into ! _w :5 ! natural =ces are inadequate1 & no hold c be obta9$ by ! h&s4 ,!y 7 fir/ inv5t$ ab\t ! ye> #afej1 by an ,engli% surgeon nam$ ,*amb]l91 :o made a secret ( 8 inv5tion & realiz$ a l>ge =tune f x4 ,s9ce t "t !y h be5 modifi$ 9 v>i\s ways1 by diff]5t practition]s1 b /ill rema9 ess5tially ! same z :5 fir/ us$4 ,! mo/ usual =m1 & probably ! be/1 is t repres5t$ bel[3 ,illu/ration3 ,,plate ,l4 ,fig4 #a4 ,fig4 #b4 ,x consi/s ( two blades articulat$ by a button1 or screw jo9t1 s t !y c be easily sep>at$ & aga9 adju/$1--,fig4 #a4 ,ea* blade is cut out 9 ! middle1 & curv$1 z se5 9 ,fig4 #b4 ,! only "p to :i* ! =ceps are int5d$ to be appli$ is ! head1 to ! dim5sions & =m ( :i* !y are specially adapt$4 ,"s practition]s h us$ !m on ! bree*1 b ! practice is n g5]ally sanction$1 because !y seldom reta9 _! hold on ?is "p & are ne>ly sure to s]i\sly injure ! *ild :5 s appli$4 ,) prop]ly con/ruct$ =ceps1 rightly appli$ to ! head1 !re is b little dang] ei!r to ! "m or ! *ild2 b 9 ! h&s ( an unskillful or c>eless p]son ! consequ5ces ( _! use may be deplorable to bo?4 ,x is sc>cely necess>y to rem>k t ! =ceps are nei!r cutt+ nor cru%+ in/rum5ts1 b are simply int5d$ to lay hold1 l ! h& itself1 & enable u to draw d[n ! head1 or *ange its position4 ,mo/ usually !y are made long & curv$1 z %[n 9 ! above plate1 b sometimes !y are made mu* %ort] & /raight4 ,!y may be us$ ^u ! head :5 x is ei!r at ! upp] or ! l[] /raits1 or :ile x is 9 ! passage2 b on no acc\nt %\ld !y be appli$ till ! p>ts are fully dilat$1 & ev]y?+ indicates t ! *ild c pass4 ,?us !y %\ld nev] be us$ :5 ! head is too l>ge1 or ! pelvis too small1 nor :5 !re are tumors 9 ! way4 ,9 %ort no attempt %\ld be made ) !m to =ce ! ftus ?r\gh a passage :i* w n admit x by reasonable ef=ts4 ,m4 ,dubois says !y %\ld nev] be us$ :5 ! pelvic diamet] is less ?an ?ree in*es1 because ) su* dim5sions ! *ild is ne>ly c]ta9 to be cru%$ to dea?1 & ! "m c sc>cely escape s]i\s bruises & lac]ations4 ,9 l mann]1 if !y are ?ru/ into ! womb be=e ! m\? ( x is naturally dilat$ !y are sure to te> & injure x4 ,x is n necess>y "h to give directions = us+ ! =ceps 9 e v>iety ( pres5tation & position1 b simply to %[ ! mode ( apply+ !m z !y are mo/ frequ5tly requir$4 ,! two blades are adju/$ sep>ately1 "o to ea* side ( ! head1 & !n lock$ toge!r1 s t ! head is firmly inclos$ betwe5 !m1 b n cru%$4 ,dr4 ,d5man gives p]haps ! be/ & simple/ directions on ?is po9t1 & ,i !re=e quote f 8 "w4 ,! fir/ "p ( ! op]ation consi/s 9 pass+ ! =ef+] ( ! "r h& beh9d ! ossa pubis & ! head ( ! *ild to ! e>2 !n tak+ ! "p ( ! =ceps to be fir/ introduc$ by ! h&le 9 ! left h&1 ! po9t ( ! blade is to be sl[ly conduct$ betwe5 ! head ( ! *ild & ! f+] till ! in/rum5t t\*es ! e>3 !re c be no difficulty or haz>d 9 c>ry+ ! in/rum5t ?us f>1 because x w be guid$1 & 9 "s measure %ield$1 by ! f+]4 ,b ! fur!r introduction mu/ be made ) a sl[ semi-rotatory motion1 keep+ ! po9t ( ! blade n rigidly1 yet closely1 to ! head ( ! *ild1 by rais+ ! h&le t[>d ! pubes4 ,9 ?is mann] ! blade mu/ be c>ri$ g5tly along ! head till ! lock rea*es ! ext]nal p>ts ne> ! ant]ior angle ( ! pud5dum4 ,! po9t ( ! blade1 :ile introduc+1 sometimes hit*es ^u ! e> ( ! *ild1 & x !n requires a little elevation4 ,b :5 x has pass$ ! e>1 & is beyond ! guidance ( ! f+]1 %\ld !re be any *eck to ! introduction ei!r ( ?is or ! o!r blade1 x %\ld be )drawn a little1 to give u an opportunity ( discov]+ ! cause ( ! ob/acle1 :i* we mu/ nev] /rive to ov]come by viol5ce1 ?\gh we mu/ proce$ ) firmness4 ,:5 ! fir/ blade is prop]ly introduc$1 x mu/ be held /eadily 9 its place by press+ ! h&le t[>ds ! pubes1 & x w be a guide 9 ! introduction & application ( ! second blade4 ,let ! second blade be introduc$ 9 ?is mann]4 ,keep ! blade fir/ introduc$ 9 its place ) ! two less] f+]s ( ! left h&1 & c>ry ! =e-f+] ( ! same h& betwe5 ! p]9eum & head ( ! *ild z high z y c rea*4 ,!n take ! second blade ( ! =ceps by ! h&le 9 ! "r h&1 &1 convey+ ! po9t betwe5 ! f+] plac$ )9 ! p]9eum & ! head ( ! *ild1 conduct ! in/rum5t1 ) ! precautions be=e m5tion$1 s f> t ! lock %all t\* ! int]ior "p ( ! p]9eum1 or ev5 press x a little backw>ds4 ,9 ord] to fix ! two blades ?us introduc$1 t :i* 0 plac$ t[>ds ! pubes mu/ be sl[ly )drawn1 & c>ri$ s f> backw>ds t x c be lock$ ) ! second blade reta9$ 9 its fir/ position2 & c>e mu/ be tak5 t no?+ be entangl$ 9 ! lock1 by pass+ ! f+] r\nd x4 ,:5 ! =ceps are lock$1 x w be conv5i5t to tie ! h&les toge!r ) suffici5t firmness to prev5t !m f slid+ or *ang+ _! position :5 !y are n held 9 ! h&1 b n 9 su* a mann] z to increase ! compression ^u ! head ( ! *ild4 ,%\ld ! blades ( ! =ceps be introduc$ s z n to be opposite ea* o!r1 !y c\ld n be lock$2 or if1 :5 appli$1 ! h&les %\ld come close toge!r1 or be at a great di/ance f ea* o!r1 !y w\ld probably slip1 or !re w\ld be a failure ( "s k9d 9 ! op]ation1 z ! bulk ( ! head w\ld n be includ$1 or !y w\ld be fix$ on "s improp] "p ( ! head2 ?\gh all[ance is to be made = ! diff]5ce 9 ! size ( ! heads ( *ildr54 ,b if a case be prop] = ! =ceps1 if !y be well appli$1 & we 7 to act sl[ly ) !m1 !re w\ld n be mu* risk ( failure or disappo9tm5t4 ,! difficulty ( apply+ ! =ceps is mo/ frequ5tly occasion$ by attempt+ to apply !m too soon1 or by pass+ !m 9 a wrong direction1 or by entangl+ ! s(t p>ts ( ! "m betwe5 ! in/rum5t & ! head ( ! *ild1 aga9/ all :i* accid5ts we are to be on our gu>d4 ,:5 ! =ceps are fir/ lock$1 !y are plac$ backw>ds1 ) ! lock close to1 or j )91 ! int]nal surface ( ! p]9eum2 & !y c h no support backw>ds1 except ! little :i* is af=d$ by ! s(t p>ts4 ,! fir/ action ) !m %\ld !re=e be made by br++ ! h&les1 grasp$ firmly 9 "o or bo? h&s1 to prev5t ! in/rum5t f play+ ^u ! head ( ! *ild1 sl[ly t[>ds ! pubes till !y come to a full re/4 ,hav+ wait$ a %ort int]val ) !m 9 t situation1 ! h&les mu/ be c>ri$ back 9 ! same sl[ b /eady mann] to ! p]9eum1 ex]t+1 z !y are c>ri$ 9 ! diff]5t situations1 a c]ta9 degree ( extract+ =ce2 & aft] wait+ ano!r int]val1 !y are aga9 to be c>ri$ t[>ds ! pubes1 accord+ to ! direction ( ! h&les4 ,?r\gh\t ! op]ation1 especially ! fir/ "p1 ! action ( t blade ( ! =ceps orig9ally appli$ t[>ds ! pubes mu/ be /rong] & m ext5sive ?an ! action ) ! o!r blade1 ?is hav+ no fulcrum to support x1 & *iefly answ]+ ! purpose ( regulat+ ! action ( ! o!r blade4 ,if !re 7 any labor pa9s :5 ! op]ation 0 begun1 or %\ld !y come on 9 ! c\rse ( x1 ! =ceps %\ld only be act$ ) dur+ ! cont9uance ( ! pa9s2 ! int5tion be+1 n only to supply ! want or insuffici5cy ( ! pa9s1 b to foll[ !m1 & imitate also ! mann] 9 :i* !y return4 ,by a few repetitions ( ?is alt]nate action & re/ be=e describ$1 we %all soon be s5sible ( ! desc5t ( ! head2 & x w be prop] to exam9e v frequ5tly1 to "k ! progress made1 t we may n use m =ce ?an ne$ful1 nor g on ) m ha/e ?an may be exp$i5t or safe4 ,9 e case we ought to proce$ sl[ly & circumspectly1 n =gett+ t a small degree ( =ce1 cont9u$ = a long "t1 w 9 g5]al be equival5t to a great] =ce ha/ily ex]t$1 & ) inf9itely less detrim5t to ! "m or *ild4 ,b aft] "s "t1 %\ld we n p]ceive ! head to desc5d1 ! =ce hi!rto us$ mu/ be gradually increas$1 till x be suffici5t to ov]come ! ob/acles to ! deliv]y ( ! pati5t4 ,x 0 be=e obs]v$1 z ! head ( ! *ild desc5d$1 t ! face w\ld be accord+ly turn$ t[>ds ! holl[ ( ! sacrum1 )\t any aim or assi/ance on our "p4 ,( c\rse ! position ( ! h&les ( ! =ceps1 & ! direction 9 :i* we ought to act ) !m1 %\ld alt]2 = !y becom+ fir/ m diagonal or oblique ) respect to ! pelvis1 & !n m & m lat]al1 e *ange 9 _! position w require a diff]5tly direct$ action1 because ! h&les %\ld ev] be antagoni/s to ea* o!r4 ,9 proportion also to ! desc5t ( ! head ! h&les ( ! =ceps %\ld approa* ne>] to ! pubes2 s t1 9 ! beg9n+ ( ! op]ation1 ?\gh we act$ 9 ! direction ( ! cavity ( ! pelvis1 t[>ds ! conclusion we %\ld act 9 t ( ! vag9a4 ,:5 we feel t we h ! comm& ( ! head1 by its be+ cle>$ ( ! pelvis1 & ! ext]nal p>ts beg9 to be di/5d$1 we ought to act yet m sl[ly1 especially 9 ! case ( a fir/ *ild1 or !re w\ld be great dang] ( a lac]ation ( ! s(t p>ts2 & ?is c only be prev5t$ by act+ v delib]ately 9 ! direction ( ! vag9a--by giv+ ! p>ts "t to di/5d--by duly support+ ! p]9eum1 :i* is ! "p *iefly 9 dang]1 ) ! palm ( ! h&--by soo?+ & mod]at+ ! hurry & ef=ts ( ! pati5t--&1 9 "s cases1 by absolutely resi/+ = a c]ta9 "t ! passage ( ! head ?r\gh ! ext]nal p>ts4 ,illu/ration3 ,,plate ,,li4 ,! head be+ drawn ?r\gh a n>r[ ,pelvis by ! ,=ceps4 ,! mann] 9 :i* ! =ceps draw ! head is well %[n 9 ! above plate1 & also ! compression ( ! head itself1 :i* is se5 to be squeez$ almo/ to a po9t at its pres5t+ "p4 ,?is compression1 h[ev]1 is n likely to d s]i\s injury1 unless x be excessive4 ,! *ild may be convuls$ a little f x1 b usually recov]s1 & suff]s no?+ aft]w>ds4 ,x is m]ely necess>y to rem>k1 9 conclusion1 t ! =ceps %\ld nev] be us$ till x is manife/ly impossible = ! *ild to be born )\t !m2 & x %\ld be rememb]$ t nature alone frequ5tly effects deliv]y "u ! mo/ unfavorable circum/ances1 by giv+ h] "t4 ,we %\ld wait !re=e z long z ! safety ( ! "m w all[1 b nev] delay a mom5t :5 t safety is compromis$4 ,! accid5ts :i* h foll[$ f ! use ( ! =ceps are num]\s & t]rible1 & ,i c\ld give a mo/ horrify+ acc\nt ( !m if x 7 necess>y4 ,x mu/ be recollect$ h[ev]1 t ^! accid5ts h *iefly foll[$ f want ( skill 9 manag+ ! in/rum5t1 or f its be+ us$ "u improp] circum/ances4 ,x is true t !re is always m or less ( pa9 & injury to be dread$ f ! =ceps1 ev5 9 ! mo/ favorable cases1 & ) ! mo/ compet5t op]ators1 b ?is is no argum5t aga9/ _! employm5t altoge!r4 ,9 e case :]e !y are really call$ =1 ! female w\ld1 mo/ probably1 die undeliv]$1 or h to be cut op51 s t x is simply a *oice ( evils1 ( :i* ! =ceps are ! lea/4 ,! cases 9 :i* ! =ceps are absolutely necess>y h[ev]1 are ,,v ,,r>e1 mu* m s 9 fact ?an _m p suppose4 ,pati5ce1 & ! p]sev]+ use ( ord9>y assi/ance1 w\ld probably succe$ alone 9 half ! cases :]e !y are n[ employ$4 ,9 ,murphy's lectures on difficult ,labors1 he gives u "s valuable /ati/ics on ?is subject4 ,he tells u t 9 sev5ty-five ?\s& n9e hundr$ & elev5 labors1 ! =ceps 7 us$ only "o hundr$ & ?irty-eight times1 or once 9 e five hundr$ & fifty labors4 ,9 ^! "o hundr$ & ?irty-eight cases ?irty-five ( ! *ildr5 di$1 & t5 ( ! mo!rs4 ,dr4 ,murphy h[ev]1 ?9ks t ! g5]al results1 to bo? "m & *ild1 w\ld be equally favorable if ! =ceps 7 n us$ at all1 & he gives ! tables ( ,dr4 ,coll9s to support 8 op9ions4 ,f ^! tables x really appe>s t1 :5 all ! difficult labors 7 left entirely to nature1 ! numb] ( dea?s 0 j ab\t ! same z :5 ! =ceps are us$1 9 fact r less1 :ile ! accid5ts1 & subsequ5t evils1 7 n ne>ly s great4 ,dr4 ,m4 !re=e ?9ks t ! =ceps %\ld nev] be us$1 except 9 a few cases :]e ev]y?+ is q favorable to ! passage ( ! ftus2 & ! ut]us _c be made1 9 a reasonable "t1 to contract & expel x2 & also :5 imm$iate deliv]y is ne$$ to save ! "m's life1 z 9 flood+4 ,9 cases ( m]e ord9>y difficulty or delay1 he decries _! use entirely2 & he evid5tly ?9ks t :5 ! labor is fit to be t]m9at$ by ! =ceps1 nature c & w t]m9ate x h]self if left alone4 ,!re is no d\bt b t !y are n[ us$ a great deal too mu*1 ei!r f a desire to op]ate1 or f want ( pati5ce2 & ,i h no hesitation 9 express+ my op9ion t m h be5 kill$ ?an sav$ by !m4 ,,o!r ,,in/rum5ts4 ,respect+ o!r in/rum5ts1 su* z ! ,crot*et1 ! ,vectis1 & ! ,cephalotribe1 or cru%+ =ceps1 x is n necess>y to say any?+ "h1 z _! use1 :5 imp]atively ne$$1 mu/ necess>ily be conf9$ to ! surgeon2 & =tunately may n[ be disp5s$ ) altoge!r4 ,! rec5tly introduc$ practice ( br++ on premature labor1 9 all cases ( de=mity or smallness ( ! pelvis1 entirely obviates ! necessity = any ( ^! dreadful resorts1 if ! difficulty be kn[n 9 "t1 :i* x is sure to be :5 a suffici5t degree ( k is dissem9at$4 ,! ,ces>ian op]ation1 or cutt+ op5 ! womb ext]nally2 & ,cephalotomy1 or ! op5+ ( ! *ild's head1 may also be dismiss$ ) ! same obs]vations4 ,!y c always be avoid$1 if ! real condition ( ! pati5t is kn[n 9 "t2 & if f neglect no?+ else c be done1 !y mu/ always be p]=m$ by a skillful surgeon4 ,,*apt] ,,xxv4 ,,op]ations ,,) ,,! ,,h&4 ,,turn+4 ,?is is "o ( ! mo/ useful op]ations t ! acc\*eur c p]=m1 9 _m cases1 & has ! advantage ( be+ altoge!r accompli%$ by ! h&4 ,its object is to *ange ! pres5tation1 :5 unfavorable1 & to facilitate deliv]y4 ,mo/ usually ! h& is introduc$ into ! ut]us1 & ! feet are br\ght d[n4 ,?is is call$ pelvic v]sion2 b sometimes ! head is br\ght to ! m\? ( ! womb1 p>ticul>ly 9 %\ld] pres5tations1 & ?is is call$ cephalic v]sion4 ,cephalic ,v]sion4--,?is c seldom be p]=m$1 & n (t5 attempt$ ) safety4 ,9 "s cases h[ev]1 :5 x is asc]ta9$ t ! %\ld] pres5ts1 & be=e ! membranes are brok51 an ef=t may be made to remove x & br+ ! head 9 its place4 ,to d ?is ! position ( ! head mu/ be asc]ta9$ ext]nally1 & "o h& plac$ ^u x2 !n ) ! two =ef+]s ( ! o!r raise up ! %\ld] f )91 z 9 ballotm5t1 & endeavor to pu% ! head into its place4 ,if ! *ild be v moveable ?is may sometimes be done1 & w be highly advantage\s2 b mo/ frequ5tly ! sub/itution _c be accompli%$1 & ! attempt ruptures ! membranes1 aft] :i* x is /ill m difficult1 & ev5 becomes dang]\s4 ,ev5 if ! head be br\ght d[n !re is always dang] ( its becom+ displac$1 & ! %\ld] aga9 pres5t$1 ow+ to ! t5d5cy :i* any pres5tation has to be reproduc$4 ,to prev5t ?is ! h& %\ld be firmly press$ on ! ftus1 ext]nally1 z soon z ! head is br\ght d[n1 to fix x2 & ! membranes %\ld be ruptur$ s t x may beg9 to desc5d1 aft] :i* !re is no dang] ( a *ange4 ,cephalic v]sion c be s seldom p]=m$ h[ev]1 & is s difficult1 & sometimes dang]\s1 t x is seldom or nev] attempt$2 m p>ticul>ly z pelvic v]sion c always be sub/itut$1 & is m easy & safe4 ,x is true t pres5tations ( ! head are ! mo/ favorable1 provid+ !y occur be=e ! rupture ( ! membranes1 b aft] t ev5t !y may n be s favorable z ^? ( ! l[] extremities1 & c]ta9ly are n s easy or safe to induce4 ,pelvic ,v]sion4--,turn+ to br+ d[n ! feet is p]=m$ = v>i\s reasons1 & "u _m diff]5t circum/ances4 ,z a g5]al pr9ciple we may say t x is done ei!r to *ange ! pres5tation1 :5 unfavorable1 or to t]m9ate ! labor :5 x is l+]+1 or :5 x is desirable to h x ov] z quickly z possible4 ,! feet may be drawn ?r\gh ! m\? ( ! ,womb :5 x is b little op5$1 & :5 !y h once pass$1 ! limbs & body soon foll[1 & ! head seldom rema9s long beh9d4 ,! ftus may 9 fact be comp>$ to a w$ge1 ( :i* ! feet are ! po9t1 & if !y ent] ! passage ! re/ "p is gradually driv5 aft] by ! ut]9e contractions4 ,! *ief cont+5cies :i* call = ! op]ation ( turn+ are1 a protract$ labor1 a pres5tation ( ! plac5ta1 caus+ hemorrhage1 & a wrong pres5tation1 p>ticul>ly "o ( ! %\ld]4 ,! op]ation ( turn+ is v cle>ly expla9$ by ,dr4 ,lee1 & ,i "k f exp]i5ce t 8 directions c be safely reli$ ^u4 ,x v frequ5tly happ5s h[ev]1 t !re w be "s peculi> circum/ances 9 a case1 :i* w necessitate m or less *ange 9 ! mann] ( proce$+1 s t ! practition] mu/ aft] all be guid$1 to a great ext5t1 by ! requirem5ts & conditions !n exi/+4 ,dr4 ,lee's directions !re=e1 mu/ m]ely be consid]$ z g5]al ones1 to be modifi$ z occasion may require3-- ,:5 ! op]ation ( turn+ is requir$ be=e ! membranes are ruptur$1 & :5 ! orifice ( ! ut]us is widely dilat$1 & !re are long int]vals betwe5 ! pa9s1 x is accompani$ ) little difficulty & dang]4 ,hav+ expla9$ to ! pati5t & h] relatives ! nature ( ! case1 let h] lie on ! left side ne> ! edge ( ! b$1 ) ! knees drawn up to ! abdom54 ,sit d[n by ! side ( ! b$1 & quietly take (f y\r coat2 lay b>e y\r "r arm by turn+ up ! %irt above ! elb[1 & cov] ! back ( ! h& & ! :ole =e>m ) cold cream1 l>d1 or a solution ( soap4 ,introduce "o f+] aft] ano!r into ! vag9a1 & sl[ly & effectually dilate its orifice4 ,! h&1 9 a conical =m1 & 9 a /ate ( half sup9ation1 mu/ !n be press$ /eadily =w>d ) a semi-rotatory motion aga9/ ! p]9eum & sides ( ! passage1 till x cle>s ! orifice ( ! vag9a4 ,?is %\ld always be done v sl[ly & g5tly1 z x is accompani$ ) great pa94 ,let ! h& rema9 "s "t 9 ! orifice ( ! vag9a1 t x may be fully dilat$1 & (f] no resi/ance 9 ! subsequ5t /eps ( ! op]ation ( turn+4 ,:5 ! h& has dilat$ ! vag9a suffici5tly1 9 ! abs5ce ( pa9 g5tly ins9uate ! po9ts ( ! f+]s & ?umb into ! os ut]i 9 a conical =m2 & if x is n suffici5tly op5 to all[ ! h& to pass1 y mu/ proce$ next to use artificial dilatation "h also1 v g5tly & sl[ly1 always /opp+ z soon z a pa9 comes on1 b n )draw+ ! f+]s altoge!r at ! "t f ! os ut]i4 ,hav+ succe$$ 9 dilat+ ! "p )\t ruptur+ ! membranes1 slide ! h& up betwe5 ! membranes & ! ant]ior "p ( ! ut]us into ! cavity1 & grasp ! feet :5 ! membranes give way4 ,mo/ frequ5tly ! membranes bur/ z ! h& is ent]+ ! ut]us1 be=e x rea*es ! feet1 & ! liquor amnii ru%es out & is lo/1 if x is n prev5t$ by press+ ! h& =w>d firmly into ! orifice4 ,nev] be cont5t$ ) "o foot :5 x is possible to grasp bo?2 & ?is c always be done :5 ! liquor amnii has n escap$1 & ! ut]us is n closely contract$ r\nd ! body ( ! *ild4 ,seize bo? feet & legs1 & :5 !re is no pa91 draw !m d[n into ! vag9a2 & z ! nates desc5d ?r\gh ! os ut]i1 ! %\ld] & arm w gradually rec$e or be retract$1 & w (f] no ob/acle to ! rema9+ "p ( ! op]ation1 :i* %\ld be complet$ z if ! nates & inf]ior extremities _h orig9ally pres5t$1 & :i* has already be5 v fully describ$4 ,9 actual practice1 except 9 tw9 cases1 ! membranes h be5 ruptur$ & ! liquor amnii is gone1 9 a great proportion ( cases--9 ab\t t5 to "o--long be=e we are call$ ^u to deliv] by turn+1 & ! op]ation is !n a mu* m s]i\s affair4 ,sometimes1 :5 ! os ut]i is half dilat$1 !re is an int]val ( fre$om f pa9 = sev]al h\rs aft] ! rupture ( ! membranes1 & p>tial escape ( ! liquor amnii4 ,"h x is advisable to turn )\t delay2 & ! h& c be pass$ up into ! ut]us & ! feet br\ght d[n ) little m difficulty ?an if ! membranes _h n be5 ruptur$4 ,! op]ation ( turn+ is h[ev] beset ) _m difficulties1 & unless ! conditions = x are v favorable1 & ! op]ator skillful1 x may cause great] mis*ief ?an x is int5d$ to rem$y4 ,! probability is1 z 9 ! case ( o!r op]ations1 t x w\ld seldom or nev] be ne$$ if prop] means 7 us$ 9 "t1 & p]sev]+ly2 & x is yet a "q :e!r ! prospect1 = bo? "m & *ild1 w\ld n be m favorable if ! deliv]y 0 always left to nature1 9 ^? cases :]e v]sion is n[ attempt$4 ,dr4 ,coll9s says1 ,z to turn+1 ! risk to ! "m is1 9 ! majority ( cases1 s great z to =bid its employm5t1 nor d ,i ?9k ! practition] ju/ifi$ by ! circum/ances 9 s greatly haz>d+ 8 pati5t's life4 ,,"p ,,ii4 ,,! ,,diseases ,,( ,,wom5 ,,dur+ ,,pregnancy1 ,,& ,,9 ,,*ild-,,b$4 ,wom5 are liable dur+ pregnancy1 & aft] *ildbir?1 to mo/ ( ! diseases :i* afflict !m at o!r times1 & also to _m d]angem5ts peculi> to ^? p]iods4 ,z a g5]al rule ei!r ( ^? conditions some:at modifies ! disease1 & also necessitates c]ta9 diff]5ces 9 its treatm5t4 ,my =m] "w on ! ,diseases ( ,wom5 hav+ treat$ on all ^? affections common to e o!r p]iod1 ,i %all 9 ?is conf9e myself *iefly to ^? peculi> to ! two conditions ref]r$ to2 giv+ _! causes1 symptoms1 & treatm5t1 ) practical h9ts = _! prev5tion4 ,,section ,,ix4 ,,! ,,diseases ,,( ,,pregnancy4 ,! diseases :i* are f\nd dur+ pregnancy are ( two k9ds2 ! fir/ k9d call$ ,sympa!tic1 or n]v\s1 consi/ ( v>i\s d]angem5ts ( diff]5t p>ts ( ! sy/em1 produc$ *iefly by n]v\s sympa?y ) ! ,womb4 ,! second k9d1 call$ ,idiopa?ic1 are real prim>y d]angem5ts ( ! ,g5]ative ,organs !mselves1 or ( ^? intimately connect$ ) !m4 ,ea* ( ^! k9ds w be treat$ ( sep>ately4 ,,*apt] ,,xxvi4 ,,sympa!tic ,,diseases ,,occurr+ ,,dur+ ,,pregnancy4 ,,sickness ,,& ,,vomit+4 ,nausea1 or sickness1 ) or )\t vomit+1 is "o ( ! mo/ frequ5t & tr\blesome accompanim5ts ( pregnancy4 ,x is s g5]al1 9 fact1 z to be look$ ^u z "o ( ! e>lie/ & mo/ reliable signs ( t /ate4 ,x is und\bt$ly caus$1 9 ! e>li] /ages1 simply by ! intimate sympa?y :i* exi/s betwe5 ! /oma* & womb1 & :i* causes "o ( ^? organs to be tempor>ily d]ang$ :5ev] ! o!r is 9 any unusual condition4 ,9 ! latt] mon?s x is also produc$ by ! enl>g$ womb press+ on ! l[] "p ( ! /oma*1 z x rises 9 ! abdom54 ,9 _m diseases ( ! womb1 p>ticul>ly 9 enl>gem5ts1 & tumors1 ! /oma* w become d]ang$ 9 precisely ! same mann] z dur+ pregnancy1 & ! pati5t is frequ5tly deceiv$ !reby z to h] real condition4 ,9 mo/ cases ! sickness does n beg9 till ab\t ! second mon?1 & x seldom la/s beyond ! ?ird or f\r?4 ,!re are "s h[ev]1 ) :om x comm5ces almo/ imm$iately aft] fecundation1 & o!rs ) :om x la/s till ! v comm5cem5t ( labor4 ,i h ev5 kn[n p]sons :o always exp]i5c$ ! nausea at ! v mom5t ( conception1 & :o 7 ?us aw>e :5 t ev5t took place4 ,) "s p]sons ! tr\ble occurs only dur+ c]ta9 p>ts ( ! day1 mo/ usually 9 ! morn+1 :ile ) o!rs x comes on irregul>ly1 or ev5 endures con/antly4 ,9 mo/ cases x is n v sev]e1 & causes b little di/ress2 occasionally h[ev]1 x is v s]i\s1 & may ev5 lead to fatal results1 9 spite ( all t c be done4 ,abortion is frequ5tly br\ght on by x2 & s are fa9t+s1 & spitt+ ( blood4 ,_m wom5 h[ev]1 w vomit ) viol5ce1 dur+ almo/ ! :ole p]iod1 )\t ei!r accid5t or evil effect4 ,! treatm5t mu/ v>y accord+ to ! cause ( ! d]angem5t1 its viol5ce1 & ! effect x produces4 ,9 reg>d to diet b little c be said t w be f\nd g5]ally applicable4 ,mild & light food is g5]ally recomm5d$1 b is n always ! be/1 = "s females c only keep on _! /oma*s ! mo/ indige/ible articles4 ,p]haps no?+ m c be said1 ) propriety1 ?an t ! pati5t %\ld take :atev] %e c reta91 p>ticul>ly if %e has become weak f want ( n\ri%m5t1 :i* is (t5 ! case4 ,"s females c only keep d[n a little bro?1 or tea1 or sweet5$ wat]1 :ile o!rs f9d solid food ! be/1 or fruits4 ,i h kn[n _m able to take ,gum ,arabic1 ei!r solid or dissolv$ 9 wat]1 & reta9 x1 :5 no?+ else c\ld be borne4 ,?is is n\ri%+1 & may (t5 keep up ! /r5g? till ! sickness abates4 ,!re are _m rem$ies t w sometimes relieve1 ?\gh frequ5tly !y are ( no use :atev]4 ,a little w9e or br&y1 or orange fl[] wat]2--a few drops ( laudanum1 or e!r1 or ess5ce ( pepp]m9t1 may be tri$4 ,"o or two ipecac1 or cay5ne1 or camphor loz5ges1 w sometimes be efficaci\s1 & s w a little ,port w9e & ,p]uvian b>k1 or a seidlitz p[d]1 or ev5 common soda wat]4 ,a tea-spoonful ( p[d]$ *>coal succe$s occasionally1 or "s v /rong bitt]s1 or a cordial1 su* z a w9e-glassful ( curacoa4 ,a pla/] ( opium may also be plac$ ov] ! /oma*1 or "o ( meal wet ) laudanum4 ,a mu/>d p\ltice ov] ! /oma*1 w frequ5tly relieve :5 ev]y?+ else fails2--sometimes x is m effective h[ev]1 :5 plac$ on ! sp9e1 opposite ! /oma*4 ,z a g5]al rule ! b[els %\ld be kept free1 ei!r ) injections or ) mild purgatives1 z ca/or oil1 or manna4 ,regul> ba?+ w (t5 act z a complete prev5tive or cure1 & ! vomit+ may be frequ5tly /opp$ by simply da%+ cold wat] ov] ! /oma*4 ,"s practition]s recomm5d emetics1 & ble$+ if ! pati5t be ( a full ple?oric habit4 ,lee*es & cups h also be5 us$ ov] ! /oma*1 & sometimes ) good effect4 ,e!r & *lor(orm h also be5 inhal$1 & h op]at$ favorably 9 a few in/ances4 ,pl5tiful draughts ( cold wat]1 or swall[+ bits ( ice w likewise af=d relief to "s4 ,9 sev]al in/ances ! vomit+ has be5 s viol5t1 & ! pati5t has suff]$ s mu*1 & become s exhau/$ f want ( n\ri%m5t1 t x has be5 absolutely necess>y1 aft] all o!r means h fail$1 to cause misc>riage1 z ! only means ( sav+ ! pati5t's life4 ,:5ev] ! tr\ble c be borne1 ,pati5ce is ! gr& specific4 ,! suff]] mu/ recollect t x w surely cease ) deliv]y1 & mo/ probably be=e4 ,,ptyalism1 ,,or ,,excessive ,,salivation4 ,"s pregnant females w secrete an imm5se am\nt ( saliva = weeks & mon?s 9 succession1 z if !y _h be5 salivat$4 ,i h nev] kn[n a case 9 :i* ?is dis*>ge caus$ any evil1 ev5 :5 v great1 ?\gh x is (t5 tr\blesome4 ,x w\ld probably n be judici\s to /op x1 ev5 if we c\ld d s1 z long z x does no h>m1 ?\gh x may be advisable at times to mod]ate x4 ,! only treatm5t prop] to effect ?is is1 to keep ! b[els free & ! body well ba!d1 & to g>gle ! m\? ) m9t or balm teas1 or canella wat]1 or a little syrup ( poppies4 ,?is dis*>ge1 l ! vomit+1 arises f ! sympa!tic action ( ! ut]us1 & x g5]ally ceases ab\t ! f\r? mon?1 ?\gh ) "s x w la/ ! :ole "t4 ,,odontalgia1 ,,or ,,too?a*e4 ,?is is also a v g5]al tr\ble dur+ pregnancy1 & sometimes a v sev]e "o4 ,l sev]al o!r sympa!tic affections x is v irregul> z to its fir/ appe>ance & duration1 "s suff]+ f x mo/ ( ! "t1 almo/ )\t int]mission1 :ile o!rs only h x at int]vals1 & b slightly4 ,x sometimes dep5ds ^u uns\nd tee?1 b is frequ5tly exp]i5c$ )\t any su* cause1 & is !n a true neuralgia4 ,:5 x arises f a bad too?1 ! pa9 is usually conf9$ m or less to ! neighborhood ( ! too?1 b :5 x is neuralgic x ext5ds ov] ! great] "p or ! :ole ( ! jaw & face1 & d>ts ab\t f "o "p to ano!r4 ,9 true too?a*e !re is also usually m or less inflammation & swell+1 :ile 9 ! mo/ agoniz+ neuralgia no?+ ( ! k9d c be se54 ,! treatm5t mu/ be regulat$ by circum/ances4 ,if ! pa9 appe>s to be kept up by an uns\nd too?1 x %\ld by all means be extract$1 unless ! pati5t be s exce$+ly n]v\s & irritable t abortion is to be fe>$1 9 :i* case ! pa9 mu/ be alleviat$ z well z x c be1 ?\gh !re is almo/ z mu* dang] 9 leav+ ! too? 9 su* cases z 9 extract+ x4 ,a few lee*es to ! gums w sometimes relieve1 or a mu/>d p\ltice to ! *eek1 or a bli/] beh9d ! e>4 ,! /oma* or b[els be+ out ( ord] may also keep up ! irritation1 & regulat+ !m may mat]ially assi/ 9 giv+ relief4 ,"s p]sons are reliev$ by lotions ( camphor1 or laudanum1 & o!rs by wa%es ( cay5ne tea1 or alum wat]4 ,9 ! neuralgic =m1 :5 no p>ticul> too? c be f\nd 9 fault1 ! treatm5t mu/ be m g5]al ?an local4 ,! ,c>bonate ( ,iron ,pills1 :i* c be pur*as$ at ! druggi/s ready made1 h frequ5tly an excell5t effect2 f two to f\r may be tak5 at a dose1 twice a day1 ! b[els be+ kept op51 if necess>y1 by a little t9cture ( rhub>b4 ,if ! pa9 comes at regul> int]vals1 or int]mits1 x may frequ5tly be /opp$ by qu99e4 ,two ( ! ord9>y qu99e pills may be tak5 e five h\rs1 = two or ?ree days4 ,if ! head feels oppress$ by _! use1 ! dose mu/ be less5$ to "o4 ,m4 ,guillemeau recomm5ds ! foll[+ to be tri$ if o!r means fail1 & ,i h kn[n x to be ( decid$ b5efit4 ,take ! :ites ( two eggs1 & two ounces ( common black pepp]1 9 p[d]1 & beat !m well toge!r4 ,spread ?is on "s t[ or cotton1 & lay x on ! *eek4 ,x may be kept on till x causes consid]able irritation1 & sometimes may be us$ on bo? sides4 ,"s females h be5 reliev$ by ba?+ ! face 9 cold wat]1 or keep+ ice 9 ! m\?1 & o!rs by hot fom5tations4 ,x has also be5 recomm5d$ to fill ! m\? ) cold wat]1 & ba! ! *eek ) hot at ! same "t6 ,occasionally an abscess1 or gum boil w =m1 & :5 !re seems a t5d5cy to t x may be promot$ by keep+ a roa/$ fig 9 betwe5 ! *eek & gum1 ov] ! "p :]e ! abscess po9ts2 :5 full1 x %\ld be lanc$1 z ! dis*>ge usually gives relief4 ,?is pa9 is h[ev] v ob/9ate sometimes1 & defies all treatm5t1 b is seldom ( su* long duration :5 s sev]e4 ,,d]angem5ts ,,( ,,! ,,appetite4 ,! p[]ful sympa!tic action ( ! womb on ! /oma* produces n only nausea & vomit+1 b v>i\s d]angem5ts ( ! appetite & ta/e also4 ,all ( ^! require notice1 & "s ne$ att5tion4 ,anorexia4--,?is means a complete di/a/e1 or ev5 disgu/1 = food1 sometimes ( p>ticul> articles only1 & sometimes = ^? ( e k9d4 ,x seldom la/s beyond ! f\r? mon?1 b occasionally dur+ ! :ole p]iod4 ,x is rem>kable h[ "s females w be affect$ 9 ?is way1 & h[ little !y w eat1 = sev]al mon?s toge!r4 ,?is h[ev] is sc>cely ev] ( any consequ5ce1 = ! sy/em does n seem to suff] 9 ! slighte/ degree2 on ! contr>y1 ! "m w rema9 q /\t1 & ! *ild be born fully develop$1 ?\gh ! quantity ( food tak5 has app>5tly be5 sc>cely suffici5t to su/a9 life4 ,9 _m cases !re is ev5 a decid$ b5efit f ?is /ate ( ?+s1 p>ticul>ly 9 ^? :o are ( a too full habit4 ,z long z ! loss ( appetite is m]ely ( a sympa!tic or n]v\s "* x is n necess>y nor advisable to resort to any special treatm5t4 ,b :5 x arises f indige/ion1 or a f\l /oma*1 x is necess>y to att5d to x4 ,a mild emetic ( ipecac or w>m mu/>d & wat]1 may be giv51 or a dose ( ,epsom ,salts4 ,?is /ate w be recogniz$ by a furr$ tongue1 unpleasant brea?1 & uneas9ess at ! pit ( ! /oma*2 :ile 9 ! purely n]v\s anorexia no?+ ( ! k9d is obs]v$4 ,sometimes x may arise m]ely f debility ( ! /oma*1 & 9 t case a few ( ! ,c>bonate ( ,iron ,pills w be ( use4 ,9 g5]al ! pati5t is b5efit$ r ?an injur$ by ?is volunt>y fa/+4 ,b\limia4--,?is /ate is ! rev]se ( ! =m]1 mean+ a rav5\s appetite4 ,"s females exhibit x 9 a mo/ extraord9>y degree1 & w eat to excess ( any?+ t comes 9 _! way4 ,_m injure !mselves 9 ?is mann]1 by caus+ indige/ion1 flatul5ce1 he>tburn1 vomit+1 & ev5 inflammation ( ! /oma*4 ,x is ( no use reason+ ) !m1 = ! appetite is s /rong t !y w eat let !m suff] ev] s mu*4 ,all t c be done 9 su* cases is1 to dr9k freely ( v>i\s n\ri%+ liquids1 su* z s\p1 bro?1 rice milk1 or *ocolate2 & by eat+ jelly1 arr[-root1 & eggs4 ,^! conta9 mu* n\ri%m5t 9 a small space1 & satisfy ! hung] )\t ov]load+ ! /oma*4 ,! appetite may also be dead5$ consid]ably by eat+ figs1 dates1 sug>1 or *ocolate2 & by dr9k+ soda wat]4 ,caprici\s ,appetite4--,sometimes a female is f\nd to h an inord9ate desire = "s "o p>ticul> article ( diet1 :i* %e w eat to excess1 b w n t\* any?+ else2 ?is is call$ malacia4 ,o!rs w h a crav+ = "s article n prop] = food2--?is is call$ ,pica4 ,!y w dev\r *alk1 c9d]s1 e>?1 wood1 flies1 spid]s1 *>coal1 & v>i\s o!r ?+s1 sometimes ( ! mo/ disgu/+ k9d1 ?\gh ord9>ily !y may be q fa/idi\s 9 _! diet4 ,?is unnatural desire is also frequ5tly se5 9 hy/]ia & *lorosis1 & 9 sev]al ut]9e diseases4 ,x does n appe> t a mod]ate indulg5ce ( ^! unusual ta/es is at all injuri\s1 unless ! article wi%$ = be ( a decid$ly hurtful "*4 ,on ! contr>y1 x is reasonably conjectur$1 by _m physiologi/s1 t !y arise f a real want 9 ! sy/em ( ! v sub/ances long$ =4 ,= in/ance1 !re may n be 9 ! "m's blood suffici5t lime to =m ! bones ( ! *ild1 & ?is defici5cy is intimat$ by h] desire = *alk or pla/]2 nature hav+ no o!r mode ( mak+ h] wants kn[n1 or ( caus+ !m to be suppli$4 ,z a g5]al rule1 s long z ! indulg5ce is n obvi\sly improp]1 x %\ld be all[$ to a reasonable ext5t1 bo? to gratify ! pati5t & to answ] to :at are probably ! dem&s ( nature4 ,x is seldom t int]f]5ce is ne$$ 9 ^! cases1 except :5 !re is dang] ( ! pati5t do+ h]self h>m2 we may !n try to alt] ! condition ( ! /oma*1 & s *ange ! ta/e4 ,a g5tle emetic w sometimes d ?is1 or a sal9e purgative4 ,if ^! fail use a few ( ! ,c>bonate ( ,iron ,pills1 or "s good /rong bitt]s1 or teas1 drunk freely1 su* z ,cammomile1 ,boneset or ,c5taury4 ,,pyrosis4 ,?is disease is m frequ5tly call$ wat] bra% & sometimes he>t burn4 ,x is *>act]iz$ by ! rais+ ( a hot acrid fluid into ! ?roat1 caus+ a s5sation ( burn+ f ! /oma* upw>d1 ev5 to ! m\?4 ,x is a v frequ5t att5dant ^u _m =ms ( dyspepsia1 & is g5]ally exp]i5c$ m or less by mo/ pregnant females1 aris+ ei!r f improp] diet or f m]e sympa!tic d]angem5t4 ,if x arises only f errors ( diet1 a re=m 9 t p>ticul> is all t is ne$$1 b if x is m]ely sympa!tic no?+ c be done beyond palliat+ x1 to give tempor>y relief4 ,= ?is purpose ! pati5t mu/ take a spoonful ( lime wat]1 9 half a tumbl] ( milk two or ?ree times a day1 or "s c>bonate ( soda1 or magnesia1 ) a few drops ( laudanum if !re be any pa94 ,9 ^? cases :i* resi/ su* rem$ies a little ( ! comp\nd iron mixture may be ( s]vice1 su* z c be obta9$ at ! druggi/s4 ,a n\ri%+ diet %\ld also be obs]v$1 & pl5ty ( ex]cise %\ld be tak5 9 ! op5 air4 ,,dysphagia4 ,difficulty ( swall[+1 :i* is meant by ?is t]m1 is a m tr\blesome & al>m+ affection1 frequ5tly att5dant on pregnancy4 ,!re is h[ev] no?+ dang]\s 9 x1 except t x fright5s ! pati5t4 ,"s w gasp & be unable to swall[1 or ev5 speak1 = a consid]able "t1 & w ?9k !y h some?+ 9 ! ?roat4 ,x is h[ev] entirely a n]v\s symptom1 aris+ f ut]9e irritation1 & seldom la/s beyond ! ?ird or f\r? mon?4 ,a little cordial1 w9e1 or br&y1 w frequ5tly relieve x1 or "s spirits ( camphor rubb$ on ! neck4 ,m4 ,colombat d'l',is]e recomm5ds ! foll[+ o9tm5t1 to be rubb$ on ! neck4 ,extract ( ,belladonna =ty-sev5 gra9s1--,extract ( ,/rammonium fifte5 gra9s1--:ite wax "o ounce1--oil ( lemons twelve drops4--,^! mu/ be w>m$ & well rubb$ toge!r4 ,a da% ( cold wat] on ! ?roat & *e/ w (t5 succe$ bett] ?an any?+ else4 ,,ga/ralgia4 ,?is is commonly t]m$ cramp at ! /oma*1 or n]v\s colic4 ,x consi/s ( a sev]e k9d ( cramp1 ) dragg+ & cutt+ s5sations 9 ! /oma*1 z if x 7 be+ ti$ 9 knots & cut to pieces4 ,sometimes ! attack w only la/ = a few m9utes1 & !n totally pass away1 at o!r times x w rema9 = half an h\r or m1 & cause ! mo/ int5se suff]+4 ,! pati5t w be drawn toge!r1 or d\bl$ up1 ) h] h&s plac$ on h] /oma*1 & w groan & exhibit 9 h] features ! greate/ agony2 sometimes ev51 %e w fa9t away ) x4 ,?is affection may1 l ! o!rs1 be m]ely n]v\s1 & !n x is att5d$ by no?+ b ! pa94 ,x may also arise f real inflammation ( ! /oma*1 & !n x is att5d$ by fev]1 excessive sor5ess & t5d]ness ( ! /oma* :5 t\*$1 & by a hot1 dry m\?4 ,9 ! n]v\s spasm ! pa9 is frequ5tly reliev$ by pressure1 b :5 inflammation exi/s ! pressure increases x4 ,"s females always h ^! attacks :5ev] ! /oma* is empty1 & !y pass away imm$iately any?+ is tak5 to eat or dr9k4 ,) o!rs !y are (t5 br\ght on by ov]load+ ! /oma*1 or by eat+ "s improp] articles4 ,to relieve ! spasm1 "o ( ! be/ ?+s is a tea-spoonful ( ,comp\nd ,spirits ( ,lav5d]1 tak5 )\t wat]4 ,?is ne>ly always gives relief 9 t5 m9utes at mo/2 b if necess>y a second spoonful may be tak5 9 a qu>t] ( an h\r4 ,a little br&y1 or pepp]m9t1 or curacoa cordial w also succe$ 9 _m in/ances1 or simply dr9k+ freely ( any hot tea1 or swall[+ half a tea-spoonful ( common pepp]4 ,a mu/>d pla/] put on hot ov] ! /oma* w sc>cely ev] fail1 ev5 )\t any?+ be+ tak5 int]nally4 ,m4 ,colombat gives ! foll[+ recipe z "o :i* he has f\nd efficaci\s1 & x is c]ta9ly a pleasant "o4 ,orange & ,l9d5 ,fl[] wat]s ea* two ounces2 ,syrup ( ,e!r & ( ,val]ian ea* "o ounce2 ,syrup ( ,poppy heads half an ounce4 ,( ?is mixture a tea-spoonful may be giv5 e qu>t] ( an h\r till ! pa9 abates4 ,to prev5t ! return ( ! attack1 ! pati5t mu/ c>efully avoid ev]y?+ t disagrees ) ! /oma*1 or creates w9d2 %e mu/ keep ! b[els free1 & accu/om h]self to regul> ba?+ or rubb+ ! body4 ,if ! /oma* appe> weak1 :i* is (t5 ! case1 "s ,boneset tea1 or ,port w9e & b>k1 or a few ( ! ,c>bonate ( ,iron ,pills may be advantage\s4 ,if !re be acid on ! /oma*1 use ! means recomm5d$ = he>tburn4 ,,con/ipation4 ,?is is a v common tr\ble ) pregnant females1 & "o t may lead to _m o!rs4 ,v frequ5tly x arises m]ely f ! pressure ( ! exp&$ ut]us ^u ! l>ge inte/9e1 b x may also arise f a simple want ( p[]1 ! ut]9e action hav+ app>5tly weak5$ ! =ce ( all ! neighbor+ organs4 ,x is advisable to correct x z soon z possible1 let x arise h[ x may1 z x is v apt to cause v>i\s d]angem5ts ( ! /oma* & inte/9es1 & ev5 inflammation ( ! womb itself4 ,z a g5]al rule1 n m ?an ?ree days %\ld elapse )\t ! b[els be+ mov$1 ?\gh "s w rema9 a week or m )\t any app>5t inconv5i5ce2 b !re is always dang] 9 su* delay4 ,_m females d !mselves mu* h>m by tak+ :at !y call op5+ m$ic9es1 ! action ( :i* is (t5 m injuri\s ?an ! con/ipation itself4 ,all dra/ic purgatives1 su* z aloes1 gamboge1 colocyn?1 & jalap %\ld be c>efully avoid$1 z !y n only make ! co/iv5ess worse aft] _! action is ov]1 b !y also frequ5tly produce inflammation1 & ev5 abortion1 by ! viol5t /ra9+ !y cause4 ,! be/ m$ic9es1 :5 !y are really ne$$1 are manna1 seidlitz p[d]s1 or ca/or oil4 ,enemas are bett] h[ev]1 z a g5]al rule1 su* z ^? ( ?9 />*1 or molasses & wat]1 to :i* may be add$ a little ca/or oil4 ,! gr& aim %\ld be1 9 all su* cases1 to /imulate ! b[els to an increas$ action )\t m$ic9es1 by a prop]ly regulat$ diet6 ,salads may be eat5 :5 !y d n cause d]angem5t ( ! /oma*1 & ripe or /ew$ fruits1 p>ticul>ly figs1 dates & prunes4 ,s\ps are also good1 except !y conta9 rice1 or v]micelli1 or macc>oni4 ,bran bread %\ld be eat5 regul>ly1 & n :ite4 ,! only meats %\ld be veal or p\ltry4 ,z a dr9k lemonade is excell5t1 ) a little cream ( t>t>1 or tam>9d tea1 or b>ley wat] sweet5$ ) honey4 ,) "s pati5ts a cup ( c(fee1 or a glass ( be] w always relieve ! b[els1 especially if a glass ( wat] is also drank aft] x4 ,i h kn[n p]sons neglect ! b[els s long t !y h become completely impact$1 by ! h>d fces1 & c\ld be reliev$ only by in/rum5ts4 ,x is v important to att5d to ?is affection 9 "t1 & to p]sev]e ) ! means ( p]man5t relief regul>ly4 ,,dys5t]y ,,& ,,di>rh,a4 ,x is frequ5tly ! case t pregnant females1 in/ead ( be+ con/ipat$ are afflict$ ) sev]e di>rha4 ,?is may arise f inflammation1 & is !n att5d$ by fev]1 & extreme t5d]ness & sor5ess ( ! b[els4 ,mo/ usually h[ev] x is entirely n]v\s1 & arises f ! sympa!tic irritation ( ! womb4 ,!re is !n no t5d]ness or sor5ess1 no fev]1 no d]angem5ts ( ! appetite1 nor 9 fact any o!r symptom ( any consequ5ce4 ,if x rema9s long un*eck$ blood w be dis*>g$1 f ! extreme irritation ( ! inte/9es1 & x is !n call$ dys5t]y4 ,?is is ne>ly always accompani$ by fev] & g5]al irritation4 ,sometimes !re w be a con/ant & pa9ful desire felt to move ! b[els1 b ) little p[] to d s1 & at ! same "t a burn+ heat & unpleasant s5sation at ! fundus4 ,?is is call$ t5esmus1 & ! /ra9+ f x has frequ5tly produc$ abortion4 ,if ! di>rha is n excessive1 & ! female does n lose h] appetite1 or /r5g?1 x is bett] let alone1 p>ticul>ly if %e be ( a full habit1 & dispos$ to fev]4 ,if ?\ght desirable to *eck x a little1 ?is may usually be done by a *ange 9 ! diet4 ,rice milk1 sago1 tapioca1 & arr[-root may be tak51 :ite bread may be us$1 & n mu* fluid drunk4 ,if su* means are insuffici5t an injection may be ?r[n up ! rectum 9 ! morn+1 ( ?9 />*1 ) a tea-spoonful ( laudanum4 ,! abdom5 may also be well fom5t$1 & a dose ( ,t9cture ( ,rhub>b tak5 occasionally4 ,if ! t5esmus is v tr\blesome1 an injection ( tepid wat] may be us$1 & ! female %\ld sit occasionally ov] ! /eam ( hot wat]3 9 extremely pa9ful cases a few lee*es may be us$ r\nd ! fundam5t1 & a hot flaxse$ p\ltice plac$ ov] ! abdom54 ,a w>m ba? is also an excell5t rem$y ) _m4 ,:5 ! di>rha /ill cont9ues not)/&+ ! above rem$ies1 resort %\ld be _h to tonics & opiates4 ,! pati5t %\ld take ,port w9e & ,p]uvian b>k1 or "s ,g5tian w9e1 & use injections ( ,/>* & ,laudanum regul>ly4 ,cammomile tea may also be freely drunk1 & an opium pill may be tak5 at night4 ,above all1 ! pati5t mu/ endeavor to avoid all m5tal agitation4 ,:5 dys5t]y sets 91 e ef=t %\ld be made to subdue x z e>ly z possible4 ,half a p9t ( rice milk1 ) t5 or fifte5 drops ( laudanum may be tak5 two or ?ree times a day1 & an injection may also be us$ night & morn+ ( flaxse$1 ) fifte5 or tw5ty drops ( laudanum4 ,m4 ,colombat recomm5ds ! foll[+ recipe z seldom fail+ to cure4 ,take ! :ites ( six eggs & beat !m up 9 a qu>t ( wat]2 !n use "o-?ird z a dr9k1 & ! re/ z an injection4 ,a neat spoonful %\ld be drunk e t5 m9utes1 & an injection us$ e two h\rs1 b n m ?an "o small syr+eful at a "t4 ,a tea-spoonful ( syrup ( poppies1 ) "s loaf sug>1 may also be add$ to e spoonful t is drunk4 ,eggs1 jellies1 & ri* s\ps1 ) meat & w9e1 if !re be no inflammation1 may be tak5 regul>ly1 9 addition to ! articles already m5tion$4 ,,dyspn,a1 ,,or ,,difficulty ,,( ,,brea?+4 ,!re are b few pregnant females :o d n compla9 m or less ( difficulty ( brea?+1 & ?is difficulty may arise f diff]5t causes4 ,9 ! e>li] mon?s x is caus$ by sympa!tic irritation only1 ! same z difficulty ( swall[+4 ,9 ! latt] mon?s x is caus$ by ! enl>g$ womb fill+ up ! abdom5 s mu* t ! lungs 9 ! *e/ are press$ ^u & h n suffici5t room to play freely4 ,x may also be caus$ by a ple?oric or too full habit1 ! lungs !n be+ 9 reality conge/$4 ,! tempor>y difficulty ( brea?+ :i* is felt 9 ! e>ly mon?s1 f n]v\s sympa?y1 ne$s sc>cely any k9d ( treatm5t1 z x passes (f naturally 9 a %ort "t4 ,9 sev]e attacks ! same rem$ies may be us$ z = difficulty ( swall[+ be=e ref]r$ to4 ,t :i* arises 9 ! latt] mon?s1 f pressure ( ! womb1 c frequ5tly be reliev$ only by ! pati5t rema9+ z long z possible 9 c]ta9 favorable positions4 ,i h kn[n _m :o c\ld nev] sleep except :5 propp$ ne>ly upright1 by means ( pill[s & cu%ions1 z imm$iately !y assum$ ! recumb5t position ! upw>d pressure became s great !y 7 ne>ly suffocat$4 ,9 su* cases ! pati5t %\ld be c>eful nev] to eat or dr9k to excess1 nor take any?+ likely to produce w9d1 because ! lea/ increase 9 ! size ( ! abdom5 adds to ! difficulty4 ,! b[els %\ld also be kept free1 & no?+ tight or heavy 9 ! way ( clo?+ %\ld be worn4 ,?is difficulty is mo/ frequ5tly se5 9 ^? :o h contract$ *e/s1 & 9 ^? :o h be5 accu/om$ to we> corsets & tight dresses4 ,a de=m$ pelvis may also give rise to x by =c+ ! womb above its usual position4 ,_m females bo? create & increase ?is difficulty by b9d+ !mselves tight] ?an usual dur+ pregnancy1 "u ! mi/ak5 idea t x enables !m to support _! burd5 s mu* easi]4 ,:5 ! dyspna arises f a full habit ! pati5t mu/ live l[1 keep ! body regul>ly ba!d & rubb$1 & ! b[els freely op5 by an occasional seidlitz p[d]1 or dose ( ,epsom ,salts4 ,if ! difficulty becomes at any "t sudd5ly great & al>m+1 ! feet %\ld be plac$ imm$iately 9 hot wat]1 :ile ! pati5t is upright2 a mu/>d pla/] %\ld also be put ^u ! *e/1 & an op5+ injection ( />* & ,ca/or ,oil adm9i/]$ z soon z possible4 ,! usual practice 9 su* cases is to ble$ f ! arm1 to ! ext5t ( eight or t5 ounces1 & 9 case no o!r means give relief1 ?is may be tri$4 ,,c\gh4 ,l ! previ\s affection c\gh is mo/ usually produc$ dur+ pregnancy by sympa!tic irritation4 ,x may arise1 h[ev] f a p>tial conge/ion1 or inflammation ( ! lungs or bron*ial tubes1 produc$ by a too great det]m9ation ( blood to !m4 ,9 ! m]ely n]v\s c\gh1 !re is no expectoration1 nor any sor5ess or pa9 9 ! *e/1 & x w frequ5tly disappe> = sev]al days toge!r4 ,no p>ticul> att5tion ne$ be be/[$ ^u ?is c\gh1 unless x become s viol5t z to ?reat5 abortion4 ,9 t case a pill1 conta9+ "o gra9 ( opium1 may be tak51 or f t5 to fifte5 drops ( laudanum1 :5ev] ! attack is sev]e4 ,b>ley wat]1 or gum arabic wat]1 may also be freely drunk1 ) a l>ge spoonful ( ,syrup ( ,poppies add$ to ea* p9t4 ,a small dose ( ,hive ,syrup1 or ,p>egoric1 w also be f\nd sometimes bett] ?an any?+ else4 ,an enema ( ,/>* & ,laudanum1 z =m]ly describ$1 w also relieve1 9 "s cases1 bett] ?an any?+ tak5 by ! m\?4 ,! body %\ld be kept w>m1 p>ticul>ly ! feet1 & a mu/>d p\ltice may be plac$ ov] ! *e/1 if ! /ra9+ at any "t becomes too great4 ,"s pati5ts exp]i5ce relief f an assaftida pill1 or a little musk1 & o!rs f a small dram ( cordial1 or w9e4 ,if !re be expectoration1 ) fev]1 & t5d]ness 9 ! *e/1 or %>p pa9s :5 a long brea? is drawn1 !re is reason to fe> inflammation ( ! lungs1 or bron*itis4 ,9 ?is case all ! above means1 except ! w9e & /imulants1 may also be us$ only m freely1 & ! mu/>d p\ltice mu/ be kept on till x makes a bli/]4 ,! pati5t mu/ live l[1 h] feet mu/ be frequ5tly ba!d 9 hot wat]1 & h] b[els regul>ly op5$ ei!r ) sal9e purgatives or enemas4 ,all t is requisite is to keep ! inflammation f ext5d+ till aft] deliv]y1 :5 x usually subsides )\t any fur!r tr\ble4 ,z soon z ! womb is empti$1 its pressure ^u ! abdom9al aorta ceases1 & ! blood c !n fl[ freely to ! l[] extremities1 & ?us ! lungs become reliev$ & ! inflammation goes d[n4 ,,palpitation ,,( ,,! ,,he>t4 ,?is is also a frequ5t accompanim5t ( pregnancy1 & "o t is likely to cause al>m sometimes1 f its viol5ce4 ,unless dep5dant ^u organic disease ( ! he>t h[ev]1 x is 9 g5]al only a n]v\s affection1 & passes away ) deliv]y4 ,we may always reasonably suppose x to be n]v\s :5 x occurs only dur+ pregnancy1 & p>ticul>ly if x is irregul> 9 its frequ5cy & viol5ce4 ,i h kn[n females :o 7 always attack$ ) x ab\t ! same p]iod1 & :o c\ld !re=e always tell :5 x 0 com+ on1 & sometimes ev5 h[ long x w\ld la/4 ,x w sometimes come on dur+ sleep1 & s =cibly z to wak5 ! pati5t in/antly4 ,at o!r times :ile awake1 x w comm5ce s sudd5ly t %e w s9k d[n z if /ruck by a p[]ful bl[4 ,! only directions t c be giv5 = alleviat+ x are1 to keep z quiet z possible1 use ! ba? regul>ly1 avoid con/ipation1 & live r l[1 p>ticul>ly if ! pati5t be ( a full habit4 ,ex]cise %\ld also be tak5 regul>ly 9 ! op5 air1 b n ( a viol5t k9d4 ,%e %\ld also sleep ) ! head on a high pill[1 & nev] eat late supp]s1 nor take any food t disagrees ) ! /oma*4 ,all k9ds ( /imulants1 su* z w9e1 c(fee & spices1 %\ld be ab/a9$ f1 & all p[]ful emotions c>efully gu>d$ aga9/4 ,dur+ an attack a few drops ( ,laudanum1 or an ,opium pill may be tak51 & ! feet plac$ 9 hot wat]4 ,an ,assaftida pill is sometimes good1 or a little ,e!r4 ,ble$+ is g5]ally practis$ 9 extreme cases1 b !re is (t5 consid]able dang] 9 x4 ,a too full habit is (t5 ! excit+ cause ( ! palpitation1 z may be se5 by ! pati5t be+ always liable on ! slighte/ ex]tion to flu%$ face1 dimness ( sight1 r++ 9 ! e>s1 swell+ ( ! limbs1 & puff9ess ( ! gums1 sometimes to su* an ext5t t ! m\? w ta/e ( blood4 ,su* p]sons %\ld c>efully obs]ve a mod]ate un/imulat+ & simple diet1 & nev] all[ ! b[els to rema9 con/ipat$ m ?an a s+le day4 ,!y %\ld also rub & wa% ! sk9 well1 & /udy calmness & quiet4 ,,syncope1 ,,or ,,fa9t+4 ,9 ?is condition1 :i* is j ! rev]se ( ! =m]1 ! he>t susp5ds its action altoge!r2 ! brea?+ ceases1 all p[] ( motion & feel+ is lo/1 ! face turns gha/ly pale1 ! eyes close1 & ! individual seems z if actually dead4 ,x seldom la/s h[ev] m ?an five m9utes1 :5 ! pulse gradually beg9s to beat1 ! color returns1 & ! individual sl[ly recov]s4 ,"s females are liable to su* attacks once a mon?1 o!rs once a week1 o!rs e few days1 & "s at irregul> p]iods4 ,!y are g5]ally prec$$ by a dull pa9 at ! pit ( ! /oma*1 fullness 9 ! head1 yawn+1 & loss ( sight1 or r++ 9 ! e>s4 ,! causes t pr$ispose to ?is fa9t+ are n v well und]/ood1 ?\gh !re is no d\bt b x is ma9ly dep5dant ^u ut]9e di/urbances4 ,9 "s females x is br\ght on by ! sudd5 motions ( ! ftus1 or by _! rema9+ too long 9 "o po/ure4 ,9 o!rs x is produc$ by /ra9+ f con/ipation1 or by sudd5 fright or ang]4 ,9 v n]v\s p]sons x n unfrequ5tly arises f unpleasant sights1 smells1 & s\nds4 ,9 fact x is caus$ 9 !m mu* ! same z a common hy/]ical fit1 su* z is describ$ 9 my ,diseases ( ,woman4 ,a full habit1 & ov] fe$+1 or dr9k+ /imulat+ liquors may also br+ x on1 & s on ! contr>y may a /ate ( weakness & exhau/ion4 ,?is accid5t is m al>m+ ?an dang]\s1 except to ! *ild1 :i* may lose its life if ! fa9t+ la/s too long4 ,to recov] a p]son f "o ( ^! fa9t+ fits1 %e %\ld be laid ^u h] back on a level place1 & e "p ( h] dress %\ld be c>efully loos$4 ,"s /rong odor %\ld !n be appli$ to ! no/rils1 su* z h>t%orn1 v9eg>1 burnt fea!rs1 or smell+ salts4 ,! body %\ld be well rubb$ ov] ! he>t & lungs1 ei!r ) ! h& or ) a s(t1 dry napk94 ,cold wat] may also be da%$ on ! face1 & ! h&s may be well *af$4 ,if ! fit /ill endures1 a mu/>d pla/] may be plac$ on ea* arm1 or ! :ole body may be plac$ 9 a w>m ba?1 if conv5i5t4 ,c>e %\ld also be tak5 to admit ! fre% air freely4 ,z soon z %e beg9s to %[ signs ( consci\sness1 a little w9e or br&y may be plac$ 9 ! m\?1 & ! body may be elevat$ a little4 ,to gu>d aga9/ su* attacks1 ! same precautions z to diet & mode ( life mu/ be obs]v$ z 7 direct$ 9 ! article on palpitation ( ! he>t2 &1 z ?is accid5t is mo/ frequ5t 9 ^? ( a hy/]ical habit1 !y %\ld c>efully foll[ ! advice giv5 9 ! article ,hy/]ia1 9 my ,diseases ( ,woman4 ,,heada*e ,,& ,,dizz9ess ,,9 ,,! ,,head4 ,ea* ( ^! di/ress+ affections1 bo? ( :i* are v common dur+ pregnancy1 may arise ei!r f n]v\s excitem5t or f a full habit & det]m9ation ( blood to ! head4 ,n]v\s heada*e is g5]ally met ) 9 ! e>li] mon?s ( pregnancy1 & is *>act]iz$ by be+ frequ5tly p]iodical1 & (t5 conf9$ to p>ticul> spots4 ,x also comm5ces sudd5ly1 f "s excitem5t or depression ( m9d1 & leaves little or no di/ress :5 x is gone4 ,! heada*e1 :i* arises f a too full habit1 comm5ces ) flu%+ ( ! face1 heav9ess 9 ! eyes1 dull pa9 9 ! =ehead1 & a s5se ( uneas9ess1 ) disposition to sleep or dose4 ,x seldom comes on mu* till ! latt] mon?s ( ge/ation4 ,heada*e may arise also accid5tally1 f d]angem5t ( ! /oma*1 b ?is cause is easily asc]ta9$ by ! furr$ tongue1 loss ( appetite1 & bitt] ta/e 9 ! m\?2 x is also felt mo/ acutely 9 ! back ( ! head1 d[n by ! neck1 & passes away imm$iately ! /oma* is correct$ by an emetic1 or by fa/+4 ,n]v\s heada*e dur+ pregnancy (t5 defies all our attempts to alleviate x1 ?\gh we sometimes succe$ 9 do+ s4 ,! be/ g5]al rem$ies are w>m ba?s1 &1 if ! b[els are con/ipat$1 enemas ( />* & ca/or oil daily4 ,to ^! may be add$ occasional small doses ( ,laudanum1 or an ,opium pill1 or two gra9s ( ,camphor4 ,smell+ odors1 su* z ,camphor1 ,cologne1 or ,h>t%orn1 w relieve "s1 b w make o!rs worse2 s t its utility c only be det]m9$ by exp]i5ce4 ,:5 a sev]e attack comes on1 ! pati5t %\ld put h] feet 9 w>m wat]1 or use a w>m ba?1 take a few drops ( ,laudanum1 or a little ,musk1 or ,val]ian1 & !n try to g to sleep4 ,to gu>d aga9/ ! attack1 %e mu/ nev] ov]load ! /oma*1 nor take any?+ indige/ible2 & nev] ?9k too mu* nor all[ h]self to become excit$ or depress$4 ,:5 ! tr\ble is caus$ by a too full habit1 %e mu/ obs]ve ! directions giv5 9 ! articles on palpitation ( ! he>t1 & ,syncope4 ,! diet mu/ be mild & n too nutriti\s1 ! b[els mu/ be regul>ly mov$ e day1 *iefly by ,epsom ,salts & ,seidlitz ,p[d]s1 & regul> g5tle ex]cise mu/ be tak5 9 ! op5 air4 ,9 ! latt] mon?s x is especially important to att5d to a sev]e heada*e imm$iately1 p>ticul>ly :5 ! pa9 is seat$ at ! top ( ! head1 because x is v likely1 if un*eck$1 to t]m9ate 9 convulsions4 ,! means above recomm5d$ mu/ be c>efully & p]sev]+ly appli$2 ! feet mu/ be kept w>m1 ! b[els freely op5$1 & ! head kept cool by wet clo!s1 or cold lotions1 or ice4 ,x is ! g5]al practice 9 all su* cases1 if ! pa9 does n abate soon1 & ! pulse be full & quick1 to ble$ freely at ! arm1 & ! mo/ em95t physicians ( ! ,allopa?ic s*ool assure u1 t ! life ( ! pati5t frequ5tly dep5ds ^u its be+ done promptly4 ,i h no d\bt1 h[ev]1 b t relief c be g5]ally obta9$ by ! simple means describ$1 if !y are us$ e>ly & p]sev]+ly4 ,,insomnia1 ,,or ,,sleeplessness4 ,!re are few affections t cause m real di/ress dur+ pregnancy ?an ?is4 ,_m females w be utt]ly unable to sleep = _m days & nights toge!r1 & o!rs c only obta9 a few m9utes brok5 & unrefre%+ sleep at di/ant int]vals4 ,!re is dang]1 :5 ?is /ate becomes highly aggravat$1 t x may lead to delirium1 or t ! want ( re/ may we> away ! /r5g? to su* a degree1 t ! pati5t w s9k f m]e exhau/ion4 ,!re are "s females1 h[ev]1 :o w rema9 )\t sleep1 or at mo/ take b v little1 = a long "t1 )\t suff]+ any inconv5i5ce4 ,?is affection is ess5tially a n]v\s "o1 & ! only means likely to relieve x are ^? t h a t5d5cy to soo! & calm ! n]ves4 ,if ! pati5t be surr\nd$ by any irritat+ circum/ances !y %\ld be at once remov$1 or %e h]self remov$ f !m4 ,p>ticul> att5tion mu/ be paid to ! diet1 s t no d]angem5t ( ! /oma* or b[els be kept up1 & a regul> sy/em ( out-door ex]cise mu/ be practis$4 ,a w>m ba? j be=e go+ to b$1 ) a good rubb+ ( ! sk91 w frequ5tly act l magic 9 procur+ re/4 ,z a g5]al rule n>cotic drugs %\ld n be us$1 b 9 extreme cases !y may be resort$ to sp>+ly4 ,a s+le ,opium pill1 or a few drops ( ,laudanum may be tak5 aft] ! ba?4 ,if ! pati5t be ?9 & delicate1 %e %\ld eat meat1 eggs1 & milk1 & take a little w9e1 if x causes no unpleasant symptoms4 ,inde$ a glass ( w9e w frequ5tly act bett] ?an ,laudanum1 & s w ale ) "s1 & c(fee ) o!rs4 ,if ! pati5t be ( a full habit ^! ?+s w be improp]1 & may injure4 ,%e %\ld !n be kept quiet1 & f$ sp>+ly4 ,music has a p[]ful effect 9 _m ( ^! cases3--a sl[1 solemn air1 play$ :ile ! pati5t is recl9+ aft] h] ba?1 seldom fails 9 induc+ sleep4 ,,tempor>y ,,affection ,,( ,,! ,,sight1 ,,he>+1 ,,& ,,smell4 ,^! disord]s are q common dur+ pregnancy1 p>ticul>ly 9 ! latt] mon?s4 ,"s females w be utt]ly unable to di/+ui% any odors1 ev5 ! mo/ p[]ful2 o!rs completely lose _! ta/e1 & o!rs aga9 become deaf or bl9d4 ,:5 !y are caus$ only by ! sympa!tic action ( ! womb1 su* deprivations are seldom ( long duration1 ?\gh !y may recur at frequ5t int]vals4 ,9 "s cases !y rema9 a consid]able "t1 & great fe> is felt t !y may become p]man5t1 b !re is little dang] ( su* a result4 ,i knew a lady :o sudd5ly lo/ h] sight :5 ab\t two mon?s gone1 & :o rema9$ totally bl9d till ab\t ?ree h\rs aft] h] deliv]y1 :5 h] sight return$ 9 a mom5t z p]fect z be=e4 ,! same ?+ has frequ5tly be5 obs]v$ ( ! o!r s5ses4 ,9 "s cases ! vision w n be lo/ b p]v]t$1 & ! pati5t w !n see ev]y?+ d\ble1 or l>g] or small] ?an natural1 or always ( a wrong color4 ,9 l mann] "s w he> imag9>y conv]sations1 or w fancy ev]ybody is %\t+1 or p]haps only :isp]+1 ?\gh !y are all ! "t speak+ 9 _! natural voice4 ,^! p]v]sions1 :5 ?us produc$1 ne$ occasion no al>m1 & seldom require att5tion1 unless accompani$ by o!r urg5t symptoms4 ,!y may arise h[ev]1 f a fullness ( blood 9 ! head1 9 :i* case !y are accompani$ by a flu%$ face & dr[s9ess1 & are prec$$ by bright sp>ks fla%+ be=e ! eyes1 or by r++ 9 ! e>s4 ,! treatm5t ( all ^! affections %\ld be ! same z t recomm5d$ = mo/ ( ! previ\s d]angem5ts1 p>ticul>ly = ,heada*e1 ,syncope1 & ,palpitation ( ! ,he>t4 ,if !re be n]v\s excitem5t m]ely1 x mu/ be calm$ 9 ! same way z recomm5d$ 9 ! articles ref]r$ to1 & also 9 ! la/ "o on sleeplessness4 ,if ! female be ( a full habit1 & !re is evid5tly a pressure ( blood on ! bra9 & n]ves ( ! special s5ses1 ! same means %\ld be adopt$ to r$uce ! sy/em1 & draw ! blood to ! extremities1 t h already be5 describ$4 ,9 su* cases ^! sudd5 deprivations ( sight & he>+ sometimes indicate ! comm5cem5t ( ,convulsions1 or ,apoplexy1 p>ticul>ly if !y occur dur+ labor1 :5 e means %\ld be resort$ to in/antly to relieve ! pressure on ! bra94 ,if no simpl] means succe$ 9 a reasonable "t1 x is ! g5]al cu/om to ble$ freely f ! arm1 & !re is no "q b ?is frequ5tly removes ! difficulty at once1 :atev] objections may be made to ! practice4 ,x is also prop] to say t _m em95t practition]s1 :o are n advocates ( ! lancet 9 g5]al1 /r5u\sly urge t x %\ld be us$ imm$iately if ! sight or he>+ sudd5ly disappe> 9 ?is way at any "t4 ,& ,i c]ta9ly h myself kn[n ^! accid5ts sometimes foll[$ by a fit ( ,apoplexy1 or ,convulsions1 & ev5 dea?4 ,su* 0 ! case ) a fri5d ( "o ( my pati5ts4 ,%e f\nd "o day1 q sudd5ly1 t %e c\ld only see half ( any ?+ %e look$ at1 & at times x ev5 disappe>$ altoge!r4 ,no?+ 0 done = h]1 & 9 ab\t five h\rs aft] ! fir/ attack %e fell spee*less & di$ be=e !y c\ld lift h] ^u ! b$4 ,x w !re=e be a necess>y precaution1 9 all pregnant females ( a full habit1 to att5d rigidly to ! advice t has be5 giv51 because simple means1 us$ 9 "t1 & regul>ly1 may prev5t ! necessity ( /rong] ones altoge!r4 ,9 purely n]v\s cases ( ?is k9d no appreh5sion :atev] ne$ be felt1 & no su* practice z ble$+ is requir$4 ,,disord]$ ,,judgm5t1 ,,incl9ations1 ,,& ,,prop5sities4 ,! sympa!tic irritation ( ! ut]us1 9 "s females produces extraord9>y ph5om5a ( ?is k9d1 f simple desire to ! mo/ furi\s crav+1 & f m]e caprice to actual insanity4 ,!re is no d\bt b t _m ( ^! unusual desires1 or long+s z !y are call$1 are ei!r produc$ or mu* aggravat$ by ! imag9ation ( ! pati5t1 & frequ5tly w\ld nev] be exp]i5c$ at all1 if ! idea 0 n sugge/$ by o!r p hav+ _h ! same4 ,cu/om & imitation are v p[]ful 9 su* cases1 p>ticul>ly :5 ! n]v\s s5sibility is mu* exalt$4 ,/ill ! mo/ s+ul> ab]rations ( ?is k9d w (t5 arise )\t any su* adv5titi\s aid1 & ! fact %\ld be borne 9 m9d1 s t ^! tempor>y vag>ies may be reg>d$ ) prop] *>ity & =be>ance4 ,"s females w entirely *ange 9 _! dispositions at ^! times1 ! mo/ amiable & mild becom+ positively ill-natur$ & malici\s2--! g5tle w turn head/rong1 ! haughty & pr\d w become humble1 & ! gay w become melan*oly1 or ! sad w madly seek e k9d ( gaiety4 ,su* ?+s h[ev] %\ld nev] be rememb]$1 nor be br\ght up aga9/ !m aft]w>ds1 = truly at su* times !y "k n :at !y d6 ,wom5 h be5 kn[n :ile 9 ?is /ate1 to become ?ievi%1 or to h an irresi/ible prop5sity to burn or kill4 ,"s h ev5 be5 kn[n to exhibit great tal5ts = music or poetry1 ?\gh ord9>ily )\t any capacity = su* ?+s4 ,"s w sudd5ly exhibit a mo/ extraord9>y intellect1 :ile o!rs w become q silly4 ,a m$ical writ] tells u an in/ance ( "o female :o always _h an excell5t s\nd judgm5t :ile pregnant1 b no memory1 :ile 9 h] ord9>y /ate %e _h a poor judgm5t b a mo/ extraord9>y good memory4 ,! celebrat$ ,baudelocque gives an acc\nt ( ano!r :o c\ld sc>cely eat any?+ b :at %e /ole1 :ile go+ to m>ket2 & ano!r writ] m5tions a lady :o long$ till %e 0 almo/ deliri\s to bite a piece out ( a bak]'s %\ld]1 :o work$ opposite h] w9d[4 ,!re is ev5 an acc\nt ( "o :o long$ to eat "s ( h] husb&1 :om %e de>ly lov$1 & :o actually kill$ him to satisfy h] appetite1 & !n salt$ pieces ( ! body to keep = future use4 ,a writ] nam$ ,vives also tells u ( a female ^: husb& paid a l>ge sum ( money = h] to be all[$ to bite a "y man's neck1 x be+ evid5t t %e w\ld be ne>ly c]ta9 to misc>ry unless s gratifi$4 ,9 ! ye> #ahaf1 at ,mons1 9 ,france1 an un=tunate woman 9 ?is condition 0 seiz$ ) an irresi/ible impulse to de/roy h] *ildr51 & actually dr[n$ ?ree ( !m1 & h]self aft]w>ds4 ,%e _h previ\sly s5t a poison$ cake also to "o at s*ool1 b =tunately x 0 n eat54 ,g5]ally speak+ all ^! ?+s pass away ) deliv]y1 if n be=e1 unless x be actual insanity1 :i* sometimes rema9s4 ,all t c be done is to att5d /rictly to ! g5]al heal?1 keep ! sk91 b[els1 & /oma*1 9 good action1 & remove all depress+ or irritat+ circum/ances4 ,if !re be a prop5sity to any?+ decid$ly injuri\s or dang]\s1 ! pati5t mu/ be /rictly wat*$1 b )\t its be+ p]ceiv$ or kn[n by h]1 = fe> ( excit+ suspicion 9 ^? :o w\ld be dispos$ to be cunn+ly secret or rev5geful4 ,prop] diet1 regul> ba?+1 & out-door ex]cise (t5 correct _m ( ^! ?+s4 ,h,,moptysis1 ,h,,matemesis ,,& ,,epi/axis4 ,^! ?ree t]ms mean spitt+ ( blood1 vomit+ ( blood1 & ble$+ f ! nose1 all ( :i* frequ5tly occur dur+ pregnancy4 ,spitt+ ( blood is mo/ usually obs]v$ 9 n]v\s wom51 & 9 ^? ( a full habit4 ,x is caus$ p>tly by sympa!tic irritation1 & p>tly by ! womb press+ upw>ds aga9/ ! diaphragm & less5+ ! size ( ! *e/1 :i* d]anges ! circulation 9 ! lungs1 & causes rupture ( _! blood vessels4 ,! premonitory symptoms are pa9s r\nd ! wai/1 cold extremities1 creep+ ( ! sk91 & a s5sation ( anxiety or depression r\nd ! he>t4 ,! attack beg9s by difficulty ( brea?+1 heat 9 ! *e/1 & dry c\gh1 foll[$ by spitt+ up m or less bloody fro?y mucus2 all :i* symptoms are mu* increas$ by viol5t ex]cise1 or a hot atmosph]e4 ,9 ord9>y cases a m]e spitt+ ( blood ne$ occasion no great al>m1 unless att5d$ by symptoms ( inflammation1 or unless ! pati5t has _h c\gh1 & o!r indications ( pulmon>y d]angem5t be=e conception4 ,9 hmatemesis ! blood is vomit$ f ! /oma*1 & is 9 black clots1 frequ5tly mix$ ) ! food1 or bile1 :ile t :i* comes f ! lungs 9 spitt+ on ! contr>y is bright r$1 & q fre%4 ,9 vomit+ ( blood also1 !re is seldom any c\gh or ex]tion ( any k9d4 ,! treatm5t ( spitt+ ( blood mu/ be ne>ly ! same z = _m o!r d]angem5ts already describ$4 ,:5 !re is a full habit1 ! pati5t mu/ live l[1 keep ! b[els free1 & ! sk9 9 good ord]1 & avoid all agitation ( m9d or ov] ex]tion ( body4 ,an ,opium pill occasionally w be useful1 or a few drops ( laudanum4 ,! c\gh mu/ be combatt$ 9 ! way recomm5d$ 9 my previ\s article on ,c\gh4 ,lemonade or tam>9d tea1 ) "s ,syrup ( ,poppies add$1 may be freely drunk1 or "s ( ! black currant root tea4 ,! treatm5t ( ,hmatemesis is precisely ! same4 ,occasionally h[ev] ! blood w pass into ! inte/9es & occasion colic1 & !n x mu/ be remov$ by adm9i/]+ an enema ( />* & ca/or oil1 or a little manna may be tak54 ,epi/axis1 or ble$+ f ! nose1 is mu* m frequ5t ?an ei!r ( ! prec$+1 b is seldom ( mu* consequ5ce4 ,9 _m cases 9 fact x is highly b5eficial1 z x relieves ! head f pressure1 & ?us obviates _m inconv5i5ces4 ,if x cont9ue too long1 or becomes excessive1 x may g5]ally be arre/$ by putt+ cold wet clo?s betwe5 ! eyes1 & on ! *eeks1 :ile ! head is kept elevat$4 ,! feet & h&s %\ld be kept w>m1 & ! air brea!d %\ld be z cold z possible4 ,9 extreme cases1 ! no/rils may be plugg$ ) bits ( sponge1 or cotton1 or "s p[d]$ alum may be snuff$ up !m4 ,! be/ plan is to raise ! h&s above ! head & put some?+ v cold1 z a lump ( ice = in/ance1 or a piece ( cold iron1 betwe5 ! %\ld]s2 ?is seldom fails4 ,,v>icose ,,ve9s4 ,v (t5 9 pregnant wom5 ! ve9s 9 diff]5t p>ts1 b p>ticul>ly ( ! ?ighs & legs w swell out 9 knots1 ei!r s+ly or 9 bun*es1 sometimes l /r+s ( beads1 or l ! l9ks ( a *a94 ,^! are call$ ,v>ices1 & occasionally !y atta9 a l>ge size1 & ext5d to v>i\s o!r portions ( ! body1 z ! ext]nal lips1 vag9a1 & m\? ( ! womb4 ,"s wom5 9 fact h !m ov] ne>ly ! :ole body4 ,!y are caus$ by ! pressure ( ! womb on ! l>ge abdom9al ve9s1 prev5t+ ! return ( ! blood & di/urb+ ! balance ( circulation betwe5 ! ve9s & art]ies4 ,9 ! majority ( cases1 unless v l>ge1 !y cause b little inconv5i5ce1 & may be let alone1 b sometimes !y cause pa91 or become s full t !re is dang] ( _! bur/+1 & !n x is necess>y to int]f]e4 ,! fir/ ?+ to be done is to relieve ! abdom9al ve9s f ! pressure ( ! womb1 & ?is may be done by ! pati5t keep+ m or less ! horizontal position1 & c>efully avoid+ all viol5t ex]tion4 ,! swell+ is always worse dur+ ! latt] "p ( ! day1 p>ticul>ly if ! woman has be5 mu* on h] feet1 %e %\ld !re=e apply a clo? roll] r\nd ! limbs be=e %e rises 9 ! morn+4 ,if ?is be c>efully put on1 j tight en\gh n to int]f]e ) ! motion ( ! limbs1 nor totally ob/ruct ! circulation1 x w prev5t ! v>ices to a great ext5t1 if n altoge!r4 ,brisk friction ) ! h& w disp]se ! swell+ 9 _m p]sons1 or w>m fom5tations1 b sometimes cold ba?+ answ]s bett]4 ,x is advisable always to disp]se !m z soon z possible1 = if !y rema9 too long t "p ( ! ve9 becomes p]man5tly weak5$ by be+ ov]/ret*$1 & w be always liable to swell aga9 f any slight cause4 ,x is p>ticul>ly advisable 9 ^! cases to avoid con/ipation1 & also to keep ! sk9 9 good action by ba?+ & frictions4 ,if at any "t "o ( ^! v>ices %\ld bur/1 x ne$ occasion no al>m1 unless x be seat$ on a l>ge ve91 & ! ble$+ becomes pr(use4 ,to /op x1 b9d on firmly ov] ! r5t any firm cold body1 z a flat /one1 or a l>ge silv] co91 pass+ ! b&age sev]al times r\nd4 ,9 slight cases a simple cold compress w be suffici5t1 or a little p[d]$ alum1 or "s v9eg> & wat]4 ,9 %ort any ( ! usual rem$ies = /opp+ ble$+ f w\nds4 ,! female mu/ be q /ill till x is /opp$1 & mu/ be c>eful :5 %e beg9s to move ab\t aga91 because x is liable to break out afre%4 ,^? ( a v full habit mu/ live l[1 & avoid all /imulants1 s z n to increase ! quantity ( blood 9 ! body m ?an is necess>y4 ,x is advisable to remove ! v>ices1 z mu* z possible1 be=e labor comes on1 p>ticul>ly if !y are situat$ on ! lips1 or 9 ! vag9a1 because !y may bur/ dur+ deliv]y & cause consid]able inconv5i5ce1 or ev5 dang]4 ,x is r>e t ^! swell+s cont9ue aft] deliv]y1 b if !y %\ld d s1 ! same treatm5t mu/ be p]si/$ 9 z be=e4 ,h,,morrhoids1 ,,or ,,piles4 ,^! are tr\blesome annoyances at any "t1 b p>ticul>ly dur+ pregnancy1 & un=tunately !y are v common at t "t4 ,!y are1 no d\bt1 *iefly caus$ 9 ! same way z v>icose ve9s1 t is by ! enl>g$ womb prev5t+ ! prop] fl[ ( ! blood 9 ! small ve9s1 & s caus+ !m to swell1 & =m tumors4 ,!y may 9 fact be call$ v>ices1 z truly s z ^? on ! limbs4 ,9 _m p]sons h[ev] !y are und\bt$ly br\ght on m]ely by ,con/ipation1 :i* w und\bt$ly ei!r cause !m or make !m mu* worse :5 o!rwise produc$4 ,9 g5]al !y become worse z ! pregnancy advances1 because ! womb becomes l>g] & ! b[els are m apt to be conf9$4 ,z long z !y only cause inconv5i5ce1 )\t any p>ticul> di/ress or urg5t symptom1 !y may be let alone1 or be slightly treat$ 9 ! way ( palliation1 till aft] deliv]y1 :5 !y w disappe>4 ,occasionally h[ev]1 !y gr[ to a l>ge size1 s z to h9d] ! passage ( ! b[els1 & prev5t ! pati5t f sitt+ d[n or walk+4 ,!y may !n cause inflammation1 & br+ on fall+ ( ! inte/9e1 or abortion1 by ! /ra9+ :i* !y necessitate :5 ! b[els are mov$4 ,& ev5 if ^! extreme results d n foll[1 !re may be s]i\s d]angem5ts ( ! g5]al heal?1 indicat$ by difficulty ( brea?+1 sleeplessness1 heada*e1 & fev]4 ,9 %ort !re are few ( ! d]angem5ts incid5t to pregnancy s annoy+ z ?is1 & un=tunately1 f its nature1 ! suff]] dislikes to speak ( x & seek ! necess>y assi/ance4 ,_m pref] und]go+ ! mo/ excruciat+ agony = mon?s1 r ?an compla91 :i* %[s ! necessity = females kn[+ h[ to treat !mselves1 :5 possible4 ,! ble$+ :i* sometimes takes place f ,piles is m (t5 b5eficial ?an o!rwise1 unless x becomes excessive1 f rupture ( a l>ge vessel1 9 :i* case1 if ! w\nd is ext]nal1 x may be treat$ ! same z ! ruptur$ v>icose ve92 if x be int]nal1 ! rem$ies mu/ be inject$ ) a syr+e1 or a l>ge roll ( l9t or cotton may be soak$ 9 alum wat] & pass$ up ! rectum4 ,frequ5tly ba?+ ! ?ighs & p]9eum ) cold wat] w be suffici5t4 ,to relieve ! pa9 & swell+1 ! female %\ld sit ov] ! /eam ( hot wat]1 & use ! w>m ba?4 ,if ! piles are ext]nal1 !y %\ld be ba!d ) hot milk & ,laudanum1 or rubb$ ) any soo?+ o9tm5t1 p>ticul>ly ! ,cucumb] ,o9tm5t1 m5tion$ 9 my ,diseases ( ,woman1 or ) ,/ramonium ,o9tm5t4 ,if !y are int]nal ! milk & ,laudanum %\ld be inject$ if possible1 or "s ?9 />* & ,laudanum1 & a /iff roll ( clo? may be sme>$ ) ! o9tm5t & introduc$4 ,9 g5]al1 o9tm5ts or o!r greasy matt]s are n s good z ! milk or />*4 ,9 conjunction ) ?is1 ! b[els mu/ be kept free1 ei!r ) enemas or ca/or oil1 or by us+ a seidlitz p[d] 9 ! morn+4 ,?is is indisp5sable1 = if con/ipation exi/s1 no applications c r5d] mu* s]vice4 ,! pati5t mu/ also avoid fatigue1 & n rema9 too long ^u h] feet1 nor sit long1 p>ticul>ly on a h>d seat1 & if %e be ( a full habit %e mu/ live l[1 to avoid mak+ too mu* blood4 ,x is also important1 at all times1 to avoid us+ dra/ic purgatives1 su* z ,aloes1 ,colocyn?1 or ,gamboge1 z !y always make piles mu* worse1 or ev5 cause !m4 ,,dema1 ,,or ,,wat]y ,,swell+s4 ,?is affection also appe>s1 l ! prec$+1 to arise f ob/ruct$ circulation1 b in/ead ( ! blood accumulat+ x is m]ely ! s]um1 or wat]y portion ( x4 ,! swell+s are g5]ally :iti%1 & spread ab\t1 & a small pit rema9s 9 !m :5 press$ ) ! f+]4 ,!y are f\nd on v>i\s p>ts ( ! l[] limbs1 & on ! gro9 or abdom51 & also ^u ! ext]nal lips1 9 :i* place !y are (t5 exce$+ly tr\blesome4 ,z a g5]al rule ^! swell+s are ( small acc\nt1 & z !y disappe> ) deliv]y1 b little att5tion ne$ be be/[$ ^u !m4 ,sometimes1 h[ev]1 !y become v ext5sive1 & s engorg$ t !y inflame & are extremely pa9ful4 ,!y h ev5 be5 kn[n to mortify1 & cause consid]able sl\gh+1 p>ticul>ly :5 *af$ & aft]w>ds wet ) ! ur9e4 ,9 ^! extreme cases !re may be s]i\s di/urbance ( ! g5]al heal?1 f ! con/ant irritation1 & f ! pati5t be+ unable to walk ab\t4 ,i h (t5 kn[n ! limbs & vulva cov]$ ) pat*es ( ,erysipelas f ?is cause4 ,sometimes ! swell+s ev5 become s l>ge t !y int]f]e ) ! process ( deliv]y4 ,! treatm5t ( ?is affection consi/s 9 re/1 p>ticul>ly ly+ d[n1 sal9e purgatives1 regul>1 & frequ5t wa%+ ! p>ts ) cold milk & ,laudanum1 or ) a solution ( ,borax1 half an ounce to a p9t ( wat]1 to be us$ cold & ) a tea-spoonful ( ,laudanum add$ to x4 ,simple cold wat] is frequ5tly q suffici5t4 ,9 g5]al all k9ds ( o9tm5ts are injuri\s1 b if o!r means fail to give relief1 ! ,cucumb] ,o9tm5t may be tri$4 ,! wa% %\ld always be us$ aft] ur9at+1 & ! p>ts mu/ n be rubb$1 b lightly dri$ ) a piece ( s(t l954 ,full]s e>? is (t5 an excell5t application :5 !re is *af+4 ,if ! pati5t be ( a full habit1 %e mu/ c>efully diet h]self1 & ba! regul>ly4 ,if %e be ?9 & weak1 a g5]\s diet w be advisable1 ) meat & ev5 a little w9e4 ,,hydrorrhea1 ,,or ,,pr(use ,,dis*>ge ,,( ,,wat]4 ,?is consi/s 9 a dis*>ge ( wat]1 m or less pr(use1 f ! vag9a1 at v>i\s p]iods dur+ pregnancy4 ,"s females w only dis*>ge a small quantity1 at int]vals1 o!rs w h a con/ant dropp+1 & o!rs aga9 w p\r out an imm5se quantity1 sometimes sev]al p9ts1 or ev5 qu>ts1 9 ! c\rse ( a few days4 ,9 g5]al ?is wat] is q limpid & colorless1 b sometimes x conta9s mu* mucus1 & at o!r times x is t+$ ) blood4 ,x does n appe> t ?is dis*>ge leads to any evil result1 ev5 :5 excessive1 & ,i only ref] to x to relieve anxiety4 ,! orig9 ( ?is wat] is n yet asc]ta9$1 b x is g5]ally ?\ght to be secret$ betwe5 ! membranes & ! womb1 & to be q di/9ct f ! liquor amnii4 ,,pu/ules1 ,,& ,,muc\s ,,dis*>ges4 ,occasionally ! ext]nal lips w be cov]$ ) pu/ules dur+ pregnancy1 & frequ5t dis*>ges ( mucus w occur f ! vag9a4 ,!y are bo? h[ev] caus$ by ! unusual action ( ! ut]9e sy/em1 & m]ely require frequ5t ba?+ ( ! p>ts ) milk & ,laudanum1 & regul> action ( ! b[els4 ,! mo/ important ?+ to rem>k 9 connection ) !m is t !y h (t5 be5 mi/ak51 ev5 by m$ical m51 = ! effects ( syphilitic disease1 & mu* di/ress has result$ f su* mi/akes4 ,,d]angem5ts ,,( ,,! ,,ur9>y ,,organs4 ,sev]al d]angem5ts ( ! ur9>y organs are liable to occur dur+ pregnancy1 p>tly f sympa!tic irritation1 & p>tly f m]e pressure4 ,"s ( ^! may be p>tially reliev$1 o!rs h to be borne z pati5tly z !y c be till deliv]y removes !m4 ,! swoll5 womb (t5 presses on ! neck ( ! bladd]1 & h9d]s ! passage ( ! ur9e1 or ev5 ob/ructs x sometimes altoge!r1 & ?us causes /ra9+1 burn+ heat1 & great di/5sion ( ! bladd]4 ,9 "s in/ances ?is passes (f z ! pregnancy advances1 ow+ to ! womb ris+ high] 9 ! abdom51 b 9 o!r cases x rema9s m or less1 dur+ ! :ole t]m4 ,x is p>ticul>ly important1 9 su* cases1 t ! female %\ld n let ! difficulty rema9 too long unrem$i$1 = if ! bladd] be v full x may become utt]ly impossible to empty x by natural ef=t4 ,sometimes ! difficulty is mu* less5$ by ly+ on ! back a %ort "t be=e attempt+ to ur9ate1 or by rais+ up ! abdom5 ) ! h& at ! "t4 ,_m females c ur9ate ) tol]able com=t :ile ly+ on ! back or abdom51 & o!rs are mu* reliev$ by con/antly we>+ a b&age4 ,con/ipation always makes ?is difficulty worse1 & sometimes ev5 causes x1 by keep+ ! rectum full & ?us increas+ ! pressure4 ,9 all su* cases x w be readily se51 t =c+ m$ic9es are n only useless1 b liable to cause injury4 ,! *ange ( position1 re/1 & support+ ! abdom5 are ! means to be reli$ ^u4 ,if ^! fail1 & ! ur9e accumulates1 ! ca!t] mu/ be us$4 ,a w>m ba?1 or fom5tation ) w>m wat] & ,laudanum1 w assi/1 & sometimes relieve alone4 ,to ease ! burn+ & di/ress ! pati5t mu/ dr9k freely ( gum wat]1 or b>ley tea1 ) a little ,syrup ( ,poppies4 ,!re is "o manuvre :i*1 if practis$ aright1 w ne>ly always all[ ! female to ur9ate ) ease1 & =tunately %e c practise x h]self4 ,x consi/s 9 introduc+ two ( ! f+]s into ! vag9a1 & rais+ up ! womb1 z if practis+ ! ballotm5t4 ,?is removes ! pressure f ! bladd]1 & ! ur9e !n escapes by natural ef=t4 ,a few trials w soon enable any "o to d ?is1 p>ticul>ly if !y notice well ! =m & position ( ! p>ts1 z %[n 9 ! plates ( ?is "w4 ,a lady :o he>d me m5tion ?is 9 "o ( my ,lectures1 aft]w>ds /at$ t ! k ( x enabl$ h] to disp5se altoge!r ) ! ca!t]1 :i* %e 0 previ\sly necessitat$ to use dur+ mo/ ( h] pregnancy4 ,:5 !re is m]ely a n]v\s irritation caus+ ! difficulty1 ! w>m ba?1 or fom5tation ) w>m wat] & ,laudanum w be suffici5t1 or a little ,belladonna ,o9tm5t may be rubb$ ov] ! meatus ur9>ius1 :ile "s />* & ,laudanum is inject$ c>efully into ! vag9a4 ,,cramps4 ,^! arise f ! womb press+ on ! n]ves ( ! sacrum1 & are !re=e n "u ! control ( m$ic9e4 ,all t c be done is to *ange ! position ( ! body z mu* z possible1 f ly+ d[n to /&+ up1 & by turn+ f "o side to ano!r4 ,brisk rubb+ ) ! h& w also assi/ 9 giv+ relief4 ,! cramps h[ev] usually disappe> aft] deliv]y1 & mu/ !re=e be borne z pati5tly z possible till t takes place4 ,,pruritus1 ,,or ,,it*+ ,,( ,,! ,,ext]nal ,,p>ts4 ,hav+ treat$ ?is affection fully 9 my ,diseases ( ,woman1 ,i _c d bett] ?an extract ! article f t "w on ! subject4 ,?is disease1 ?\gh n s imm$iately dang]\s z "s o!rs1 is p]haps ! mo/ di/ress+ t c be met )4 ,x consi/s 9 an intol]able & incessant it*+ ( ! p>ts1 :i* no?+ seems to allay4 ,sometimes x is s bad t ! female is almo/ torm5t$ to dea?2 %e _c see company1 or walk out1 & (t5 %uts h]self up alone 9 h] agony4 ,_m h fa9t$ f x1 & "s h ev5 become deliri\s4 ,i h se5 pati5ts ^: h&s x 0 necess>y to tie1 to prev5t !m te>+ !mselves to pieces4 ,! causes ( pruritus appe> to be mo/ ( ^? t produce simple inflammation1 :i* x v frequ5tly accompanies or prec$es4 ,pregnant females are v liable to x1 & 9 "s x w cont9ue1 9 spite ( all t c be done1 till aft] deliv]y1 :5 x usually disappe>s4 ,i h kn[n x produce abortion4 ,"s females always h x at ! m5/rual p]iod1 & o!rs dur+ nurs+4 ,occasionally !re is a little eruption att5d+ x1 b n always1 ?\gh ! p>ts are g5]ally swoll5 & r$4 ,p>asites are sometimes ! excit+ cause1 & %\ld always be de/roy$ imm$iately4 ,! treatm5t consi/s 9 fir/ att5d+ /rictly to ! diet1 :i* mu/ be light & unirritat+1 & to ! regul> action ( ! b[els & womb2 & 9 us+ ! cool+ wa%es & lotions be=e m5tion$4 ,if ! it*+ /ill cont9ues1 use ei!r ( ! foll[+ wa%es to ! p>ts3--,sub4 c>bonate ( pota% ?ree dra*ms1 wat] f\r ounces2 put a tea-spoonful ( ?is into a qu>t ( w>m wat]1 & use x ?ree times a day4--,a tea-spoonful ( ,eau de ,cologne to a p9t ( w>m wat]4--,sulphate ( ,z9c1 half a tea-spoonful to a qu>t ( w>m wat]4 ,bo? ^! may be us$ _m times 9 ! day4--,borax half an ounce1 ,sulphate ( ,morphia six gra9s2 pure wat] half a p9t4 ,?is la/ seldom fails ( giv+ relief4 ,x %\ld be appli$ ?ree or f\r times a day1 ) a piece ( s(t l951 ! p>ts be+ fir/ wa%$ ) w>m soap & wat]4 ,a tea-spoonful ( laudanum w sometimes answ] z well z ! six gra9s ( ,sulphate ( ,morphia4 ,cau/ic has be5 employ$1 & bli/]s to ! inside ( ! ?ighs1 b su* viol5t rem$ies are seldom ei!r necess>y or s]viceable4 ,i h kn[n ! p>ts to be deeply sc>ifi$ ) ! lancet1 & ev5 burnt ) a r$ hot iron1 )\t at all alleviat+ ! pruritus4 ,9 "y p]sons x seems to be (t5 produc$ by con/ipation1 worms1 & gravel2 b x mo/ probably dep5ds1 ess5tially1 on "s impurity1 or irritat+ quality1 9 ! blood1 or 9 ! natural secretions ( ! p>ts1 :i* %\ld !re=e nev] be all[$ to rema9 long unwa%$4 ,sitt+ 9 cold wat]1 & ! application ( ice to ! p>ts1 has giv5 relief4 ,i h also effect$ _m cures1 almo/ in/antane\sly1 by means ( a small ,galvanic plate1 s con/ruct$ z to be worn j )9 ! vulva4 ,all rem$ies mu/ ( c\rse be appli$ ) caution dur+ pregnancy2 & x mu/ be recollect$ t sometimes ! disease w cont9ue1 m or less1 till aft] deliv]y1 ?\gh ! di/ress f x may be mu* alleviat$4 ,,*apt] ,,xxvii4 ,,idiopa?ic1 ,,or ,,prim>y ,,diseases ,,incid5t ,,to ,,pregnancy4 ,,flood+1 ,,or ,,hemorrhage4 ,flood+ is "o ( ! mo/ dang]\s accid5ts t occur dur+ pregnancy1 its consequ5ces be+ (t5 ( ! mo/ s]i\s "*4 ,! causes t lead to flood+ are v num]\s1 "s ( !m pr$ispos+ to x1 & o!rs imm$iately excit+ x4 ,among ^! may be m5tion$ a too full habit1 viol5t ex]tion1 falls1 c\gh+1 vomit+1 /ra9+ f co/iv5ess or viol5t purgatives1 =c+ m$ic9es1 crim9al attempts at abortion1 ov]walk+1 bl[s on ! abdom51 too mu* danc+1 or runn+ up /airs1 /rong m5tal emotions1 fright1 or ang]1 & c]ta9 excesses4 ,! imm$iate cause is ! sep>ation ( ! membrane 9 :i* ! ftus is inclos$ f ! walls ( ! womb4 ,flood+ may h[ev] result f ! plac5ta gr[+ ov] ! m\? ( ! womb1 & be+ torn z t op5s--usually ab\t ! six? or sev5? mon?4--7,see ! article ,flood+ dur+ ,labor47 ,9 mo/ cases flood+ is prec$$ by dull pa9 9 ! lo9s & gro9s1 & a s5sation ( weight & dragg+4 ,simil> s5sations h[ev] are (t5 produc$ by o!r causes1 :i* makes x difficult to pr$icate1 ) any degree ( c]ta9ty1 :e!r ! pati5t is ab\t to flood or n4 ,! v fir/ appe>ance ( blood f ! vag9a mu/ !re=e be wat*$ = c>efully1 z t removes all d\bt1 & w>ns u to be prompt ) ! prop] rem$ies4 ,sometimes a female w flood int]nally1 ! blood be+ reta9$ by ! passage be+ clos$ or plugg$ up by clots1 or by its pass+ beh9d ! membranes1 or "u ! c5tre ( ! plac5ta4 ,^! int]nal or conceal$ hemorrhages are v dang]\s1 z ! pati5t may lose mu* blood be=e h] condition is suspect$4 ,x is !re=e necess>y to be> ?is 9 m9d1 & c>efully use e means to asc]ta9 :e!r su* an accid5t has occurr$ or n4 ,9 g5]al ! indications are pretty pla91 ! pati5t suff]+ f deep seat$ & di/ress+ pa9s 9 ! back & gro9s1 ) great weakness 9 ! limbs1 fa9tness1 weak pulse1 dimness ( sight1 r++ 9 ! e>s1 coldness ( ! h&s & feet1 swell+ ( ! abdom51 & f9ally fa9t+1 p>ticul>ly if ! reta9$ blood sudd5ly escapes1 :i* x usually does4 ,9 ! e>ly mon?s !re is m dang] to ! *ild f flood+ ?an !re is to ! "m1 because x is ne>ly c]ta9 to lead to abortion4 ,9 ! latt] mon?s1 on ! contr>y1 ! "m runs ! greate/ risk1 z ! *ild may !n live if x be expell$1 :ile ! "m may s9k & die f excessive loss ( blood4 ,!re are _m females ( a v full habit1 :o suff] b little f hemorrhage1 unless x be excessive1 inde$ "s seem to be b5efitt$ by x1 & are ?us reliev$ f heada*e & convulsions4 ,x %\ld1 h[ev]1 be c>efully wat*$1 & its effects duly not$4 ,! treatm5t ( flood+ mu/ dep5d mat]ially ^u its sev]ity1 & ! "t :5 x occurs4 ,9 ! e>ly mon?s1 :5 ! dis*>ge is slight1 & :5 x causes little di/ress1 simple means w answ]4 ,! pati5t mu/ lie on h] back1 on a h>d mattress1 ) ! pelvis rais$1 by means ( a pill[1 high] ?an ! re/ ( ! body4 ,! air mu/ be kept fre% & cool ar\nd h]2 %e mu/ keep h]self quiet 9 body & m9d1 live r l[1 & dr9k freely ( cool+ dr9ks1 su* z soda wat]1 lemonade1 tam>9d tea1 or ice wat]4 ,! fulle/ directions = mak+ & us+ all ^! dr9ks w be f\nd 9 my ,diseases ( ,woman4 ,if ! flood+ does n /op ) ^! simple means1 ext]nal applications mu/ be made1 ( cold1 wet clo?s1 or ev5 ice1 ov] ! abdom51 & inside ! ?ighs4 ,f9ally1 if fur!r treatm5t is /ill ne$$1 cold a/r+5t injections may be c>efully ?r[n into ! vag9a4 ,cold wat] is p]haps z good z any?+ = ?is purpose1 & ,i h frequ5tly kn[n a mo/ sev]e flood+ *eck$ imm$iately by inject+ cold wat] into ! vag9a & rectum1 & apply+ cold wet clo?s ov] ! abdom51 & inside ! ?ighs4 ,"s a/r+5t dr9k may also assi/1 su* z a little syrup ( comfrey1 or extract ( ,rhatany1 & p>ticul>ly a tea made ( ! root ( ! black currant1 z recomm5d$ 9 my ,diseases ( ,woman4--,a h&ful ( ! root may be boil$ 9 two qu>ts ( wat]1 = tw5ty m9utes2 x %\ld be sweet5$ to ta/e & drunk freely4 ,! common blackb]ry1 or ! dew b]ry1 is also excell5t1 ?\gh n s good z ! black currant4--,if ! pati5t be n]v\s & irritable1 or suff] mu* f pa91 an opium pill may be tak51 or f t5 to tw5ty drops ( laudanum4 ,! g5]al practice 9 ^! cases is to ble$ freely & give opium6 ,& z ?is practice c]ta9ly does succe$ 9 _m extreme cases1 ,i %\ld c]ta9ly recomm5d1 if ! simpl] means fail1 to resort to x at once4 ,i dislike ble$+ v mu*1 9 any cases1 & "h x seems p>ticul>ly inappropriate2 ,i %\ld !re=e say try almo/ any?+ & ev]y?+ fir/1 b nev] ob/9ately refuse to d x if no?+ else succe$s4 ,9 "s cases a plug or tampon is us$1 to fill up ! vag9a4 ,x may be made ( a roll ( clo?1 cotton1 or a piece ( sponge4 ,?is practice1 h[ev]1 is useless 9 ! latt] mon?s ( pregnancy1 & v (t5 fails ev5 at o!r times4 ,:5 x succe$s x causes ! blood to coagulate1 & ?us closes up ! m\?s ( ! vessels4 ,q z (t51 h[ev]1 x only keeps x 91 & makes x accumulate 9 ! womb till x all ru%es away at once2 /ill x may be tri$4 ,if ! hemorrhages %\ld occur s frequ5tly1 or be s excessive1 9 spite ( all treatm5t1 z to endang] ! safety ( ! pati5t1 !re is no o!r res\rce left to save h] life b to produce abortion1 because ! pres5ce ( ! ftus & its app5dages is evid5tly !n ! irritat+ cause :i* keeps up ! dis*>ge1 & x _c be expect$ to /op till ! womb is empti$4 ,,abortion1 ,,or ,,misc>riage4 ,:5 ! ftus is prematurely expell$ be=e x c survive1 x is call$ an ,abortion1 b if its expulsion take place s late t x c live1 x is call$ ,misc>riage4 ,bo? ^! are s]i\s accid5ts4 ,9 abortion ! *ild is lo/1 z a matt] ( c\rse1 b 9 misc>riage x may live1 aft] ! sev5? mon?4 ,! dang] to ! "m is consid]able f bo?1 ?\gh greate/ probably f abortion4 ,x is probable t _m v e>ly misc>riages take place unp]ceiv$1 ! female suff]+ b little f ! accid5t1 & ! embryo be+ too small to be se51 unless c>efully look$ =4 ,! mo/ frequ5t p]iods = su* accid5ts are f\nd to be six mon?s1 five mon?s1 & ?ree mon?s2 & :at is v s+ul>1 a mu* great] numb] ( male *ildr5 are abort$ ?an females1 ! proportion be+ ab\t sixte5 to elev54 ,^! accid5ts are s intimately connect$ ) flood+1 t _m writ]s always treat ( !m toge!r1 consid]+ ! flood+ m]ely z ! mo/ frequ5t cause & symptom ( misc>riage or abortion4 ,9 speak+ !re=e ( ! imm$iate causes ( premature expulsion ( ! ftus1 we place hemorrhage fir/1 & ! causes be=e enum]at$ :i* produce t z be+ its mo/ frequ5t remote ones4 ,a full habit1 ) t5d5cy to local conge/ion1 seems to pr$ispose a female v mu* to misc>riage2 e "o s con/itut$ %\ld c>efully avoid luxuri\s liv+ & an inactive life4 ,viol5t bodily ex]tion1 falls1 or bl[s1 or /rong m5tal excitem5t are mo/ usually ! imm$iate causes1 ?\gh ) "s x w come on spontane\sly )\t any su* excit+ ag5cies4 ,"s females w misc>ry _m times 9 succession1 & always s ne> ! same p]iod1 t !y c tell to a day or two :5 x w happ54 ,x seems to become a habit ( ! womb ) !m to contract at t p>ticul> "t1 & ! only way to break ?r\gh ! habit is = !m to avoid becom+ pregnant = "s consid]able "t1 say two or ?ree ye>s aft]1 !y may !n g ! full "t1 b w seldom d s if !y conceive imm$iately aft] hav+ misc>ri$4 ,9 "s p]sons misc>riage is caus$ by a too eag] gratification ( c]ta9 desires2 b 9 o!rs x may arise f ! opposite cause4 ,!re is a disease ( ! womb also by no means unfrequ5t1 ?\gh b little und]/ood1 :i* und\bt$ly causes mu* misc>riage1 & t is ,rheumatism ( ! ,womb6 ,?is mo/ly exi/s be=e ! pregnancy h[ev]1 & %\ld be !n treat$ accord+ to ! plan laid d[n 9 my ,diseases ( ,woman4 ,misc>riage also arises 9 _m females f a rigid /ate ( ! muscul> fibres ( ! womb1 :i* n relax+ suffici5tly to all[ t organ to exp& become irritat$ by ! pressure !y exp]i5ce1 & beg9 to contract4 ,?is contraction ( ! womb ( c\rse soon leads to ! expulsion ( its cont5ts1 ! same z 9 real labor4 ,wom5 ) _! fir/ *ildr5 are m liable to misc>riage ?an o!rs on ?is acc\nt1 ! womb n hav+ become habituat$ z x 7 to ! necess>y relaxation4 ,& ?is is ! reason also :y "s females1 aft] suff]+ f ?is accid5t _m times 9 succession at la/ escape x4 ,9 g5]al !y misc>ry e>ly ! fir/ "t1 f ! womb n relax+ suffici5tly1 b g a little long] ! next "t1 & long] /ill ! next1 & s on till !y rea* ! full p]iod4 ,! fibres ( ! womb h gradually become accu/om$ to relax1 & h borne ! irritation long] & long] ea* pregnancy1 till at la/ !y h =borne to contract till ! prop] "t4 ,i knew "o female :o misc>ri$ tw5ty-"o times 9 succession1 gett+ gradually ne>] to ! full p]iod ea* "t1 till at la/ %e rea*$ n9e mon?s1 & 0 rew>d$ ) a liv+ *ild4 ,sometimes ! accid5t may be produc$ by a ut]9e tumor1 by a great quantity ( wat] 9 ! womb1 or ev5 by !re be+ m ?an "o *ild1 because 9 ei!r ( ^! cases !re is requir$ m room ?an ord9>y2 & ( c\rse f ! great] expansion requir$1 ! liability is increas$4 ,v>i\s womb diseases may also be m5tion$ z causes1 or adhesions ( its walls or ligam5ts to ! walls ( ! abdom51 & also a diseas$ /ate ( ! plac5ta4 ,! pressure ( corsets & tight dresses also n unfrequ5tly lead to ! same result4 ,"s g5]al diseases und\bt$ly (t5 cause misc>riage1 su* z measles1 jaundice1 sc>let fev]1 consumption1 & probably _m o!rs1 p>ticul>ly ^? 9 :i* ! quality ( ! blood is mu* alt]$1 or ! n]v\s p[] mu* exalt$ or depress$4 ,convulsions h already be5 m5tion$ z be+ frequ5t causes ( misc>riage1 & all /rong m5tal or moral impressions4 ,inde$ ^! la/ causes op]ate m ?an is suspect$1 & make x necess>y = a pregnant female to be kept z calm 9 h] m9d z x is possible = h] to be4 ,i h ev5 kn[n "o to misc>ry f a fright 9 a dream4 ,x is also a fact1 ?\gh n g5]ally kn[n1 t !re are c]ta9 diseases ( ! fa!r t may produce misc>riage1 & un=tunately !y are ( t k9d t (t5 rema9 = a long "t 9 ! sy/em )\t mu* ext]nal manife/ation1 s t _m p]sons ?9k !y are p]fectly free f !m ev5 :ile !y are work+ su* mis*ief4 ,! dea? ( ! *ild also is sure to produce misc>riage1 & ?is may result f v>i\s causes1 su* z ext]nal injuries & viol5ce1 or f rema9+ too long 9 ! w>m ba? & !reby caus+ conge/ion ( blood 9 ! womb4 ,small pox & syphilis 9 ! "m may also cause ! dea? ( ! *ild1 ?\gh n always4 ,_m hav+ be5 born at full t]m ) ^! diseases ^u !m4 ,9 g5]al ! ftus is expell$ v soon aft] x dies1 b occasionally x is reta9$ = a consid]able "t1 & may n pass away till x is completely decay$4 ,x has ev5 be5 kn[n to become almo/ fluid1 & sev]al mon?s elapse be=e x 0 entirely expell$4 ,mo/ wom5 "k :5 x dies1 by its seem+ to fall d[n to ! bottom ( ! abdom51 l a dull weight1 & also by its feel+ v cold4 ,v (t51 h[ev]1 !re is no indication ( its dea? :atev]4 ,m4 ,*ailly m5tions a case :]e ! embryo di$1 probably :5 ab\t fifte5 days old1 b ! plac5ta cont9u$ to gr[1 & ! lady 0 deliv]$ :5 ab\t six mon?s & a half gone ( ! dead embryo1 only ab\t a qu>t] ( an in* 9 l5g?1 ?\gh ! aft]-bir? 0 ne>ly l>ge en\gh = "o ( ! usual size4 ,9 ?is case x _h di$ b n decay$1 & rema9$ 9 ! womb six mon?s & a half4 ,9 cases ( tw9s also1 "o w sometimes die at an e>ly p]iod1 b rema9 till ! o!r is born at full t]m4 ,! gr[? ( ! plac5ta ov] ! m\? ( ! womb1 & %ortness ( ! *ord1 h already be5 ref]r$ to z causes bo? ( flood+ & misc>riage2 & to ^! may be add$ mon/r\s or de=m$ ftuses1 :i* r>ely rea* ! full t]m4 ,x is probable t !re are _m con/itutional & individual peculi>ities pr$ispos+ to misc>riage1 ) :i* we are n mu* acqua9t$1 & :i* may acc\nt = ! con/ant occurr5ce ( t accid5t 9 _m females1 not)/&+ all we c d4 ,a scr(ul\s ta9t is ) good reason suppos$ to be "o ( ^!1 & x is probable t ! disease ( ! plac5ta1 & its consequ5t sep>ation f ! womb1 be=e ref]r$ to1 is mo/ly caus$ by a ta9t ( ?is k9d4 ,9 _m in/ances1 :]e a female has misc>ri$ f no app>5t cause1 if ! plac5ta be c>efully exam9$ x w be f\nd dott$ "h & !re ) diseas$ spots1 sometimes l scr(ul\s sores6 ,x is advisable always to asc]ta9 ?is1 & to c>efully exam9e ! ftus & its app5dages4 ,9 all cases ! advice ,i gave to keep f be+ pregnant = "s "t1 w be f\nd mo/ likely to succe$ 9 av]t+ ! accid5t1 bo? because x gives ! womb "t to rega9 its /r5g? & break ?r\gh its habit1 & also because x gives u "t to op]ate ^u ! con/itutional ta9t1 if !re be reason to suppose x exi/s4 ,x is a curi\s fact1 b "o (t5 obs]v$1 t liv+ 9 c]ta9 localities ev5 pr$isposes to misc>riage4 ,!re is a c]ta9 di/rict 9 ,france :]e ! females are s liable to x1 t all :o c d s leave ! place :5 !y become pregnant1 & ?us escape ! great] risk4 ,misc>riage also becomes epidemic at c]ta9 times1 & prevails l contagi\s diseases2 sev]al in/ances ( ?is are record$ 9 hi/ory4 ,ble$+ is also suppos$ to be a cause ( abortion1 & probably x may lead to x 9 c]ta9 /ates ( ! sy/em1 b by no means s c]ta9ly z _m suppose4 ,in/ances h be5 kn[n ( pregnant females be+ bl$ f t5 to tw5ty times )\t any evil result1 ev5 ?\gh c>ri$ s f> z to make !m fa9t4 ,mauriceau tells u ( "o :o 0 bl$ n9ety times1 & yet 0 deliv]$ ( a heal?y liv+ *ild at full t]m4 ,9 l mann] _m o!r ord9>y causes ( abortion w (t5 fail entirely ( _! usual effects4 ,?us ,mauriceau in=ms u t a female sev5 mon?s gone fell ^u ! h>d pavem5t f a ?ree /ory w9d[ & broke h] arm1 b yet did n misc>ry4 ,madame ,la*apelle also tells u ( a "y pregnant woman :o ?rew h]self d[n /airs purposely1 f fe> t %e %\ld h to submit to ! ,ces>ean op]ation1 %e hav+ a de=m$ pelvis4 ,! fall caus$ h] dea? soon aft]1 b did n make h] misc>ry4 ,c]ta9 p[]ful m$ic9es are also tak5 by "s1 a v small quantity ( :i*1 9 mo/ cases1 produces abortion imm$iately1 b )\t effect+ :at !y desire1 ?\gh x sometimes poisons !mselves4 ,inde$ ! p[] :i* ! womb sometimes exhibits to reta9 its cont5ts 9 spite ( ! mo/ viol5t di/urb+ ag5cies1 is truly a/oni%+4 ,cases h be5 kn[n ev5 :]e ! womb itself has be5 sev]ely w\nd$1 & yet misc>riage did n take place2 z 9 ! case ( a poor c\ntry-woman :om ,i he>d (1 :o accid5tally fell ^u a %>p wood5 /ake1 & run x f> into ! body1 injur+ ! womb 9 a t]rible mann]1 b /range to say1 ?\gh f> advanc$ 9 pregnancy1 %e recov]$ & w5t safely ?r\gh h] full "t4 ,i h (t5 kn[n wom5 beg9 to flood & suff] f dreadful pa91 ) o!r common symptoms ( abortion1 z e>ly z ! second mon?1 & yet !y w5t safely ! full "t1 ?\gh ^! signs cont9u$ ! :ole "t4 ,9 "s cases ! wat]s h ev5 be5 p>tially dis*>g$1 & yet abortion did n result4 ,m4 ,velpeau tells u ( an in/ance :]e ! bag ( wat]s broke1 9 a female six mon?s gone1 & "o arm ( ! *ild ev5 came d[n into ! vag9a1 & yet ! arm return$1 ! dis*>ge ceas$1 & %e w5t h] full t]m4 ,! progress ( a misc>riage v>ies accord+ to ! "t at :i* x occurs1 & ! causes f :i* x arises4 ,:5 x results f any viol5ce or accid5t1 x usually takes place 9 a %ort "t1 & is prec$$ by abundant flood+1 :i* comes on imm$iately4 ,! dis*>ge ( blood h[ev]1 is less] ! ne>] we approa* ! full t]m1 s t a female six mon?s gone is n 9 ne>ly s mu* dang] f flood+ z "o only two or ?ree mon?s gone4 ,! reason is ?is1 9 ! e>ly mon?s ne>ly ! :ole ( ! ftal membranes are atta*$ to ! womb1 s t 9 case ( _! be+ sep>at$1 x ble$s f ne>ly all its int]nal surface1 b 9 ! latt] mon?s ! only po9t ( atta*m5t is ! plac5ta4 ,9 ! latt] mon?s also ! womb contracts vigor\sly1 & s closes its vessels1 b 9 ! e>ly mon?s its contractions are comp>atively feeble4 ,9 ^? cases also1 :]e ! *ild has be5 dead a consid]able "t be=e its expulsion1 !re is seldom mu* flood+1 ! connection betwe5 x & ! "m hav+ be5 m or less de/roy$ by decay ( ! p>ts4 ,! same result mo/ly foll[s a misc>riage f int]nal disease1 p>ticul>ly ( ! plac5ta4 ,inde$ 9 "s ( ^! cases1 ! blood-vessels connect+ ! ftus ) ! "m h be5 s completely de/roy$1 t no blood :atev] c\ld escape f !m4 ,9 reg>d to ! probable consequ5ces ( premature deliv]y1 x has already be5 rem>k$ t x is m dang]\s 9 ! e>ly mon?s ?an ! latt]4 ,x may also be add$ t x is mu* m dang]\s1 at any "t1 :5 caus$ by viol5ce ( any k9d1 or by =c+ m$ic9es1 ?an :5 x occurs naturally4 ,! dang] is mu* increas$ if x occurs dur+ fev]1 or any eruptive disease1 or if ! pati5t be suff]+ f di>rha or convulsions4 ,z a g5]al rule we may say1 9 all cases1 t misc>riage or abortion is always m dang]\s to "m & *ild ?an natural labor1 bo? 9 its pres5t & 9 its future consequ5ces4 ,dur+ an attack ( jaundice an abortion may t]m9ate fatally 9 a few h\rs2 & v frequ5tly ! tr\ble ) ! aft] treatm5t is v great & long-cont9u$4 ,! treatm5t 9 an accid5t ( ?is k9d mu/ v>y accord+ z we are requir$ to prev5t x1 or to rem$y ! evils t foll[ :5 x has occurr$4 ,if an abortion be ?reat5$ f any cause1 ! same g5]al practice mu/ be adopt$ z recomm5d$ = flood+1 ! indications be+ ! same4 ,i believe myself t 9 mo/ cases1 except f accid5tal viol5ce or int]nal disease1 misc>riage may be av]t$4 ,i knew a lady :o _h misc>ri$ _m times1 always at ! same p]iod1 :o avoid$ x at la/ by simply prev5t+ con/ipation f ! fir/ comm5cem5t ( pregnancy1 & by us+ an enema e ev5+ ( w>m />* & wat]1 pretty ?ick1 ) ab\t ?irty drops ( laudanum4 ,?is 0 adm9i/]$ by means ( a common injection pipe1 j be=e go+ to b$1 & cont9u$ till aft] %e _h quick5$1 & repeat$ occasionally aft] t1 if %e felt any premonitory symptoms ( ut]9e di/urbance4 ,if ! pati5t be ( a full habit1 %e %\ld also1 f ! v beg9n+1 live l[1 keep ! b[els free1 & ! sk9 9 good action1 & take g5tle regul> ex]cise 9 ! op5 air4 ,:5 all ! means us$ are f\nd ( no avail1 & x becomes evid5t t ! ftus mu/ be expell$1 e endeavor %\ld be us$ to assi/ nature 9 its removal z e>ly & z safely z possible4 ,= ?is purpose ! same treatm5t1 z f> z practicable1 mu/ be pursu$ z 9 a real labor4 ,if ! h& c be conv5i5tly introduc$1 )\t undue =ce1 x may be s1 to remove clots1 or to take hold ( any "p ( ! ftus :i* may pres5t1 & assi/ 9 its extraction4 ,9 ! e>ly mon?s consid]able help may be giv51 sometimes by introduc+ ! f+] into ! m\? ( ! womb1 ) a little extract ( ,belladonna1 to promote its relaxation1 b no =ce mu/ be ex]t$ 9 do+ s4 ,if any "p ( ! aft]-bir? c be laid hold ( x %\ld be )drawn1 b no extraord9>y ef=t mu/ be us$ to rea* x4 ,frequ5tly x happ5s t a portion ( ! aft]-bir? rema9s 9 spite ( all attempts to take x away1 & !re is a possibility t x may produce inflammation ( ! womb1 b no v s]i\s appreh5sions ne$ be felt ( su* a result1 provid+ ! pati5t is prop]ly att5d$ to 9 o!r respects4 ,! reta9$ portion gradually decays1 & passes away1 m]ely occasion+ inconv5i5ce & be+ v (f5sive4 ,! dang] f leav+ x except at a v late p]iod1 is g5]ally ?\ght to be less ?an t f us+ any =cible means to remove x4 ,! be/ means = correct+ ! (f5sive dis*>ge are cleans+ & antiseptic injections4 ,w>m soap suds are v good1 or a decoction ( ,p]uvian b>k 9 wat]4 ,/rong c(fee is also excell5t1 or a weak solution ( *loride ( lime4 ,! b[els mu/ be kept free1 & ! sk9 c>efully cleans$ & well rubb$4 ,on all occasions :5 ! h& c be introduc$ ) mod]ate & safe ef=ts x %\ld be s1 & ! aft]-bir? remov$4 ,9 conclusion x %\ld be rem>k$1 t ! t5d5cy to misc>ry1 l _m female diseases1 is und\bt$ly ow+1 9 great "p1 to ! g5]al debility & weakness :i* *>act]izes s _m wom5 at ! pres5t day1 & :i* is br\ght on *iefly by neglect ( _! physical education :5 girls1 & by _! artificial mode ( life aft]w>ds4 ,,section ,x4 ,,! ,,diseases ,,( ,,wom5 ,,9 ,,*ildb$1 ,,aft] ,,ly+ ,,94 ,,*apt] ,,xxviii4 ,,diseases ,,( ,,*ildb$4 ,,pu]p]al ,,fev]1 ,,or ,,*ildb$ ,,fev]4 ,?is is und\bt$ly ! mo/ s]i\s ( all ^? maladies t s (t5 foll[ labor4 ,x appe>s f m$ical records t pu]p]al fev] has be5 kn[n f v remote times1 & t x has frequ5tly become epidemic1 or has spread f "o to ano!r1 l ! ,*ol]a4 ,9 hospitals ?is has (t5 be5 obs]v$1 & also 9 cities1 sometimes almo/ e female deliv]$ 9 ! place hav+ be5 attack$ :ile x prevail$4 ,!re is also no d\bt b t x is contagi\s1 or capable ( be+ transmitt$ f "o p]son to ano!r1 l small pox4 ,num]\s in/ances h be5 kn[n :]e nurses & physicians h convey$ x to all :om !y att5d$1 dur+ a long p]iod aft] hav+ be5 ) a s+le case4 ,"o physician1 aft] att5d+ a case ( pu]p]al fev]1 lo/ n9e pati5ts successively f ! same disease1 be=e he suspect$ ! cause1 & an old nurse assur$ me1 t :5 %e 0 a "y woman1 %e 0 ! un=tunate means ( convey+ x to two females :om %e visit$1 by m]ely hav+ be5 9 ! room a %ort "t ) "o :o 0 suff]+ f x4 ,x is !re=e highly important t all p]sons :o may happ5 to be ) a female s affect$ %\ld n att5d ano!r case ( *ildbir? = "s "t1 & p>ticul>ly t !y %\ld n we> any portion ( ! same clo?+ !y _h !n on1 & t !y %\ld ba! ! :ole body sev]al times4 ,if a case occurs 9 a hospital or o!r public in/itution1 ! female mu/ be c>efully isolat$ f all ! o!rs1 & none ( h] att5dants mu/ be p]mitt$ on any acc\nt1 to visit o!r pu]p]al pati5ts1 till aft] a suffici5t "t has elaps$1 & e precaution has be5 tak54 ,! causes t produce ?is t]rible disord] are n v well und]/ood2 "s ( !m probably pr$ispose to x be=e deliv]y1 or ev5 be=e pregnancy1 :ile o!rs are connect$ ) labor & its consequ5ces4 ,among ! =m] may be m5tion$1 improp] diet1 an inactive life1 anxiety ( m9d1 bad air1 a damp situation1 a full habit1 or great weakness1 ! frequ5t use ( /imulants1 & c]ta9 excesses6 ,! pr9cipal causes op]at+ imm$iately are difficult labors1 viol5t treatm5t1 ! use ( in/rum5ts1 te>+ away ! plac5ta too soon1 ret5tion ( ! lo*ia1 cold1 ris+ f ! b$ too soon1 depression or excitem5t ( ! m9d1 ov] ex]tion 9 talk+ to & see+ company1 & neglect ( cleanl9ess4 ,! mo/ frequ5t cause probably is cold or damp1 :i* *ecks ! lo*ia & ! p]spiration1 & leads directly to inflammation4 ,x is on ?is acc\nt t ! compla9t is ne>ly always worse 9 w9t] ?an 9 summ]1 & prevails mo/ 9 l[ damp situations1 & 9 badly v5tilat$ ap>tm5ts1 or 9 ^? insuffici5tly w>m$4 ,9 mo/ w>m c\ntries1 & 9 ^? ( an equable temp]ature1 :]e ! females rema9 mu* 9 ! op5 air1 & use regul> ex]cise1 pu]p]al fev] appe>s to be b little kn[n4 ,! nature ( ?is compla9t appe>s to be a sev]e & sudd5 inflammation1 comm5c+ ei!r 9 ! womb or "s ( ! neighbor+ p>ts1 :i*1 if n arre/$1 rapidly ext5ds to all ! organs ( ! pelvis & abdom51 & ha/5s to a fatal t]m9ation ) fe>ful spe$4 ,! precise seat1 & place ( comm5cem5t1 ( ! inflammation1 v>ies 9 diff]5t cases1 b ?is makes little diff]5ce ei!r 9 ! symptoms1 consequ5ces1 or treatm5t ( ! disease1 & x is ( b little use to give a sep>ate "n to all ^! v>i\s =ms4 ,ut]9e ,phlebitis1 ,metro ,p]itonitis1 ,pu]p]al ,metritis1 & ,pu]p]al ,p]itonitis1 are all ess5tially ! same compla9t1 & id5tical ) :at is call$ ,pu]p]al1 or ,*ildb$ fev]4 ,! disease g5]ally appe>s f ! second to ! fif? day aft] deliv]y1 b may be delay$ z late z ! fifte5? or tw5tie? day1 or comm5ces z e>ly z two or ?ree h\rs aft]2 & has ev5 be5 kn[n to %[ itself be=e labor came on4 ,x usually beg9s ) heada*e1 g5]al debility1 uneasy feel+s1 creep+ ( ! fle%1 & *ills3 !n foll[ trembl+s1 numbness ( ! limbs1 cold feet & h&s1 ) a burn+ heat 9 ! body4 ,! abdom5 gradually gets t5d]1 s t x _c be> ! slighte/ pressure1 %>p pa9s are felt 9 v>i\s p>ts ( x1 & ! pati5t cont9ually compla9s ( twi/+ & burn+ )94 ,%e pref]s to lie on h] back1 ) ! head rais$ & ! knees drawn up1 s z to relax ! abdom9al muscles4 ,v soon %e compla9s ( great ?ir/1 & cries out repeat$ly f ! %>pness ( ! pa92 ! heada*e increases1 & ! brea?+ becomes labori\s4 ,hicc\gh g5]ally occurs at an e>ly /age1 & is usually accompani$ or foll[$ by vomit+ & di>rha1 b sometimes by ob/9ate con/ipation4 ,! abdom5 cont9ues to swell1 & becomes /ill m t5d]1 ! face is pale1 ba!d ) cold p]spiration1 & indicates 9 e l9e ! anxiety & suff]+ "u :i* ! pati5t labors4 ,! features seem to be drawn upw>ds1 & all toge!r1 or p9*$ up1 & inde$ ! :ole body seems to %r9k4 ,9 g5]al ! lo*ial dis*>ge ei!r /ops altoge!r or less5s v mu*1 ! brea/s rema9 empty or ne>ly s1 & ! pulse is weak & irregul>4 ,9 "s few cases h[ev]1 ! lo*ia cont9ues to fl[1 or ev5 increases1 & ! brea/s rema9 full up to ! "t ( dea?4 ,! ur9e is high color$ & ?ick1 & causes sm>t+ & burn+ z x passes away4 ,! tongue furs & becomes po9t$1 & pale color$4 ,! eyes (t5 seem mu* engorg$1 & ! :ite "p become yell[1 z inde$ ! sk9 does ov] ! :ole body1 ow+ to d]angem5t ( ! bile1 & alt]ation 9 ! "* ( ! blood4 ,9 mo/ cases ! m9d reta9s its faculties ne>ly till dissolution1 b !re is frequ5tly a vague s5se ( uneas9ess & fe>1 ) great depression ( spirits & weep+4 ,"s ev5 feel assur$1 f ! beg9n+1 t !y w nev] recov]1 & occasionally become deliri\s4 ,! duration ( ?is disord] v>ies consid]ably1 ?\gh 9 mo/ cases x c>ries (f ! suff]] 9 a %ort "t1 frequ5tly ev5 9 two or ?ree days4 ,x may h[ev] la/ five1 t51 or twelve days1 & has be5 kn[n to d s f\rte54 ,! mann] 9 :i* x t]m9ates is also diff]5t 9 diff]5t cases4 ,! fluid result+ f ! inflammation may ei!r be absorb$1 or suppuration may ensue1 & ! matt] be dis*>g$1 ei!r f "o ( ! natural passages or f an artificial op5+2 or x may n be dis*>g$ at all4 ,sometimes gangr5e or mortification ensues1 & sometimes ! inflammation p>tly subsides & becomes *ronic4 ,:5 x t]m9ates by resolution1 :i* is ! mo/ favorable mode1 ! pati5t beg9s to improve ab\t ! f\r? or fif? day2 ! pa9s become less acute1 ! swell+ & t5d]ness become less1 & ! milk1 lo*ia1 & o!r secretions t 7 suppress$ beg9 to reappe>4 ,! pati5t is also able to lie ei!r on ! back or sides1 & soon feels consci\s h]self t %e is improv+4 ,b ev5 :5 a turn = ! bett] has decid$ly tak5 place1 too mu* confid5ce %\ld n be prematurely felt1 nor %\ld !re be any relaxation ( att5tion1 = ! slighte/ causes may br+ back all ! symptoms ) m ?an _! =m] sev]ity4 ,:5 suppuration ensues1 :i* is mo/ commonly ! case1 a mass ( fluid =ms 9 ! womb or abdom51 & is pla9ly indicat$1 ei!r by its mov+ ab\t or by a portion escap+ f ! body4 ,9 ?is case also ! pa9 & t5d]ness decreases1 & ! abdom5 seems less h>d1 b ! pulse becomes weak]1 a s5se ( weight is felt ab\t ! womb1 ! extremities become cold1 *ills come on1 & gradually ! p[]s ( ! sy/em seem to fail till complete exhau/ion ensues4 ,:5 gangr5e or mortification ensues1 ! t]m9ation is ne>ly ! same1 b m rapid1 & all ! above symptoms are m m>k$4 ,:5 x passes into ! *ronic =m1 !re is b little p]man5t abatem5t 9 ! sev]ity ( ! symptoms = "s "t2 !y p>tially less5 at int]vals1 b return aga91 sometimes ) r5ew$ vigor1 & x rema9s long a matt] ( d\bt :e!r ! disease has really pass$ ! critical p]iod or n4 ,recov]y takes place occasionally 9 ?is =m ( ! disease1 b m frequ5tly ! pati5t becomes daily weak] & m emaciat$1 di>rha & sl[ fev] set 91 ! vital p[]s /eadily s9k1 & at la/ dea? ensues4 ,?is fatal t]m9ation may h[ev] be delay$ = an indef9ite p]iod1 & may ultimately result f ,consumption or ,dropsy1 bo? ( :i* frequ5tly foll[ *ronic pu]p]al fev]4 ,9 reg>d to ! probable t]m9ation ( ?is disease1 b little hope c be ent]ta9$ t x w be favorable4 ,nor are !re _m indications t c be reli$ ^u ) c]ta9ty1 z to :at c\rse x is likely to take4 ,9 g5]al x is favorable :5 ! swell+ subsides1 & ! pa9s abate 9 sev]ity1 & p>ticul>ly if ! milk & lo*ia beg9 to be secret$ aga94 ,! indications are also good 9 proportion z ! symptoms are mild1 & :5 !re is no great sympa!tic di/urbance ( o!r p>ts ( ! sy/em4 ,x is reg>d$ z unfavorable :5 ! pa9 & t5d]ness ext5ds ov] a l>ge portion ( ! abdom51 & :5 ! attack comm5ces v sudd5ly4 ,! dang] is also consid]$ great] 9 proportion z ! disease beg9s ne>] to deliv]y2 & :5 its fir/ symptoms exhibit !mselves be=e labor x is always consid]$ mortal4 ,x is likewise m dang]\s ) tw9s ?an ) a s+le bir?1 & ) fir/ *ildr5 ?an aft]w>ds4 ,x is seldom possible h[ev] to come to any probable conclusion till betwe5 ! fif? & t5? day1 & ev5 !n x is 9 g5]al a matt] ( great unc]ta9ty4 ,! be/ treatm5t ( ?is fe>ful disease is "o ( ! greate/ problems 9 m$ical sci5ce4 ,s _m diff]5t plans h be5 adopt$1 & ) su* v>i\s success1 t ! hi/ory ( pa/ cases af=ds b little reliable data to guide u 9 future ones4 ,9 g5]al ! mo/ p[]ful antiphlogi/ic measures1 or ^? ?\ght mo/ likely to r$uce ! inflammation at once1 are imm$iately resort$ to1 su* z ble$+1 purgatives1 & cold ba?+4 ,ble$+ is 9 p>ticul> ! great ag5t dep5d$ ^u1 ei!r f ! arm1 or by cups & lee*es to ! abdom5 & vulva4 ,dr4 ,gordon1 ( ,ab]de5 9 ,scotl&1 :o once met ) a regul> epidemic ( pu]p]al fev] 9 t city1 assures u t no?+ else succe$$ 9 arre/+ ! disord] b copi\s & frequ5t ble$+1 at ! v comm5cem5t4 ,he c>ri$ x s f> z to take tw5ty-f\r ounces at once1 & he says t :5 he did s ! pati5t 0 ne>ly sure to recov]1 b t at fir/1 :5 he only ab/ract$ ab\t twelve ounces1 %e 0 z ne>ly sure to die4 ,9 ab\t fifty cases to :i* he 0 call$ 9 "t1 he only lo/ five1 & tak+ ! av]age ( all he att5d$ ! recov]ies 7 ab\t two-?irds ( ! :ole numb]1 :i* is above ! usual proportion4 ,x appe>s h[ev]1 f ! exp]i5ce ( ! mo/ em95t practition]s1 t ! ble$+ mu/ comm5ce e>ly2 t ! fir/ ab/raction %\ld n be omitt$ beyond tw5ty-f\r h\rs aft] ! fir/ symptoms ( ! disease1 & %\ld be z mu* e>li] z possible4 ,) v few exceptions !y also ?9k ,gordon's /&>d ( tw5ty-f\r ounces n too mu*4 ,inde$ x is g5]ally admitt$ t if ! blood be n drawn at fir/ & 9 l>ge portions1 x _h bett] n be drawn at all4 ,!re may be ( c\rse _m peculi> circum/ances t w make ble$+ improp]1 :i* no?+ b exp]i5ce & obs]vation w tea* a practition]1 b ! numb] ( su* cases is ?\ght to be small4 ,! use ( lee*es meets ) b few advocates1 & c]ta9ly !y seem to h _h b p>tial success1 comp>$ ) ! lancet4 ,dr4 ,coll9s ( ,dubl9 dep5d$ *iefly ^u lee*es & ,calomel1 b he tells u t 9 eighty-eight cases fifty-six di$ :5 s treat$1 :ile 9 fifte5 t 7 freely bl$ f ! arm only eight di$4 ,9 %ort x appe>s t ! ble$+ mu/ be c>ri$ f> en\gh1 at ! v beg9n+ ( ! disease1 to cut x %ort at once1 or x w be ( no avail1 x be+ ( little or no use m]ely to *eck x6 ,9 conjunction ) ! ble$+ x is also usual to give enemas ( />* & ca/or oil1 or some?+ simil>1 & to ba! ! extremities 9 hot wat]4 ,i "k t ?is practice ( ble$+ meets ) /rong opposition f _m physicians1 & t x is object$ to by pati5ts g5]ally4 ,i myself am z mu* oppos$ to x z any "o reasonably c be1 & ,i am well aw>e ( ! num]\s evils :i* foll[ x1 b /ill x _c be d5i$ t ,dr4 ,gordon's plan has cur$ a great] numb] ( cases ( pu]p]al fev] ?an any o!r yet tri$4 ,x is true t _m ( ^? ?us cur$ may h aft]w>ds di$ ( dropsy1 convulsions1 typhus & o!r diseases produc$ by ! ble$+1 b !n ! risk !y run ( dy+ f ^! 0 less ?an t f ! pu]p]al fev]1 & 9 a *oice ( evils we ought to *oose ! lea/4 ,x %\ld also be rememb]$ t "s em95t practition]s ass]t1 if ?is plan be adopt$ promptly & fully1 x w always cure1 or at lea/ ) v few exceptions4 ,sev]al o!r modes ( treatm5t h also be5 adopt$ to disp5se ) ble$+1 "s ( :i* h be5 mu* m successful ?an o!rs1 ?\gh none s mu* s z we c\ld desire4 ,?us "s practition]s resort imm$iately to hot fom5tations & sweat+ m$ic9es1 or a hot ba? if conv5i5t1 toge!r ) brisk purgatives1 & injections4 ,"s dep5d ^u ,calomel 9 l>ge doses1 ) lee*es to ! gro9s & vulva4 ,o!rs aga9 use cold fom5tations1 & cold injections bo? to ! rectum & to ! vag9a4 ,o!rs aga9 use bli/]s ov] ! abdom51 9 conjunction ) purgative enemas & mod]ate ble$+2 b ?is mode seems to d b little good4 ,ano!r plan is to give ab\t six gra9s ( ipecac1 & to repeat ! dose sev]al times1 at int]vals ( an h\r or less1 9 conjunction ) purgatives & w>m fom5tations4 ,turp5t9e has also be5 us$ int]nally & by enema1 b seems to h accompli%$ little good4 ,p]haps ! mo/ frequ5t plan aft] ble$+1 is to rub "o or two dra*ms ( ,m]curial ,o9tm5t well on ! sk91 ov] ! abdom51 e two or ?ree h\rs1 sometimes = sev]al days regul>ly2 eight or t5 gra9s ( ,calomel be+ also giv5 daily1 at ! same "t4 ,?is br+s on salivation1 & 9 _m cases ! symptoms beg9 to abate 9 sev]ity z soon z t comm5ces4 ,i am n aw>e h[ev]1 t ?is treatm5t is any m successful ?an ble$+1 nor d ,i ?9k ! consequ5ces aft]w>ds1 9 a case ( recov]y1 are any less to be dread$4 ,x is difficult 9 fact to say :at plan c be be/ recomm5d$1 ev5 9 ! majority ( cases1 & c]ta9ly no "o yet tri$ is applicable to all1 on acc\nt ( ! peculi>ities & v>y+ circum/ances ( ea*4 ,if ! practition] or pati5t is n decid$ly oppos$ to ! ble$+ plan1 t has und\bt$ly ! be/ recomm5dation1 f =m] success4 ,next to t p]haps comes ! m]curial treatm5t1 :i* usually meets ) z mu* opposition z ! ble$+1 b :i* c]ta9ly has be5 frequ5tly f\nd efficaci\s4 ,! o!r plans h met ) b little favor1 ?\gh possibly !y might sometimes succe$ :5 ! re/ fail4 ,if ,i 7 ask$ :at ,i %\ld advise = ^? :o w\ld n submit to ! use ei!r ( ! lancet or m]cury1 ,i %\ld say1 comm5ce ) a /rong dose ( ,epsom ,salts1 or ,jalap1 & repeat x 9 ab\t five h\rs aft] its full op]ation4 ,also apply w>m fom5tations to ! abdom51 or put ^u x a flannel bag full ( hops soak$ 9 v9eg>1 z hot z x c be borne1 & put mu/>d p\ltices on ! feet1 & inside ( ! ?ighs4 ,! h&s mu/ also be kept z w>m z possible1 & ! head cool4 ,! diet %\ld be v sp>e1 & conta9 no?+ heat+ or /imulat+1 & cool+ dr9ks1 su* z ice wat]1 or cold lemonade1 %\ld be drunk freely4 ,! purgative %\ld be repeat$ at lea/ e day1 = two or ?ree days1 or m if ! symptoms are n modifi$1 & ! mu/>d p\ltices may be regul>ly us$ to v>i\s p>ts ( ! limbs1 = ! same l5g? ( "t4 ,9 conjunction ) ^! means ! brea/s %\ld also be kept w>m1 to promote ! fl[ ( ! milk1 & injections ( />* & ca/or oil %\ld be ?r[n up ! rectum daily4 ,! object be+1 z f> z possible1 to keep ! surface ( ! body w>m1 & to cool ! int]nal fev]1 at ! same "t t all ! natural secretions are excit$ z mu* z possible to remove any morbid matt] t may be =m$4 ,x %\ld also be m5tion$ t ! ur9e sometimes /ops1 or at lea/ becomes v scanty & ?ick1 9 :i* case a little sweet nitre may be giv51 or if necess>y ! ca!t] mu/ be us$4 ,"s bitt] tea1 z boneset or *ammomile1 %\ld also be tak5 occasionally1 & a ,james's ,fev] ,p[d] ) x once or twice a day1 to promote p]spiration2 or if !re be sev]e pa9s1 a dose ( ,dov]'s ,p[d]s may be us$ in/ead4 ,if ! disease passes ! acute /age & becomes *ronic1 ! same means mu/ be pursu$1 & ) /rict regul>ity1 or !re w be dang] ( its aga9 becom+ acute4 ,9 all cases s5d = ! mo/ exp]i5c$ practition] z e>ly z possible1 & :atev] 8 plan may be1 if 8 pa/ success proves x to be tol]ably successful1 submit to x1 :e!r x be ble$+1 salivation1 or any?+ else4 ,if !re be no "o at h& on :om dep5d5ce c be plac$1 foll[ ! plan ,i h laid d[n z ne>ly z circum/ances w all[1 b practise x fully )\t delay1 & till a *ange takes place4 ,^? p]sons :o make light ( ?is disease1 & pret5d to say t ?is or t simple treatm5t is all-suffici5t1 ei!r deceive !mselves or wi% to impose ^u o!rs4 ,!re are few affections m s]i\s1 z w be evid5t :5 x is borne 9 m9d t1 on an av]age1 two females die out ( e ?ree attack$ by x4 ,to avoid all liability to x z f> z possible1 att5d well to ! g5]al heal? dur+ pregnancy1 h ev]y?+ com=table1 clean1 & :olesome1 dur+ labor1 & be c>eful to avoid cold1 damp1 & all k9ds ( m5tal & bodily excitem5t aft]w>ds4 ,! assi/ant also1 :oev] x may be1 mu/ be z c>eful & z g5tle z possible1 s z to avoid all viol5ce or undue =ce1 & n to hurry nature4 ,a want ( att5tion to su* simple details has1 und\bt$ly1 br\ght on _m attacks ( ?is fe>ful disease t o!rwise w\ld nev] h be5 exp]i5c$4 ,,affections ,,( ,,! ,,brea/ ,,occurr+ ,,aft] ,,pregnancy4 ,! functions ( ! brea/s are liable1 f _m causes1 to become d]ang$1 & su* d]angem5ts may lead to s]i\s results1 bo? to ! "m & ! *ild4 ,x is a common op9ion t females :o nurse are n s liable to suff] 9 ?is way z ^? :o d n1 b exp]i5ce proves ?is op9ion to be untrue2 nev]!less1 z x is ! duty ( mo!rs to n\ri% _! own (fspr+1 x %\ld be a subject ( c>eful /udy to relieve !m ( ?is liability z f> z possible1 or to assi/ !m :5 necess>y4 ,galact]rha4 ,?is means an ov]fl[1 or excessive secretion ( ! milk1 :i* sometimes takes place1 p>ticul>ly 9 ^? :o d n nurse4 ,at ! comm5cem5t ( ! milk fev]1 ,galact]rha ne$s b little att5tion1 b if x cont9ue to ! second or ?ird day1 prop] rem$ies %\ld be appli$ to correct x4 ,^! consi/ 9 complete re/1 bo? ( body & m9d1 cool+ dr9ks1 & sp>e diet4 ,if ^! d n correct x soon1 a flaxse$ p\ltice %\ld be plac$ on ea* brea/1 & ! pati5t %\ld be made to p]spire1 ei!r by w>m teas & clo?+1 or by means ( /eam+4 ,! b[els %\ld also be freely op5$ ) ca/or oil1 or a seidlitz p[d]1 & x w (t5 b5efit v mu* to give w>m wat] freely to dr9k1 ) t5 gra9s ( nitrate ( pota% 7saltpetre7 to ! p9t4 ,9 ^? t nurse x is v seldom ! case t ! secretion ( milk is too pr(use1 unless ! *ild has be5 kept too long f ! brea/4 ,z a g5]al rule x %\ld be put to nurse 9 a few h\rs aft] bir?1 ev5 if !re be no milk1 because its suction w mat]ially help to br+ on ! fl[4 ,x frequ5tly happ5s1 :5 ! *ild is kept away till ! milk comes1 t ! brea/s h swell$ s t ! nipple is buri$ & _c be laid hold ( well by ! m\?1 9 consequ5ce ( :i* ! *ild does n get n\ri%m5t en\gh1 & ! brea/s n be+ well empti$ become engorg$1 & _! functions d]ang$4 ,all ?is may be avoid$ by putt+ x too e>ly4 ,sometimes h[ev] not)/&+ e precaution1 ! fl[ ( milk is excessively great1 & con/itutes a real disease1 :i* may cause great weakness & debility4 ,9 su* cases x w g5]ally be f\nd t ! diet is too /imulat+ or too ri*1 or t ! b[els h be5 too inactive1 & ! fir/ /ep t[>ds an improvem5t mu/ consi/ 9 correct+ ^! faults4 ,! sk9 %\ld also be kept active by frequ5t ba?+ & good friction1 & ! quantity ( n\ri%m5t tak5 %\ld n be great] ?an ! m]e heal?y support ( ! body requires4 ,9 p>ticul> no /imulat+ liquors %\ld be us$4 ,agalaxy4--,?is compla9t is ! rev]se ( ! =m]1 z x consi/s 9 a defici5t secretion ( milk4 ,! causes ( ?is defici5cy are v>i\s2 sometimes x arises f a con/itutional in]tness ( ! brea/s1 sometimes f insuffici5t n\ri%m5t1 & sometimes f pr(use dis*>ges 9 o!r p>ts4 ,all excesses also t5d to decrease ! quantity ( ! milk1 p>ticul>ly ^? ( a c]ta9 k9d2 & x is seldom s abundant or la/+ ei!r 9 extreme y\? or advanc$ age4 ,! appe>ance ( ! m5ses 9 l mann] g5]ally causes ! fl[ to become less1 & x ceases naturally 9 "s mu* e>li] ?an 9 o!rs4 ,sometimes !re is a de=mity 9 ! *ild's m\?1 :i* prev5ts its suck+ prop]ly1 & ! milk may /op = want ( be+ completely drawn4 ,! brea/s also may be diseas$1 or ! nipple n suffici5tly prom95t1 & ! same difficulty be ?us produc$ 9 ano!r way4 ,9 treat+ agalaxy1 !re=e1 ! fir/ ?+ is to asc]ta9 if !re be no de=mity or disease 9 ei!r "m or *ild1 :i* prev5ts prop] nurs+4 ,if !re be no?+ ( ! k9d1 x mu/ next be asc]ta9$ :e!r ! "m has any excessive secretion else:]e1 su* z di>rha1 great fl[ ( ur9e1 or heavy sweats2 if %e h1 ^! mu/ be correct$4 ,x mu/ next be se5 if %e takes suffici5t n\ri%m5t1 & ( a prop] k9d = h] /oma* & b[els4 ,sometimes a little spic$ w9e is excell5t1 or "s port]1 ) :ite meats1 & arr[-root milk4 ,if %e be ( a full habit1 h[ev]1 & makes mu* blood1 ! contr>y c\rse mu/ be pursu$1 & ! diet be made l[ & un/imulat+1 :ile ! b[els are kept free & ! sk9 9 good action4 ,9 _m cases :5 ! nipple is small1 x may be mu* enl>g$ by titillation1 j be=e ! *ild is put to x1 aft] :i* ! suction w increase x /ill m4 ,if ! female be advanc$ 9 life1 or v weak1 or if %e becomes pregnant1 x may be bett] to procure a nurse ?an to attempt to /imulate ! fl[ at all4 ,! appe>ance ( ! m5ses ne$ n occasion a susp5sion ( nurs+1 unless x evid5tly d]anges ! secretion ( ! milk1 or affects ! heal? ( ! "m2 9 ei!r ( :i* cases ! *ild %\ld be wean$ at once4 ,engorgem5t ( ! ,brea/s4--,! brea/s are liable to become swoll51 or engorg$1 f colds1 bl[s1 h>d nurs+ f ! *ild1 ov] fe$+1 & f sor5ess or excoriations prev5t+ !m be+ fully empti$4 ,?is /ate may occur at any "t1 b is mo/ frequ5t a few days aft] deliv]y4 ,9 g5]al !re is no dang] f x1 unless x be v bad or cont9ues too long2 x may !n inflame & dis*>ge1 or become p]man5tly h>d5$4 ,to prev5t su* accid5ts ! brea/s %\ld always be suffici5tly empti$1 ei!r by ! *ild or by artificial means1 & e precaution %\ld be us$ aga9/ cold or viol5ce4 ,con/ipation mu/ also be gu>d$ aga9/1 & ! diet & dr9k mu/ be c>efully obs]v$1 s t x be n too fe$+1 or too /imulat+4 ,w>m fom5tations or p\ltices may also be us$ :5 ! brea/s are pa9ful1 & a ,dov]'s ,p[d] may be giv5 at night1 aft] ba?+ ! feet 9 w>m wat]1 to promote p]spiration4 ,inflammation ( ! ,brea/s4--,?is is only a m advanc$ /age ( ! previ\s malady1 produc$ by ! same causes1 & by want ( timely att5tion4 ,l simple swell+1 x may arise at any "t dur+ nurs+1 b is m frequ5t a few days aft] deliv]y4 ,z soon z ! inflammation comm5ces ! brea/s become r$1 swoll51 & excessively t5d]1 p>ticul>ly at "o po9t1 :i* soon beg9s to project l a nipple1 if ! disease is n /opp$1 & at la/ bur/s & dis*>ges ! conta9$ pus4 ,sometimes ! inflammation is comp>atively sup]ficial1 & ext5ds only ov] a small portion ( ! surface1 b at o!r times x goes deep & spreads wide4 ,9 proportion to its ext5t is ! sev]ity ( ! symptoms1 :i* are ^? ( inflammation 9 g5]al1 su* z heada*e1 ?ir/1 fev]1 g5]al uneas9ess1 & cutt+ pa9s 9 ! "p affect$4 ,z soon z ! abscess is =m$ & c be pla9ly discov]$1 x is usual to op5 x imm$iately1 because ! long] x rema9s ! m ext5sive x becomes1 & ! l>g] portion ( ! brea/ becomes diseas$4 ,x is necess>y h[ev] to be c]ta91 be=e mak+ an op5+1 t x is really an abscess on :i* we are go+ to op]ate1 = sometimes a heal?y "p ( ! brea/ feels v mu* l "o1 & a mi/ake may easily be made2 9 fact su* a mi/ake has (t5 be5 made1 & by m5 ( exp]i5ce too4 ,9 ! e>ly /age ( ! inflammation e ef=t %\ld be us$ to prev5t an abscess f =m+1 by ! use ( purgatives1 sweat+ m$ic9es1 l[ diet1 cool+ dr9ks1 & w>m fom5tations ov] ! :ole *e/4 ,"s females practice cold fom5tations ov] ! brea/s1 & ) good success1 9 ! comm5cem5t ( ! inflammation1 b x may increase ! difficulty ) o!rs1 &1 s f> z ,i h se51 is no m g5]ally useful ?an ! o!r me?od4 ,! w>m ba? all ov] ! body is also v s]viceable 9 a numb] ( cases4 ,x usually happ5s h[ev]1 9 spite ( e precaution1 t matt] w =m1 & its dis*>ge become necess>y4 ,z soon z ?is is evid5t1 x %\ld be promot$ z mu* z possible1 by hot fom5tations & p\ltices1 till ! head ( ! abscess is suffici5tly di/9ct = x to be safely op5$4 ,:ile ! swell+ is go+ on ! pa9 is (t5 v sev]e1 & x %\ld be eas$ z mu* z possible1 by us+ laudanum 9 ! fom5tations1 or by putt+ on an opium pla/]4 ,aft] an abscess has op5$ & dis*>g$1 x %\ld be kept op5 = "s "t1 by little pl$gets ( l9t1 to prev5t its clos+ up too soon1 o!rwise a portion ( ! matt] may be %ut 9 by ! w\nd heal+ ov] x1 & ano!r abscess w =m4 ,w>m p\ltices & lotions %\ld also be us$ aft]w>ds1 to promote ! dis*>ge z mu* z possible1 b !y %\ld n be us$ aft] x has evid5tly begun to cease naturally4 ,9 %ort e means po9t$ out %\ld be us$ en]getically 9 ! fir/ /age1 to prev5t ! ga!r+1 b if x takes place 9 spite ( !m1 !n x %\ld be ha/5$ & dis*>g$ z e>ly z possible1 to prev5t its ext5d+4 ,aft] ?is1 :5 x has evid5tly all escap$1 ! w\nd may be suff]$ to heal1 & ! pati5t mu/ be enjo9$ to be v c>eful 9 future1 = ! same accid5t w be v liable to reappe>4 ,sometimes ^! abscesses become v ext5sive1 & rema9 = a long "t4 ,i h kn[n t5 or twelve on "o brea/1 & ,i h kn[n !m to cont9ue op5 = _m mon?s4 ,:5 ?is is ! case x is mu* to be deplor$1 z x is v likely inde$ to de/roy ! brea/1 & may ev5 lead to m s]i\s results4 ,att5tion !re=e _c be be/[$ ^u !m too e>ly or too unremitt+ly1 p>ticul>ly if ! female be scr(ul\s1 or ( a v full habit4 ,sometimes ! inflammation attacks bo? brea/s1 & at o!r times only "o1 9 :i* case e ef=t %\ld be ex]t$ to prev5t its ext5d+ to ! o!r4 ,9 _m p]sons ! same side is always affect$1 & becomes a scape-goat z x 7 = ! o!r4 ,:5 ! means us$ succe$ 9 scatt]+ ! swell+1 its disp]sion is usually foll[$ by "s critical dis*>ge1 su* z di>rha1 or a great fl[ ( ur9e1 or ev5 by pr(use p]spiration1 :i* %[s h[ nature op]ates 9 remov+ ! diseas$ matt]1 & cautions u n ra%ly to *eck su* dis*>ges4 ,x is a v s]i\s matt] = ! swell+ to indurate or h>d51 z x sometimes w1 )\t ei!r scatt]+ or disp]s+1 z x is !n con/antly liable to become worse aga91 besides de/roy+ ! /ructure ( ! gl&4 ,e means %\ld !re=e be us$ to prev5t ?is1 by promot+ its disp]sion or dis*>ge1 9 ! way already po9t$ out4 ,x is also v good 9 ^! cases to ba! frequ5tly ) alum wat]1 or decoction ( :ite oak b>k1 or ev5 to rub on "s ( ! ,o9tm5t ( ,hydriodate ( ,potassa1 dilut$ ) an equal weight ( fre% l>d4 ,a piece z l>ge z a hickory nut may be well rubb$ on twice a day1 = ?ree or f\r days1 b x %\ld be /opp$ imm$iately ! swell+ beg9s to subside1 & n us$ aga9 unless x /ill rema9s or aga9 increases4 ,9 _m cases pretty frequ5t friction1 ) ! h& ano9t$ ) a little oil1 w be all suffici5t1 especially if a hot fom5tation be us$ aft]w>ds4 ,excoriations1 or ,cracks 9 ! ,brea/s4--,! annoyance f ?is cause is sometimes v great1 ! pa9 :i* is exp]i5c$ :5 ! *ild beg9s to nurse be+ s acute t x is impossible = ! "m to all[ x to rema94 ,frequ5tly ,i h kn[n x compel wean+ mu* e>li] ?an 0 desirable1 & sometimes x has ev5 be5 s bad1 t ! dress c\ld sc>cely be borne aga9/ ! brea/s4 ,! precise cause ( ?is liability to crack is n kn[n1 nor d we "k ( any c]ta9 means to prev5t x4 ,9 _m cases h[ev] ,i h kn[n x prev5t$1 to a great ext5t1 by hav+ ! nipple g5tly suck$1 v frequ5tly1 = six weeks or two mon?s be=e *ildbir?4 ,?is h>d5s x1 & if a wa% ( borax wat] be also us$1 aft] ea* "t1 x w be gradually prep>$ = its prop] use4 ,our means ( cur+ ?is tr\blesome affection are v limit$1 & frequ5tly ev]y?+ fails t is tri$4 ,! mucilage ( ,qu9ce se$1 prep>$ by bruis+ & boil+ !m 9 a small quantity ( wat]1 rubb$ ov] ! sores ) a s(t fea!r1 imm$iately aft] nurs+1 (t5 does mu* good4 ,! mucilage f ! t5d] tops ( "y sassafras sometimes succe$s bett] ?an t f ! ,qu9ce1 & a bruis$ leaf f ! l>ge horse-%oe ,g]anium1 laid on l a p\ltice1 is sometimes bett] ?an ei!r4 ,a good lotion may also be made ) a qu>t] ( an ounce ( borax1 & a tea-spoonful ( laudanum1 to half a p9t ( w>m wat]1 to be us$ frequ5tly dur+ ! day4 ,"s females use a wa% made ( sal]atus1 ) consid]able b5efit1 & o!rs f9d relief f "o made ( nut galls1 or :ite oak b>k4 ,mo/ ( ^! means h[ev] are well kn[n1 & _m o!rs also1 :i*1 l !m1 sometimes succe$ & (t5 fail4 ,! artificial nipple1 or %ield1 %\ld be tri$ if none ( ^! means succe$1 & frequ5tly x w enable ! "m to all[ ! *ild to nurse1 ?\gh x may n altoge!r prev5t ! pa94 ,x n unfrequ5tly happ5s t ! *ild's m\? may be diseas$1 p>ticul>ly ) ap?1 or ?ru%1 & ?is may possibly keep up ! excoriations2 9 l mann] ! /ate ( ! brea/s may also influ5ce ! m\?1 & !re=e ! condition ( ea* %\ld be well asc]ta9$ :5 any?+ is ! matt] ) ei!r4 ,,bron*ocele1 ,,or ,,swell+ ,,9 ,,! ,,?roat4 ,?is is (t5 obs]v$ 9 *ildb$1 & sometimes ev5 comes on dur+ labor4 ,x is usually attribut$ to cold1 & no d\bt x (t5 does arise f cold1 b m frequ5tly x is ow+ to sympa!tic d]angem5t1 & f viol5t attempts to swall[ dur+ & aft] ! pa9s4 ,_m females 9 fact cry out at ^? times1 t some?+ has brok5 9 ! ?roat1 & !y fe> !y are go+ to suffocate4 ,z a g5]al rule ! swell+ gradually subsides 9 a %ort "t1 )\t any special treatm5t1 b sometimes x increases & inflames1 & an abscess =ms :i* may become v tr\blesome1 & ev5 dang]\s4 ,to prev5t ?is x %\ld be frequ5tly treat$ ) w>m fom5tations & p\ltices1 till ! inflammation subsides1 & !n ) ! same wa%es recomm5d$ = indurat$ or h>d5$ brea/1 9 ! prec$+ section ( ?is *apt]4 ,if ! swell+ becomes h>d1 & rema9s indol5t1 ! o9tm5t ( hydriodate ( potassa may also be prep>$ & us$1 z !re recomm5d$4 ,,phlegmasia ,,alba ,,dol5s1 ,,or ,,milk ,,leg4 ,?is is a pa9ful tumefaction or swell+ ( "o or bo? ( ! limbs1 :i* comes on f ! fif? to ! fifte5? day aft] deliv]y4 ,x g5]ally comm5ces ) slight pa91 or /iffness1 or cramp1 becom+ m pa9ful z x proce$s2 b1 sometimes1 %oot+1 cutt+ pa9s1 ( great viol5ce1 are felt sudd5ly1 at ! v comm5cem5t4 ,! swell+1 also1 sometimes comes on gradually1 b1 at o!r times1 rapidly4 ,9 mo/ cases ! pati5t compla9s ( a sudd5 pa9 9 ! gro9 & ?igh1 :i* is prec$$ by a *ill foll[$ by fev]1 & !n ! limb beg9s to enl>ge4 ,mo/ frequ5tly ! l[] "p swells fir/1 & !n x ext5ds upw>d1 sometimes1 ev5 to ! hip4 ,! sk91 on ! swoll5 "p1 looks :ite1 %9+ & tight1 z if ready to break2 x is also extremely pa9ful1 s t pressure ^u x c sc>cely be borne4 ,x looks 9 fact l a ?9 bag ( sk9 fill$ ) milk1 & h5ce ! "n milk leg1 f an idea t x 0 really fill$ ) milk1 :i* _h1 by "s means1 rea*$ !re f ! brea/4 ,?is idea is errone\s1 9 ! s5se x is usually tak52 ! milk does n fl[ into ! leg z _m imag9e1 nor is any?+ l x to be f\nd !re1 except a peculi> ?91 :ite matt]1 :5 x breaks4 ,/ill1 h[ev]1 a sudd5 /oppage ( ! milk may cause su* a swell+1 l a sudd5 /oppage ( any o!r secretion1 b 9 no o!r way4 ,x is1 probably1 mo/ frequ5tly produc$ by sudd5 cold1 :i* *ecks t pr(use p]spiration into :i* females gradually fall imm$iately aft] deliv]y1 & s drives ! p]spirable matt] )91 & causes inflammation & suppuration4 ,a difficult or prolong$ labor may also lead to x1 by prev5t+1 = a long "t1 ! prop] circulation ( ! blood ?r\gh ! l>ge ve9s ( ! pelvis1 & s engorg+ ^? bel[4 ,or ! ve9s may become p>alyz$1 z x 71 by ! pressure !y h su/a9$1 & s become1 = a "t1 unable to transmit ! blood4 ,9 fact1 bo? ! ve9s & lymphatics become engorg$1 z if ti$ above ! limb1 & exhibit knots & bundles1 l bun*es ( grapes4 ,sometimes ! fev] w occur "s days fir/1 & ! female _c tell :at x is ow+ to1 till ! swell+ comes on2 & ev5 ?is may take place s gradually1 & ) s little pa91 t ! limb may be v l>ge be=e x is obs]v$4 ,i h kn[n females compla9 ( a slight fev] only1 on go+ to sleep at night1 & wake up 9 ! morn+ ) a confirm$ case ( milk leg2 & ,i h kn[n o!rs />t ) a sudd5 pa9 9 ! gro91 or hip1 & be affect$ 9 ! same way1 9 less ?an two h\rs4 ,! disease usually la/s f a mon? to sev5 or eight weeks1 & t]m9ates1 ei!r by a gradual resolution1 or scatt]+1 ( ! fluids1 or by suppuration & dis*>ge4 ,:5 suppuration ensues1 !re w1 sometimes1 =m "o or m v l>ge abscesses1 :i* x may be difficult to heal1 & :i* may lead to s]i\s results1 ei!r f _! ext5t1 or f ! con/itutional irritation !y produce4 ,! treatm5t1 at fir/1 consi/s 9 w>m fom5tations1 su* z ^? ( poppy-heads1 or hops1 ) cool+ dr9ks1 purgatives1 l[ un/imulat+ diet1 & occasional doses ( ,james's ,fev] ,p[d]1 to promote p]spiration4 ,?is is int5d$ to disp]se ! swell+1 &1 9 g5]al1 x does s4 ,if1 h[ev]1 ! abscess =ms & breaks1 9 spite ( all ! means us$1 x mu/ be treat$ ! same z abscess 9 ! brea/1 previ\sly describ$4 ,9 ord9>y practice1 x is ! g5]al cu/om to ble$ at ! comm5cem5t ( ! disease1 or to apply lee*es to ! gro94 ,?is sometimes does good1 b frequ5tly is ( no s]vice at all1 ev5 if x does n make matt]s worse4 ,i w\ld1 h[ev]1 make ! same rem>ks on ble$+ "h1 z ,i did 9 reg>d to its use 9 pu]p]al fev]1 to :i* milk leg has a resemblance1 9 "s respects4 ,ano!r practice is to use tight b&ages1 ! same z = v>icose ve9s1 b ,i ?9k ! plan is n1 9 g5]al1 a successful "o1 ?\gh x may be occasionally4 ,plung+ ! limb 9 cold wat]1 or keep+ x wrapp$ 9 cold wet clo?s1 has succe$$ mu* m frequ5tly1 & is1 ) "s1 a favorite rem$y4 ,/ramonium leaves boil$ 9 v9eg>1 & laid on hot1 w also effect a cure sometimes2 & s w ba?+ ) hot lye or alcohol4 ,a l>ge p\ltice ( hops1 soak$ 9 hot v9eg>1 has also be5 f\nd useful4 ,,tr\ble ,,) ,,! ,,ur9e4 ,! bladd]1 f its position1 is v apt to be inconv5i5tly press$ dur+ ! passage ( ! *ild1 & to be tempor>ily affect$ = a %ort "t aft]1 9 consequ5ce4 ,sometimes1 ! neck ( ! bladd] w be p>alyz$1 & ! ur9e _c be dis*>g$4 ,9 ?is case1 fom5tations ( w>m milk & laudanum mu/ be us$1 or a w>m hip ba?1 if !re be no dang] ( flood+1 & ! b[els mu/ be freely op5$4 ,if ?is does n relieve1 ! ca!t] mu/ be us$1 & always be=e ! bladd] is too full4 ,to avoid its becom+ s1 ! att5dant %\ld inquire ( ! female1 dur+ ! fir/ day1 if %e has ur9at$1 or feels any incl9ation t way1 s t he may "k 9 "t if ! difficulty exi/s4 ,9 g5]al1 ?is p>alysis passes (f 9 ! c\rse ( a day1 b may endure long] sometimes2 9 :i* case ! pati5t h]self %\ld speak ( x4 ,cases h be5 kn[n :]e ! bladd] has become s full z to bur/ ?r\gh inatt5tion to ?is matt]4 ,! contr>y difficulty is occasionally obs]v$1 & ! ur9e _c be reta9$1 b x fl[s away z fa/ z x is secret$4 ,x is v seldom1 h[ev]1 t ?is /ate rema9s m ?an a s+le day &1 m frequ5tly only a few h\rs4 ,a da% ( cold wat] on ! pubes1 & aga9/ ! meatus ur9>ius1 has (t5 correct$ x at once1 & s has a s+le purgative dose4 ,if x rema9 aft] ! fir/ two days )\t am5dm5t1 x is cu/om>y to put a small bli/] on ! abdom51 :i* usually relieves 9 a %ort "t4 ,,app5dix4 ,,on ,,prev5t+ ,,pa9 ,,9 ,,*ildbir?4 ,,use ,,( ,,*lor(orm ,,9 ,,midwif]y4 ,,an ,,enquiry ,,into ,,! ,,utility ,,& ,,propriety ,,( ,,prev5t+ ,,! ,,pa9 ,,& ,,suff]+ ,,:i* ,,usually ,,att5ds ,,*ildbir?1 ,,) ,,an ,,acc\nt ,,( ,,! ,,means ,,to ,,be ,,employ$ ,,= ,,t ,,purpose4 ,9 ! preface to ?is "w ,i rem>k$ t a great "p1 &1 p]haps1 ne>ly ! :ole1 ( ! suff]+ & dang] to :i* p>turi5t females are expos$1 arises1 und\bt$ly1 f _! bad physical education & mode ( life2 & t1 9 a m rational /ate ( exi/5ce1 x 0 probable t bo? w\ld be s slight z to excite no appreh5sion4 ,?is improv$ /ate ( ?+s is mu* to be desir$1 & %\ld1 ( c\rse1 be /riv5 = by all fri5ds ( humanity4 ,b1 9 ! mean "t1 x is prop] to consid] :e!r !re are any means by :i* ^? n[ liv+ c be reliev$ 9 _! h\rs ( di/ress4 ,! agony :i* _m females endure at ?is "t is s great t !re are few circum/ances "u :i* relief is m ne$$1 or w\ld be m acceptable2 & ,i1 = "o1 _c subscribe to ! doctr9e t su* relief w\ld be improp]1 unless x prove to be injuri\s4 ,!re are "s p]sons1 ,i "k1 :o say t ?is suff]+ has be5 orda9$ = woman1 & t x ought to be endur$4 ,?is notion1 ,i ?9k1 ne$s no refutation1 x be+ j z unreasonable z to say t ! sick %\ld be all[$ to suff] & die )\t assi/ance1 because _! condition has be5 orda9$4 ,!re are o!rs1 & m5 ( sci5ce1 too1 :o ?9k t ! pa9s ( *ildbir? are necess>y to its safe accompli%m5t1 & t !y are also valuable 9 a moral po9t ( view4 ,?is op9ion w be exam9$ by & by1 & ! facts on :i* x is f\nd$1 c>efully analyz$2 b x is fir/ necess>y to /ate ! means ( prev5tion usually employ$1 & to note _! mode ( action1 & effects4 ,"s ye>s ago1 a celebrat$ physiologi/1 :o suppos$ t ! *ief cause ( pa9 & difficulty 9 labor 0 ! size & h>dness ( ! *ild's bones1 advanc$ ! !ory t if ^! bones 7 less develop$1 & s(t]1 ! pa9 & difficulty w\ld be mat]ially less5$1 if n entirely remov$4 ,he propos$1 !re=e1 s9ce ! h>dness ( ! bones is caus$ by ! deposition ( lime 9 !m1 :i* is d]iv$1 ( c\rse1 f ! blood ( ! "m1 t %e %\ld avoid tak+ any?+ to eat or dr9k1 dur+ pregnancy1 t conta9$ lime4 ,?is1 he suppos$1 w\ld keep ! bones ( ! *ild s(t till aft] bir?1 & s all[ !m to give way & cru% toge!r dur+ deliv]y1 & ?us prev5t ! suff]+ & difficulty usually exp]i5c$4 ,x 0 also ?\ght t ! bones ( ! "m w\ld be p>tially s(t5$ at ! same "t1 & give way a little1 s z to facilitate ! process /ill m4 ,i am n aw>e1 h[ev]1 t ?is !ory has ev] succe$$ 9 practice1 ei!r 9 ! human species or 9 ! l[] animals1 ?\gh frequ5tly tri$4 ,nature w "w on h] own plan1 & w develop ! bones ( ! ftus1 :ile 9 ! womb1 to a c]ta9 ext5t1 provid+ %e has ! means to d s2 & if ^! are )held1 %e is v likely to susp5d its developm5t altoge!r1 r ?an s5d x =? imp]fect4 ,i h kn[n cases :]e ev]y?+ 0 )held1 = ! :ole p]iod1 t conta9$ a p>ticle ( lime1 & yet ! *ild's bones 7 z h>d at bir? z 9 any o!r case2 ! mat]ial be+1 probably1 tak5 f ! bones ( ! "m1 :i* might be ?us weak5$1 & made liable to displacem5t1 )\t any good result :atev]4 ,x is also a "q :e!r su* a c\rse1 suppos+ x to succe$1 might n be dang]\s 9 ano!r way1 by caus+ an imp]fection 9 ! *ild :i* its future gr[? c\ld n ov]come4 ,i h kn[n "s cases :]e ?is practice appe>$ to h caus$ abortion f imp]fect developm5t1 & sev]al o!rs 9 :i* !re 0 too mu* reason to fe> t ! *ild 0 injur$1 ?\gh safely born4 ,z ?is is1 !re=e1 at be/1 a v unc]ta9 & ineffective process1 & is also1 probably1 dang]\s to ! "m or *ild1 or bo?1 x does n appe> to me wor?y ( fur!r att5tion1 & ,i m]ely allude to x 9 ord] to make ! pres5t sket* ( su* means complete4 ,! o!r means are su* z d n int]f]e1 9 any way1 ) ! natural processes1 b m]ely prev5t s5sation or feel+ at ! "t ( deliv]y4 ,mesm]ism has be5 recomm5d$1 &1 9 "s few in/ances1 tri$1 = ?is purpose1 b its success has ei!r be5 s small1 or its action s unc]ta91 t no dep5dance c be plac$ ^u x1 not)/&+ _m p]sons ass]t its p[]4 ,opium & o!r p[]ful drugs h also be5 giv51 b s mu* ( !m is requir$1 at t "t1 to produce a suffici5t effect1 t _! use becomes dang]\s4 ,o!r sub/ances1 9 ! =m ( vap\r1 or gas1 h also be5 us$1 ! effects ( :i* only la/ = a %ort "t1 & are n1 g5]ally speak+1 at all dang]\s4 ,among !m may be m5tion$ nitr\s oxide1 or laugh+ gas1 c>bonic acid1 sulphuric e!r1 & *loric e!r1 all ( :i* 7 fir/ employ$ 9 sev]e surgical op]ations4 ,! success ( ^! ag5ts1 especially e!r & *lor(orm1 9 prev5t+ pa91 is und\bt$2 nor d !y appe> to h any o!r effect1 nor to prev5t any necess>y ef=t or process ( nature1 except 9 a few cases :i* w be m5tion$ fur!r on4 ,_m hundr$ op]ations ( ! mo/ sev]e k9d1 su* z cutt+ (f limbs1 remov+ tumors1 /ones1 & s =?1 h be5 p]=m$ :ile ! pati5ts 7 "u ! influ5ce ( ^! ag5ts1 & )\t caus+ !m ! slighte/ pa92 9 fact1 _m rema91 dur+ ! :ole process1 9 a pleasant dream1 & _c be p]suad$1 :5 !y wake1 t ! dread$ op]ation is ov]4 ,! same ?+ has also be5 obs]v$ 9 hundr$s ( cases ( midwif]y1 bo? 9 natural labor & :5 in/rum5ts h be5 us$4 ,9 num]\s in/ances ! female has be5 put to sleep1 & safely deliv]$1 )\t kn[+ or feel+ any?+ :atev]1 dur+ ! :ole "t2 ! fir/ intimation t %e _h become a "m1 be+ ! *e]+ cry ( h] newborn babe4 ,9 "s in/ances1 ! /ate ( ins5sibility has be5 cont9u$ = a long "t1 & dur+ its cont9uance1 ! mo/ haz>d\s op]ations h be5 safely p]=m$4 ,s f> z c be safely judg$1 f ! limit$ "t dur+ :i* su* means h be5 us$1 x appe>s t !re is no dang] :atev]1 f _! employm5t1 except :5 improp]ly adm9i/]$1 & 9 c]ta9 peculi> conditions ( ! sy/em2 :i* causes ( dang] w1 ( c\rse1 be remov$ by compet5t exp]i5ce & k4 ,x is highly enc\rag+ h[ev]1 to note1 ?\gh e!r & *lor(orm h bo? be5 us$ s ext5sively & indiscrim9ately1 bo? by ^? :o und]/ood _! nature & ^? :o did n1 t ! cases 9 :i* !y are prov$ to h done injury1 are n m ?an two or ?ree2 & 9 all ^? t ,i h he>d (1 "s obvi\s impropriety _h be5 committ$ 9 _! use4 ,x %\ld be borne 9 m9d1 h[ev]1 t ev5 if ! dang] f !m 0 consid]able1 we might /ill be ju/ifi$ 9 _! use4 ,x is well kn[n t1 9 num]\s cases1 ! fe> ( suff]+1 be=eh&1 & its sev]ity :ile be+ endur$1 produce ! mo/ s]i\s1 & ev5 fatal results4 ,_m a pati5t has pass$ safely ?r\gh ! ord9>y effects ( a pa9ful op]ation1 & yet sunk f ! m]e effects ( fe> & physical suff]+4 ,in/ances h ev5 be5 kn[n 9 :i* a fe> ( ?is k9d has caus$ dea?1 & frequ5tly x has giv5 a %ock f :i* ! pati5t nev] fully recov]$4 ,!re is also1 frequ5tly1 great dang] f ! viol5t ef=ts & /ruggles ( a p]son 9 pa91 & _m necess>y op]ations are ev5 prev5t$ altoge!r by !m2 ?is is (t5 obs]v$ 9 difficult labors4 ,:5 ins5sibility is produc$1 h[ev]1 all ^! causes ( difficulty & dang] are remov$2 ! pati5t's fe>s are quiet$1 suff]+ is entirely prev5t$1 & !re is no /ruggl+ to prev5t ! necess>y assi/ance4 ,suppos+1 !re=e1 t ! ill effects ( ^! ag5ts 7 m c]ta9 & great] 9 am\nt ?an has yet appe>$1 x w\ld /ill be a "q :e!r ! evil !y really prev5t is n great] ?an t :i* !y possibly may cause4 ,9 reg>d to ! two ag5ts n[ *iefly us$1 e!r & *lor(orm1 !re is no diff]5ce 9 _! mode ( action1 b ! *lor(orm appe>s to be m spe$y1 c]ta91 & efficaci\s1 & is1 !re=e1 ! mo/ valuable1 b proportionably m dang]\s :5 improp]ly adm9i/]$4 ,!re are num]\s in/rum5ts or inhal]s1 = adm9i/]+ ^! vapors1 mo/ ( :i* are bo? co/ly & complicat$1 & all ( :i* may be easily disp5s$ )4 ,a v good plan is to take a l>ge sponge & dip x 9 hot wat]1 !n squeeze out ! wat] & p\r on ! e!r or *lor(orm1 & hold x ov] ! m\? & nose4 ,9 two or ?ree m9utes consci\sness & feel+ w bo? be gone1 & ! pati5t w s9k into a calm sleep :i* w la/ sometimes t5 or fifte5 m9utes1 & may be kept up z long z desir$1 by putt+ ! sponge to ! m\? = a few m9utes :5ev] !re are signs ( wak+4 ,:5 x is left (f ! pati5t gradually comes r\nd z if wak+ f ord9>y sleep1 & frequ5tly speaks ( hav+ be5 9 a dream1 sometimes ( a v pleasant "*1 b nev] kn[s :at has tak5 place4 ,no ill effects foll[1 b sometimes !re is a little dr[s9ess or /iffness ( ! limbs1 :i* soon passes (f4 ,a pocket h&k]*ief soak$ 9 ! fluid1 & held ov] ! m\? & nose w answ] equally well2 b :atev] is us$1 x mu/ n be press$ close1 because a portion ( air ought to ent] ) ! vapor to prev5t suffocation2 & x %\ld also be remov$ imm$iately ! effect is produc$4 ,:5 x is borne 9 m9d h[ mu* ^! requisites h be5 neglect$1 & h[ impure ! e!r or *lor(orm has (t5 be51 x is wond]ful t m accid5ts h n occurr$2 & ! fact t s few h happ5$ "u su* a /ate ( ?+s1 & ) our little exp]i5ce1 goes f> to prove t !re is little or no dang] at all 9 compet5t h&s1 ) pure mat]ials4 ,! acc\nts circulat$ 9 ! pap]s ( dea? f e!r1 & fatal effects ( *lor(orm1 h mo/ly be5 gross exagg]ations1 & frequ5tly false altoge!r4 ,9 mo/ ( ! cases :]e dea? has foll[$ f ! use ( ^! ag5ts1 x has be5 prov$ to arise f o!r causes1 & w\ld h happ5$ if !y _h n be5 us$4 ,9 "o or two cases1 h[ev]1 ( surgical op]ations1 ! e!r itself appe>s to h caus$ dea? by produc+ suffocation1 or conge/ion ( ! lungs2 b1 ev5 9 ^!1 x has be5 %[n t x 0 us$ 9 an improp] mann]4 ,?us a "y woman 9 ,newca/le 9 ,engl&1 inhal$ e!r to h a diseas$ toe-nail cut (f1 & di$4 ,x appe>s1 h[ev]1 t !re 0 an evid5t disposition 9 h] to conge/ion or ru%es ( blood1 & !re=e %e 0 n a fit subject1 & besides1 ! e!r 0 p\r$ on a ?ick table clo?1 :i*1 ( c\rse1 prev5t$ ! entrance ( air along ) ! vapor1 & ?us suffocat$4 ,i believe !re is n a s+le case on record ( injury result+ :5 due precautions h be5 us$1 & ,i h n he>d ( "o at all 9 midwif]y practice4 ,e!r hav+ be5 ! fir/ article us$1 ,i %all fir/ give an acc\nt ( its effects1 & !n proce$ to *lor(orm1 expla9+ ! mode ( adm9i/ration1 & o!r incid5tal matt]s1 z ,i proce$4 ,! be/ article on e!r :i* ,i h met )1 is a review 9 ! ,briti% & ,=eign ,m$ical ,review = ,april1 #ahdg1 ( "s pamphlets on ! subject1 f :i* ,i %all make an extract4 ,9 ! /ate ( p]fect e!rization we believe all s5sation is aboli%$2 9 a less p]fect /ate an obscure p]ception ( ext]nal objects rema9s1 :ile ! s5se ( pa9 is ext9ct4 ,! psy*ical /ate is v>i\s4 ,g5]ally speak+1 ! s5se ( ext]nal impressions becomes at fir/ confus$1 !n dull1 !n false1 ) optical spectra or auditory illusions1 g5]al m5tal confusion1 & !n a /ate ( dream+ or utt] oblivion4 ,9 ! majority ( cases ! m9d is busy 9 dream+1 ! dreams be+ g5]ally ( an active k9d1 (t5 agreeable1 sometimes ! rev]se1 occasionally mo/ s+ul>2 &1 frequ5tly1 a great deal is transact$ 9 ! few %ort mom5ts ( ?is s+ul> trance4 ,_m ( ! pati5ts :o h und]gone ! mo/ dreadful op]ations1 su* z amputation ( "o or bo? ?ighs or arms1 extraction ( ! /one1 excision ( bones1 extirpation ( ! mamma1 h readily detail$ to u1 & mo/ ) wond]+ ?ankfulness1 ! dreams ) :i*1 & ) :i* alone1 !y 7 occupi$ dur+ ! op]ations4 ,! "* ( ! dreams seem$ to be influ5c$1 z 9 ord9>y cases1 by v>i\s causes1 imm$iate or remote1 pres5t or pa/1 relat+ to ev5ts or fl[+ f temp]am5t4 ,a good _m seem$ to fancy !mselves on ! railway amid its :irl & noise & smoke2 "s "y m5 7 hunt+1 o!rs rid+ on coa*es2 ! boys 7 happy at _! sports 9 ! op5 fields1 or ! fil?y lane2 ! worn ,london] 0 9 8 old haunts c>\s+ ) 8 fell[s2 & our m]ry fri5d1 ,paddy1 ( ! ,london ,hospital1 0 aga9 at 8 fair1 wield+ 8 %elala 9 def5ce ( 8 fri5ds4 ,o!rs1 ( mild] mood1 & especially "s ( ! wom5 pati5ts f ! c\ntry1 felt !mselves sudd5ly transport$ f ! great city & ! cr[d$ hospital-w>d to _! old quiet home 9 ! di/ant village1 happy once m ) _! mo!rs & bro!rs & si/]s4 ,z ) ! dy+ gladiator ( ! poet1 ! ?\ghts ( ^! poor p-- ,7 ) ! he>t1 & t 0 f> away4 ,"s seem$ transport$ to a less def9ite b /ill happy region1 :i* !y vaguely indicat$ by say+ !y 7 9 heav52 :ile o!rs _h /ill odd] & w>m] visions1 :i* ne$ n be p>ticul>iz$4 ,= ! purpose ( obta9+ in=mation on all ! po9ts ( ?is mo/ int]e/+ subject1 we p]sonally que/ion$ all ! pati5ts 9 ! ,london hospitals1 :o1 at ! p]iod ( our visits1 /ill rema9$ 9 ! w>ds aft] ! e!r-op]ations4 ,!y 7 9 all fifty-f\r1 & ! great majority _h be5 ! subjects ( capital op]ations4 ,!y 7 unanim\s 9 _! expressions ( delight & gratitude at hav+ be5 reliev$ f _! diseases )\t suff]+4 ,9 li/5+ to _! reports1 x 0 n always easy to rema9 unmov$ "u ! influ5ce ( ! conceptions !reby communicat$1 ( ! a/oni%+ contra/ betwe5 ! actual physical condition ( ! mangl$ body 9 its app>5t tortures on ! op]at+ table ( a cr[d$ !atre1 & ! really happy m5tal /ate ( ! pati5t at ! "t4 ,?is p]fect fre$om f pa9 is prov$ by e case :]e9 ! vapor has be5 effici5tly adm9i/]$1 al?\gh !re are frequ5tly ! same cries utt]$1 & ! same motions practis$ z :5 pa9 is exp]i5c$ :i* proves t no?+ is prev5t$ b ! m]e feel+1 :i* x c be ( no use :atev] = any "o to suff] f4 ,*lor(orm has be5 m rec5tly introduc$ ?an e!r1 b has nev]!less be5 us$ q z mu*1 or probably m1 &1 9 g5]al1 ) /ill m success4 ,x 0 fir/ describ$1 ,i believe1 by ,pr(essor ,simpson ( ,ed9burgh1 at a sitt+ ( ! m$ical society ( t city1 9 ,novemb]1 #ahdg1 & sev]al cases 7 n>rat$1 two ( :i* ,i quote4 ,i h employ$ x 9 ob/etric practice ) entire success4 ,! lady to :om x 0 fir/ exhibit$ dur+ p>turition1 _h be5 previ\sly deliv]$ 9 ! c\ntry by p]=ation ( ! head ( ! infant1 aft] a labor ( ?ree days' duration4 ,9 ?is1 h] second conf9em5t1 pa9s sup]v5$ a =tnight be=e ! full "t4 ,?ree h\rs & a half aft] !y comm5c$1 ere ! dilatation ( ! os ut]i 0 complet$1 ,i plac$ h] "u ! influ5ce ( ! *lor(orm1 by moi/5+ ) half a teaspoonful ( ! liquid1 a pocket-h&k]*ief1 roll$ up 9 a funnel %ape1 & ) ! broad or op5 end ( ! funnel plac$ ov] h] m\? & no/rils4 ,9 consequ5ce ( ! op]ation ( ! fluid x 0 once m r5ew$ 9 ab\t t5 or twelve m9utes4 ,! *ild 0 expell$ 9 tw5ty-five m9utes aft] ! inhalation 0 begun4 ,! "m subsequ5tly rema9$ long] soporose ?an commonly happ5s aft] e!r4 ,! cry+ ( ! *ild did n1 z usual1 r\se h]2 & "s m9utes elaps$ aft] ! plac5ta 0 expell$1 & aft] ! *ild 0 remov$ by ! nurse into ano!r room1 be=e ! pati5t awoke4 ,%e !n turn$ r\nd & obs]v$ to me t %e _h enjoy$ a v com=table sleep1 &1 inde$1 requir$ x z %e 0 s tir$1 b w\ld n[ be m able = ! "w be=e h]4 ,i evad$ ent]+ into conv]sation ) h]1 believ+1 z ,i h already /at$1 t ! mo/ complete possible quietude =ms "o ( ! pr9cipal secrets = ! successful employm5t ( ei!r e!r or *lor(orm4 ,9 a little "t1 %e aga9 rem>k$1 t %e 0 afraid h] sleep _h /opp$ ! pa9s4 ,%ortly aft]w>ds h] infant 0 br\ght 9 by ! nurse f ! adjo9+ room1 & x 0 a matt] ( no small difficulty to conv9ce ! a/oni%$ "m t ! labor 0 entirely ov]1 & t ! *ild pres5t$ to h] 0 really h] own liv+ baby4 ,p]haps ,i may be excus$ = add+1 t s9ce publi%+ on ! subject ( e!r inhalation 9 midwif]y1 sev5 or eight mon?s ago1 & !n = ! fir/ "t direct+ ! att5tion ( ! pr(ession to its great use & importance 9 natural & morbid p>turition1 ,i h employ$ x1 ) few & r>e exceptions1 9 e case ( labor t ,i h att5d$1 & ) ! mo/ delightful results4 ,& ,i h no d\bt :atev]1 t "s ye>s h5ce ! practice w be g5]al4 ,ob/etricians may oppose x1 b ,i believe our pati5ts !mselves w =ce ! use ( x ^u ! pr(ession4 ,i h nev] _h ! pleasure ( wat*+ ov] a s]ies ( bett] & m rapid recov]ies1 nor once witness$ any disagreeable result foll[ to ei!r "m or *ild1 :il/ ,i h (t5 se5 an imm5se am\nt ( mat]nal pa9 & agony sav$ by its employm5t4 ,& ,i mo/ consci5ti\sly believe t ! pr\d mission ( ! physician is di/9ctly tw(old--namely1 to alleviate human suff]+1 z well z pres]ve human life4 ,9 ano!r "p ( ! same publication ,pr(essor ,simpson has ano!r li/ ( cases1 all equally favorable4 ,9 "s ( ^! ! labors 7 protract$ _m h\rs1 & 9 o!rs1 op]ations ) in/rum5ts 7 p]=m$1 ( ! mo/ t]rible "*1 su* z w\ld1 "u ord9>y circum/ances1 h be5 att5d$ ) ! mo/ horrible suff]+4 ,z ?is article gives an in/ance ( ne>ly e k9d ( deliv]y "u ! influ5ce ( *lor(orm1 & conta9s also "s admirable reflections ^u its employm5t1 ,i quote x 9 ord] to make ! pres5t acc\nt complete4 ,,case #b4--,se5 ) ,mr4 ,c>mi*ael2 a second labor2 %e began ! *lor(orm inhalation be=e ! dilatation ( ! os ut]i 0 entirely complet$2 ! *ild 0 expell$ 9 fifty m9utes aft]w>ds4 ,i kept h] "u ! *lor(orm = a qu>t] ( an h\r1 till ! plac5ta 0 remov$1 ! b9d] appli$1 & ! body & b$-clo!s 7 arrang$ & adju/$4 ,on awak+ %e decl>$ t %e _h be5 sleep+ refre%+ly2 %e 0 q unaw>e t ! *ild 0 born1 till %e sudd5ly he>d x cry+ at its fir/ toilet 9 ! next room4 ,an h\r aft]w>ds %e decl>$ %e felt p]fectly unfatigu$1 & n z if %e _h borne a *ild at all4 ,9 h] fir/ or prec$+ conf9em5t %e _h be5 9 sev]e labor = tw5ty h\rs1 foll[$ by flood+4 ,no hmorrhage on ! pres5t occasion4 ,,case #c4--,pati5t unm>ri$2 a fir/ labor2 tw9s2 ! fir/ *ild pres5t$ by ! pelvis1 ! second ) ! h& & head4 ,! *lor(orm 0 exhibit$ :5 ! os ut]i 0 ne>ly fully dilat$2 ! passages spe$ily became greatly relax$1 7z has happ5$ 9 o!r cases plac$ "u its full influ5ce17 & 9 a few pa9s ! fir/ *ild 0 born1 assi/$ by traction4 ,i broke ! membranes ( ! second1 pu%$ up ! h&1 & secur$ ! m complete pres5tation ( ! head2 ?ree pa9s expell$ ! *ild4 ,! "m 0 !n b\nd up1 h] clo!s 7 *ang$1 & %e 0 lift$ into ano!r b$2 dur+ all ?is "t %e slept s\ndly on1 & = a full h\r aft]w>ds1 ! *lor(orm act+ 9 ?is z 9 o!r cases ( its prolong$ employm5t1 z a soporific4 ,! pati5t recollect$ no?+ f ! "t ( ! fir/ inhalations1 & 0 greatly di/ress$ :5 n "o b two liv+ *ildr5 7 br\ght 9 by ! nurse to h]4 ,dr4 ,*ri/ison1 :o 0 anxi\s to obs]ve ! effect ( ! *lor(orm ^u ! ut]us1 w5t along ) me to ?is pati5t4 ,,case #d4--,primip>a2 ( full habit2 :5 ! fir/ exam9ation 0 made1 ! passages 7 rigid1 & ! os ut]i difficult to rea*4 ,betwe5 six & sev5 h\rs aft] labor began1 ! pati5t1 :o 0 compla9+ mu*1 0 apa?iz$ ) ! *lor(orm4 ,9 ab\t two h\rs aft]w>ds1 ! os ut]i 0 fully dilat$1 & 9 f\r h\rs & a half aft] ! inhalation 0 begun1 a l>ge *ild 0 expell$4 ,! plac5ta 0 remov$1 & ! pati5t b\nd up & dress$ be=e %e 0 all[$ to awake4 ,?is pati5t requir$ an unusual quantity ( *lor(orm1 & ,dr4 ,williamson1 :o rema9$ beside h]1 /ates to me1 9 8 notes ( ! case1 ! h&k]*ief 0 moi/5$ (t51 9 ord] to keep up ! soporific effect4 ,on "o occasion ,i all[$ h] to em]ge f ?is /ate = a %ort "t1 b on ! accession ( ! fir/ pa91 %e call$ out s l\dly = ! *lor(orm t x 0 necess>y to pacify h] by giv+ h] "s imm$iately4 ,9 all1 f\r ounces ( *lor(orm 7 us$4 ,l ! o!rs1 %e 0 q unconsci\s ( :at _h gone on dur+ h] soporis$ /ate1 & awoke altoge!r unaw>e t h] *ild 0 born4 ,,case #f4--,second labor4 ,! pati5t--a p]son ( a small =m & delicate con/itution--bore h] fir/ *ild prematurely at ! sev5? mon?4 ,aft] be+ six h\rs 9 labor1 ! os ut]i 0 fully exp&$1 & ! head well d[n 9 ! pelvic cavity4 ,= two h\rs subsequ5tly x rema9$ fix$ 9 ne>ly ! same position1 & sc>cely1 if at all1 advanc$1 al?\gh ! pa9s 7 v di/ress+1 & ! pati5t becom+ fa9t & exhau/$4 ,%e ent]ta9$ "s mi/ak5 religi\s feel+s aga9/ e!r or *lor(orm1 :i* _h made h] object to ! e>li] use ( ! latt]2 b ,i n[ plac$ h] "u its influ5ce4 ,%e lay1 z usual1 l a p]son s\ndly asleep "u x1 & ,i 0 n[ able1 )\t any suff]+ on h] "p1 to increase ! int5sity & =ce ( ea* recurr+ pa91 by excit+ ! ut]us & abdom9al muscles ?r\gh pressure on ! l[] "p ( ! vag9a & p]9um4 ,! *ild 0 expell$ 9 ab\t fifte5 m9utes aft] ! inhalation 0 comm5c$4 ,9 a few m9utes %e awoke to ask if x 0 really possible t h] *ild _h be5 born1 & 0 ov]joy$ to be told t x 0 s4 ,i h ! conviction1 t 9 ?is case ! =ceps w\ld 9 all probability h be5 ultimately requir$1 provid$ ,i _h n be5 able to h int]f]$ 9 ! way m5tion$4 ,i might1 x is true1 h foll[$ ! same proce$+1 ?\gh ! pati5t 0 n 9 an an/hetic /ate2 b ,i c\ld n h done s )\t inflict+ great agony ^u h]4 ,,case #g4--;,a ?ird labor2 ! pati5t _h be5 twice be=e conf9$ ( dead premature *ildr52 once ( tw9s1 "u ! c>e ( ,mr4 ,/one1 ( ,london2 ! second "t ( a s+le *ild "u my *>ge4 ,! liquor amnii began to escape ab\t "o o'clock1 ,a4,m41 b )\t pa9s = "s "t4 ,i saw h] betwe5 ?ree & f\r o'clock1 ) ! pa9s comm5c+ & ! os ut]i beg9n+ to dilate4 ,9 two h\rs aft]w>ds1 ! ?ird /age 0 well advanc$1 & ! pa9s becom+ v sev]e1 %e _h ! *lor(orm exhibit$ to h]1 & slept s\ndly "u its influ5ce4 ,9 tw5ty m9utes ! *ild 0 born & cri$ v l\dly )\t r\s+ ! "m4 ,9 ab\t twelve or fifte5 m9utes m %e awoke z ! application ( ! b9d] 0 go+ on1 & imm$iately dem&$ if h] *ild 0 really born alive1 z %e ?\ght %e _h "s recollection ( he>+ ! nurse say s4 ,%e 0 rejoic$ beyond measure on h] son be+ br\ght 9 & pres5t$ to h]4 ,,case #i4--;,9 ! ,mat]nity ,hospital2 fir/ *ild4 ,labor began at #aj ,p4,m41 7,nov4 #ba/47 ,i 0 desir$ to see h] at six ,a4,m41 7#bbnd47 ,! os ut]i 0 well dilat$1 b x 0 evid5t t ! pelvic canal 0 contract$ ?r\gh\t1 & ! head 0 pass+ ) unusual difficulty ?r\gh ! brim4 ,! pati5t 0 compla9+ mu* ( h] suff]+s4 ,x 0 evid5t t x w\ld be a v t$i\s1 & probably1 at la/1 an in/rum5tal case1 & "o !re=e calculat$ to te/ ! l5g? ( "t dur+ :i* *lor(orm might be us$4 ,%e began to inhale x at a qu>t] pa/ six1 ,a4,m41 & 0 kept "u its influ5ce till a qu>t] pa/ sev51 ,p4,m41--! date ( h] deliv]y--?irte5 h\rs 9 all4 ,f ! "t x 0 begun till ! "t deliv]y 0 complet$1 h] cries & compla9ts ceas$1 & %e slept on s\ndly ?r\gh\t ! day4 ,! bladd] requir$ to be empti$ sev]al times ) ! ca!t]4 ,! head pass$ ! os ut]i at t5 ,a4,m41 & dur+ ! day1 gradually desc5d$ ?r\gh ! pelvis4 ,at sev5 ,p4,m41 ,i at la/ deem$ x prop] to deliv] h] by ! =ceps2 ! head1 :i* 0 n[ elongat$ & demat\s1 hav+ by t "t re/$ = "s h\rs aga9/ ! contract$ pelvic outlet1 ) little or no evid5ce ( advancem5t2 ! bones ( ! ftal cranium ov]lapp+ ea* o!r1 & ! ftal he>t becom+ less /rong & di/9ct 9 its pulsations4 ,a w>m ba?1 irritation ( ! *e/1 c41 7 necess>y to excite full & p]fect respiration 9 ! infant4 ,:il/ we 7 all busi$ ) ! infant1 ! "m lo/ "s blood1 b ! plac5ta 0 imm$iately remov$1 & ! ut]us contract$ p]fectly4 ,on aft]w>ds measur+ ! quantity ( blood lo/1 x 0 calculat$ to am\nt to fifte5 or eighte5 ounces4 ,! "m's clo!s 7 *ang$1 %e 0 b\nd up1 & remov$ to a dry b$ be=e %e awoke4 ,%e _h at fir/ no idea t ! *ild 0 born1 & 0 9 no respect consci\s ( be+ deliv]$4 ,9 fact1 %e _h be5 sleep+1 accord+ to h] own acc\nt1 f ! "t %e _h begun ! inhalation1 & ?\ght %e rememb]$ or dream$ t %e he>d ,dr4 ,williamson1 ! h\se-surgeon1 speak ne> h] once or twice4 ,dr4 ,beilby1 ,dr4 ,ziegl]1 c41 saw ! case ) me4 ,?ree days aft]w>ds ,i f\nd ! "m & *ild p]fectly well4 ,%e cont9u$ to recov] s rapidly1 t %e insi/$ on leav+ ! hospital on ! t5? day aft] deliv]y4 ,a suffici5t numb] ( su* acc\nts z ^! c\ld be collect$ to fill a l>ge volume2 b ^! are q suffici5t = our purpose4 ,9 reg>d to ! objections to us+ *lor(orm or e!r1 9 midwif]y1 x w be ?\ght by mo/ p]sons1 & ) good reason1 too1 t ! safety & success :i* has att5d$ _! use1 is itself a suffici5t answ] to all objections4 ,x 0 at fir/ ?\ght1 by "s physicians1 t ! expulsive =ce ( ! womb 0 less5$ :5 ! pa9 0 prev5t$2 b ?is is n ! case2 on ! contr>y1 x has be51 9 _m cases1 mu* increas$4 ,x 0 also ?\ght by o!rs t !re 0 m dang] f flood+1 & convulsions1 ?an 9 ord9>y cases2 b ?is is also equally at v>iance ) tru?1 = x appe>s1 beyond d\bt1 aft] a c>eful exam9ation ( all ! cases record$1 t !re is mu* less dang]1 p>ticul>ly f convulsions1 ?an :5 ! pati5t is all[$ to be tortur$ & t]rifi$ by feel+ pa94 ,dr4 ,simpson rem>ks 9 ano!r "p ( ! article above quot$3-- ,! "q :i* ,i h be5 repeat$ly ask$ is ?is--,w we ev] be ju/ifi$ 9 us+ ! vapor ( e!r to assuage ! pa9s ( natural labor8 ,n[1 if exp]i5ce betimes goes fully to prove to u ! safety ) :i* e!r may1 "u prop] precautions & managem5t1 be employ$ 9 ! c\rse ( p>turition1 !n1 look+ to ! facts ( ! case1 & consid]+ ! actual am\nt ( pa9 usually endur$1 ,i believe t ! "q w require to be q *ang$ 9 its "*4 ,=1 in/ead ( det]m9+1 9 relation to x1 :e!r we %all be ju/ifi$ 9 us+ ?is ag5t "u ! circum/ances nam$1 x w become1 on ! o!r h&1 necess>y to det]m9e :e!r1 on any gr\nds1 moral or m$ical1 a pr(essional man c\ld deem himself ju/ifi$ 9 )hold+ & n us+ any su* safe means1 7z we at pres5t presuppose ?is to be17 provid$ he _h ! p[]1 by x1 ( assuag+ ! pa9s & angui% ( ! la/ /age ( natural labor1 & ?us c\nt]act+ :at ,velpeau describes z ^? pi]c+ cries1 t agitation s lively1 ^? excessive ef=ts1 ^? inexpressible agonies1 & ^? pa9s app>5tly intol]able1 :i* accompany ! t]m9ation ( natural p>turition 9 ! human "m4 ,s9ce ! latt] end ( ,janu>y ,i h employ$ e!rization ) few & r>e exceptions1 9 e case ( labor :i* has be5 "u my c>e4 ,& ! results1 z ,i already /at$ 9 ,,! ,,lancet1 h be51 inde$1 mo/ happy & gratify+4 ,i nev] _h ! pleasure ( wat*+ ov] a s]ies ( m p]fect or m rapid recov]ies2 nor h ,i once witness$ any disagreeable result to ei!r "m or *ild4 ,i d n rememb] a s+le pati5t to h tak5 x :o has n aft]w>ds decl>$ h] s9c]e gratitude = its employm5t1 & h] indubitable det]m9ation to h rec\rse aga9 to simil> means "u simil> circum/ances4 ,mo/ h subsequ5tly set out1 l zeal\s mission>ies1 to p]suade o!r fri5ds to avail !mselves ( ! same measure 9 ! h\r ( suff]+4 ,& a numb] ( my mo/ e/eem$ pr(essional bre?r5 9 ,ed9burgh h adopt$ x ) success & results equal to my own4 ,at ! same "t1 ,i mo/ s9c]ely believe t we are1 all ( u1 call$ ^u to employ x1 by e pr9ciple ( true humanity1 z well z by e pr9ciple ( true religion4 ,m$ical m5 may oppose1 = a "t1 ! sup]9duction ( an/hesia 9 p>turition1 b !y w oppose x 9 va92 = c]ta9ly our pati5ts !mselves & _! fri5ds w =ce ! use ( x ^u ! pr(ession4 ,! :ole "q is1 ,i believe1 ev5 n[1 "o m]ely ( "t4 ,x is n--,%all ! practice come to be g5]ally adopt$8 b--,:5 %all x be g5]ally adopt$8 ,&1 = my "p1 ,i m ?an d\bt if any man 7reject+ will+ly its b5efits7 is really ju/ifi$1 on any gr\nds1 moral or m$ical1 9 delib]ately desir+ & ask+ 8 pati5ts to %riek & wri! 9 _! agonies = a few mon?s1 or a few ye>s long]1 9 ord] t1 by do+ s1 !y may def]1 =soo?1 to 8 pr(essional apa?y1 or p&] to 8 pr(essional caprices & prejudices4 ,ano!r objection has also be5 advanc$ aga9/ ! employm5t ( e!r or *lor(orm1 ! =ce ( :i* mu/ be e/imat$ by e "o = !mselves4 ,x is well kn[n t _m1 if n mo/ ( ! l[] animals dur+ labor1 or imm$iately aft]w>d1 exp]i5ce c]ta9 feel+s & desires /rong] ?an at any o!r "t2 & x is suppos$ t su* w\ld be ! case1 z a g5]al rule1 ) human be+s1 if x 7 n = ! pa9 :i* ov]p[]s ev]y?+ else4 ,?is supposition has1 9 fact1 be5 p>tly v]ifi$ 9 a few cases2 sev]al females hav+ confess$1 aft] recov]+ f a pa9less labor "u ! influ5ce ( e!r1 t _! dreams dur+ ! sleep 7 ( a peculi> w>m "*6 ,h[ f> ?is may be g5]ally ! case1 ( c\rse1 we h no means ( asc]ta9+1 nor d ,i consid] x to be practically ( any consequ5ce to "k1 because x c 9 no way int]f]e ) ! safe progress & t]m9ation ( ! labor1 :i* alone is :at we are prop]ly conc]n$ 94 ,i h m]ely ?\ght x prop] to /ate ! fact z be+ a s+ul> "o1 & to make my read]s acqua9t$ ) x4 ,physicians are well aw>e t ! peculi> feel+s ref]r$ to are frequ5tly produc$ by v>i\s causes :i* act on ! n]v\s sy/em1 su* z mesm]ism1 & ev5 by /rong devotional excitem5t4 ,i h kn[n females ) /rong moral impressions :o always c>efully avoid$ bo? ! above causes1 f hav+ discov]$ _! liability to produce su* effects2 9 fact1 ?is has be5 "o objection rais$ to all[+ mesm]i/s to op]ate ^u "y p]sons1 & sev]al cases ( moral fail+ hav+ be5 attribut$ to ?is cause4 ,x is n at all improbable1 !re=e1 t su* results may occasionally occur dur+ labor1 ?\gh we are n at all ju/ifi$ 9 assum+ t !y w 9 any p>ticul> case4 ,h[ f> ?is may be consid]$ an objection to ! employm5t ( su* means1 mu/ be h[ev]1 z ,i be=e rem>k$1 decid$ by all p]sons = !mselves1 & = !mselves only6 ,x is n a m$ical "q at all4 ,notices ( ,dr4 ,hollick's ,lectures4 ,,dr4 ,,hollick ,,& ,,physiology4--,! second ( a s]ies ( ,lectures1 by ?is g5tleman1 on human physiology1 & ! all important tru?s connect$ ) our physical con/itution1 0 att5d$ by a full h\se1 9 ,national ,hall1 la/ ev5+4 ,! "t 0 well sp5t1 & s appe>$ to ?9k ! audi5ce4 ,on ! deliv]y ( ! fir/ ( ^! ,lectures on ,tuesday ev5+1 ! speak] 9 a compreh5sive & well-dige/$ exordium1 plac$ himself & ! subject "r ) ! public4 ,8 mann]1 language & /yle1 did ! fir/2 8 s\nd logic1 8 argum5t1 8 c&or & rese>*1 accompli%$ ! second4 ,ap>t f ! int]e/+ & apposite details ( ! wond]s ( reproduction1 ! illu/rations ( ! immutable wisdom ( nature1 :i* teem 9 ! animal & vegetable worlds--:i* ,gl[s 9 ea* /em1 & blossoms 9 ea* tree2 ,lives ?r\gh all life1 ext5ds ?r\gh all ext5t1 ,spreads undivid$1 op]ates unsp5t4 ,ap>t f all ?is1 ,dr4 ,hollick's ,lecture 0 excell5t z a def5ce ( tru?1 a v9dication ( ! "r ( free & un%ackl$ inquiry1 & z a conv9c+ refutation ( t silly1 b f> too preval5t op9ion t !re are tru?s ( :i* x is bett] to rema9 9 a /ate ( ignorance4 ,_h no?+ else be5 imp>t$ 9 ! =cible & well def9$ exordium ( ,dr4 ,hollick ?an ?is judici\s demolition ( t fallaci\s1 silly1 b injuri\s twaddle :i* w\ld =bid rese>* to pass 9 advance ( ! old l&m>ks prescrib$ by cu/om1 ignorance1 or a spuri\s morality--ev5 t w\ld well des]ve ! public patronage4 ,tru?s1 well set =?1 w make an impression1 :e!r _! inve/igation be fa%ionable or n4 ,!re is an aff9ity betwe5 ! capacity to le>n1 & ! tru?s to be le>n$1 :i* always results1 :5 a fitt+ opportunity is pres5t$1 9 a free inquiry1 & ! g5tleman :o is br++1 9 a judici\s & elevat$ mann]1 a k ( ^? fundam5tal pr9ciples ( our corporeal exi/5ce :i* are abus$ because unkn[n1 w accompli% m good ?an half a doz5 tea*]s ( high] pret5sions1 & l[] ability4 ,x 0 gratify+ to obs]ve ! decorum--! s5se ( respect = bo? speak] & subject1 t 0 obs]v$ ?r\gh\t ! ev5+1 :i* evid5tly %[s t ^? :o g !re are actuat$ by high] motives ?an m]e curiosity2 by desires m ennobl+ ?an a pass+ gratification2 9 a ^w1 x 0 cle> t ^? :o compos$ ,dr4 ,h4's he>]s1 7 m5 :o "k & d>e to ?9k1 & :o w pr(it by ^! mo/ useful disc\rses4--,new ,york ,h]ald1 ,aug4 #g1 #ahdd4 ,,! ,,orig9 ,,( ,,life4--,we att5d$ ,dr4 ,hollick's ,lecture at ! ,masonic ,hall1 on ,monday ev5+1 & if we 7 to say we 7 delight$1 we %\ld b feebly express ! gratification we exp]i5c$4 ,x 01 9 fact1 a :ole s]ies ( anatomical lectures cr[d$ into "o1 & t "o s dive/$ ( te*nicalities1 & r5d]$ s concise1 s intelligible to ! mo/ illit]ate m9d1 & )al c\*$ 9 su* delicate z well z p]spicu\s language1 t ! mo/ fa/idi\s c\ld f9d no fault1 nor ! idle/ curiosity g away un9=m$4 ,! human figure--a ,fr5* model1 made1 we believe1 ( papi] ma*e--is beautifully con/ruct$1 & e trifl+ organ is n only an accurate c\nt]p>t ( nature1 b c be tak5 ap>t1 op5$1 exam9$1 c41 ) an ease t r5d]s ! /udy z p]fect z an actual dissection1 )\t ! desagrem5s t att5d a scrut9y ( ! real subject4 ,we advise all :o love k1 & p>ticul>ly a k ( _! physical organization1 to att5d ^! lectures4--,phila4 ,_s ( ! ,times1 ,dec4 #d1 #ahdd4 ,at a ,meet+ ( ! ,class att5dant ^u ,dr4 ,hollick's ,select ,lectures on ! ,physiology & ,philosophy ( ! ,orig9 ( ,life 9 ,plants & ,animals1 held at ! ,lecture ,room ( ! ,museum1 ,w$nesday ev5+1 ,decemb] #a1 #ahdd1 ,george ,g4 ,we/1 ,esq41 0 call$ to ! ,*air1 & ,samuel ,w4 ,black appo9t$ ,secret>y4 ,resolv$1 ,t we h li/5$ ) unfeign$ pleasure & int]e/ to ! ,c\rse ( ,lectures deliv]$ by ,dr4 ,hollick1 & n[ br\ght to a close1 & t we deem x an act ( ju/ice to him & ! community1 to express our entire confid5ce 9 8 "*1 ability1 & ! mann] ( illu/rat+ 8 subject1 :i*1 to use ! words ( a daily j\rnal1 is c\*$ 9 su* delicate z well z p]spicu\s language1 t ! mo/ fa/idi\s c\ld f9d no fault1 nor ! idle/ curiosity g away unimprov$4 ,resolv$1 ,t a committee ( ?ree be appo9t$ to t5d] to ,dr4 ,h4 ! ?anks ( ! ,class = 8 c\rtesy to ! memb]s 9 af=d+ !m e facility = obta9+ in=mation ^u ! subject ( 8 ,lectures1 & t he be reque/$ to repeat ! ,c\rse at ! e>lie/ p]iod consi/5t ) 8 o!r engagem5ts4 ,publi%$ 9 all ! ,philadelphia daily pap]s ( ,decemb] #ad1 #ahdd1 & sign$ by "o hundr$ & =ty ( ! mo/ respectable & influ5tial inhabitants4 7,see simil> ,resolutions1 ) ov] two hundr$ names atta*$1 9 ! ,philadelphia daily pap]s ( ,m>*1 #i1 #ahdd2 also ( ,m>* #af2 & on sev]al o!r occasions47 ,f ! ,philadelphia ,daily ,pap]s1 ,feb4 #ba1 #ahde4 ,at a meet+ ( ! ,ladies compos+ ,dr4 ,hollick's ,class1 held on ,w$nesday aft]noon1 ,febru>y #ai?1 9 ! ,lecture ,room ( ! ,museum1 ! foll[+ ,resolutions 7 unanim\sly adopt$1 & ord]$ to be publi%$ 9 "o or m ( ! city pap]s3 ,resolv$1 ,t we h li/5$ ) great pleasure & int]e/ to ,dr4 ,hollick's ,lectures1 & are happy to add our te/imony to ! _m already record$ 9 behalf ( su* ,lectures3 & reg>d+ ,dr4 ,hollick z a b5efactor ( 8 race1 & especially ( our sex1 we cordially wi% = him abundant success1 & ample rew>d 9 ! consci\sness ( do+ good4 ,resolv$1 ,t we w ex]t ourselves to induce our female fri5ds & acqua9tances to avail !mselves ( ! great & r>e privilege ( obta9+ ! valuable in/ruction imp>t$ 9 ^! ,lectures 9 s *a/e & dignifi$ a mann]4 ,sign$ on behalf ( ! meet+ by ,,s>ah ,,webb1 ,sec'y4 ,,susan ,,wood1 ,presid5t4 -- ,) ov] #ej names atta*$ !reto4 7,see also simil> ,resolutions1 ) num]\s names1 on ,feb4 #bg1 #ahdf1 ,m>* #bj1 #ahdf1 & on ,april #aj1 #ahdf1 ) ov] ?ree hundr$ names atta*$47 ,,dr4 ,,hollick',s ,,lectures4--,^! ,lectures cont9ue to attract mu* att5tion1 & are comm5d$ by all :o he> !m4 ,dur+ ! pa/ week ,dr4 ,h4 has giv5 a private ,lecture & exhibition ( 8 models to _m ( our prom95t ,s5ators & public m51 all ( :om express$ !mselves highly gratifi$1 & desir\s t ano!r class %\ld be =m$ to accommodate _! fri5ds :o _h n att5d$4--,national ,intellig5c]1 ,jan4 #cj1 #ahdf4 ,,dr4 ,,hollick is a g5tleman ( no less k 9 8 pr(ession ?an eloqu5ce 9 8 means ( imp>t+ x1 & he is c]ta9ly des]v+ ( great cr$it & support = 8 ex]tions 9 a new field ( su* univ]sal importance4 ,we comm5d ^! ,lectures ) ! fulle/ confid5ce to ! att5tion ( our citiz5s4--,n4 ,y4 ,sun1 ,aug4 #f1 #ahde4 ,,lett]s ,,f ,,new ,,york1 ,,no4 #aa4 99 99 99 99 ,!re h be5 sev]al c\rses ( ,lectures on ,anatomy1 ?is w9t]1 adapt$ to popul> compreh5sion4 ,i rejoice at ?is2 = x has long be5 a *]i%$ wi% ) me t a g5]al k ( ! /ructure ( our bodies1 & ! laws :i* gov]n x1 %\ld ext5d f ! sci5tific few into ! common education ( ! p4 ,i "k ( no?+ s well calculat$ to dim9i% vice & vulg>ity z univ]sal & rational in=mation on ^! subjects4 ,b ! impure /ate ( society has s p]v]t$ nature1 & bl9d$ common s5se1 t intellig5t wom51 ?\gh eag]ly /udy+ ! /ructure ( ! ,e>?1 ! attraction ( ! ,planets1 & ! reproduction ( ,plants1 seem a%am$ to "k any?+ ( ! /ructure ( ! human ,body1 & ( ^? ,physiological facts mo/ intimately connect$ ) _! deepe/ & pure/ emotions1 & ! holie/ exp]i5ce ( _! lives4 ,i am (t5 tempt$ to say1 z ,sir ,c4 ,gr&ison did to ! ,prude--',wotte/ ?\ n h[ mu* 9-delicacy !re is 9 ?y delicacy8' ,! only ,lectures ,i happ5$ to att5d 7 ^? ( ,dr4 ,hollick1 :i* int]e/$ & edifi$ me mu*4 ,!y 7 pla91 famili> conv]sations1 utt]$ & li/5$ to ) great mode/y ( language1 & propriety ( demeanor4 ,! ,manik91 or ,artificial ,anatomy1 by :i* he illu/rat$ 8 subject1 is a mo/ wond]ful ma*9e inv5t$ by a ,fr5* ,physician4 ,x is made ( papi] ma*e1 & repres5ts ! human body ) admirable p]fection1 9 ! %ape1 color+1 & arrangem5t1 ev5 to ! m9ute/ fibres4 ,by ! removal ( wires x c be dissect$ completely1 s z to %[ ! locality & functions ( ! v>i\s ,organs1 ! int]ior ( ! ,he>t1 ,lungs1 c4 ,until ,i exam9$ ?is curi\s piece ( me*anism1 ,i _h v fa9t & imp]fect ideas ( ! miracul\s ma*9]y ( ! h\se we live 94 ,i f\nd x highly sugge/ive ( _m ?+s to my m9d4 99 99 99 ,l4 ,m4 ,c4 ,extract f a ,lett] 9 ! ,bo/on ,c\ri] ( ,monday1 ,june #c;d1 #ahdd1 by ,mrs4 ,l4 ,m4 ,*ild4 ,,dr4 ,,hollick',s ,,lectures4--,we cordially say to ^? :o love a sci5tific treat n to fail to att5d4 ,m in/ruction is conta9$ 9 ^? ?ree ,lectures1 ?an c be ma/]$ by a twelve mon?'s read+4--,baltimore ,clipp]1 ,m>* #cj1 #ahdg4 ,,writ+ ,,desk ,,& ,,gold ,,p5 ,,pres5t$ ,,to ,,dr4 ,h4 ,by ,,"o ,,( ,,8 ,,lady ,,classes4 ,illu/ration ,,dr4 ,,hollick--,de> ,sir3 ,! memb]s ( y\r class1 desir+ ! gratification ( (f]+ y "s te/imonial ( _! p]sonal reg>d1 & grateful appreciation ( ! b5efits :i* y are conf]r+ ^u !m & _! sex g5]ally1 respectfully reque/ y\r acceptance ( ! accompany+ writ+ desk4 ,7 x necess>y1 we might repeat our assurances t y\r s]vices to humanity w be1 by u1 long & gratefully rememb]$4 ,! wom5 ( ?is g5]ation h reason to rejoice t1 by y\r ef=ts1 a new & ext5sive field ( in=mation has be5 op5$ to !m1 :5ce !y may d]ive treasures ( k1 ( imm5se importance to !mselves & _! po/]ity1 hi!rto conceal$ )9 pr(essional enclosures4 ,wi%+ y heal? & happ9ess1 we beg leave to subscribe ourselves1 ,truly y\r ,fri5ds1 ,sign$ on behalf ( ! class by1 ,m4 ,g4 7#ejj pres5t47 ,o4 ,w4 ,b4 ,philadelphia ,m>* #bj1 #ahde4 ,illu/ration ,,notices ,,( ,,books4 ,f ! ,new ,york ,h]ald4 ,,outl9es ,,( ,,anatomy ,,& ,,physiology1 ,,) ,a ,,dissect+ ,,plate ,,or ,,! ,,human ,,organization1 by ,fr$]ick ,hollick1 ,m4 ,d4 ,we reg>d ?is z "o ( ! mo/ valuable works issu$ 9 a long "t4 ,x is a complete g5]al treatise on anatomy & physiology1 & ! dissect$ plate answ]s ! purpose ( a model ( ! human frame4 ,dr4 ,hollick is entitl$ to great cr$it = 8 laudable desire to dissem9ate a k ( subjects t are ( su* vital consequ5ce to all1 b :i* hi!rto has be5 monopoliz$ by ! m$ical pr(ession4 ,we comm5d x to all z a "w ( great m]it & usefulness4 ,f ! ,patriot1 ,baltimore1 ,m>* #bd?1 #ahdg4 ,,outl9es ,,( ,,anatomy1 c4--,dr4 ,f4 ,hollick1 ^: hi/ory z ! great simplifi] ( ! human anatomy1 s well kn[n ?r\gh\t ! c\ntry1 & ^: public ,lectures h won = him s high a reputation1 has j publi%$ a "w :i* he designates ,outl9es ( ,anatomy & ,physiology = ,popul> ,use4 ,?is book conta9s a v curi\sly & +5i\sly arrang$ plate1 :i* op5s by pieces1 s t ! diff]5t p>ts ( ! organs ( ! human sy/em may be se5 9 all _! v>iety1 all ( :i* are fully expla9$ 9 ,engli%4 ,! second "p ( ?is invaluable "w gives a g5]al description ( ^! organs & p>ts ( ! sy/em1 "u ! division ( bones1 muscles1 art]ies1 ve9s1 c41 c4 ,?is "w %\ld fall into ! h&s ( e family4 ,f ! ,new ,york ,argus1 ,janu>y #i1 #ahdg4 ,,neuropa?y4--,?is is a new "n1 b a good "o1 be+ ! title ( a "w by ,dr4 ,f4 ,hollick1 ^: excell5t ,lectures on v>i\s subjects w be rememb]$ by _m ( our citiz5s4 ,9 ?is "w is expla9$ ! action ( ,galvanism1 ,electricity & ,magnetism2 ,homopa?y & ,allopa?y are contra/$ 9 !ory & practice2 ,mesm]ism is discuss$1 & o!r subjects too num]\s to m5tion1 treat$ 9 a mann] at once novel & in/ructive4 ,dr4 ,hollick has also publi%$ a "w on ,anatomy & ,physiology = ,popul> ,use1 illu/rat$ ) a new dissect$ plate ( ! human organization1 ( mo/ +5i\s con/ruction4 ,( ?is "w we %all h m to say anon4 ,x is no ord9>y production4 ,f ! ,new ,york ,sunday ,times & ,mess5g]1 ,jan4 #aj1 #ahdg4 ,,outl9es ,,( ,,anatomy ,,& ,,physiology1 ,,= ,,popul> ,,use1 illu/rat$ by a new dissect$ plate ( ! human organization1 & by sep>ate views4 ,! "w is design$ ei!r to convey a g5]al k ( ^! subjects 9 itself1 or z a key = expla9+ l>g] & m complete works4 ,^! ,outl9es %\ld be 9 ! h&s ( e body2 & ,dr4 ,hollick1 or any "o else1 is a public b5efactor :o fur!rs ! publication ( su* able1 int]e/+1 & truly important works4 ,f ! ,p5nsylvanian1 7,philadelphia17 ,jan4 #bf1 #ahdg4 ,! foll[+ 9 reg>d to two works f ! p5 ( ,dr4 ,hollick1 ( ?is city1 we copy f ! ,wa%+ton ,union1 ( ! #bj? in/ant3-- ,,outl9es ,,( ,,anatomy ,,& ,,physiology ,,= ,,popul> ,,use4 ,by ,fr$]ick ,hollick1 ,m4 ,d41 ,lectur] on ,anatomy1 ,physiology1 c4--,we reg>d ?is z an em95tly useful publication4 ,x gives 9 a =m f> m cond5s$ & intelligible ?an we h be=e se51 a v compreh5sive view ( ! human organization4 ,! dissect$ plate ( ! human anatomy1 :i* =ms an int]e/+ feature ( ! "w1 is to u at lea/ a novelty4 ,! explanations are drawn up ) great simplicity1 & _c be misund]/ood by ! g5]al read]1 :ile !y1 ) ! illu/rations1 w (t5 s]ve to r5d] m cle> & precise ! views ( sci5tific & pr(essional /ud5ts4 ,f ! ,sunday ,m]cury1 ,new ,york4 ,,dr4 ,,hollick',s ,,la/ ,,"w--,! ,diseases ( ,woman1 _! ,causes & ,cure famili>ly expla9$1 ) ,practical ,h9ts = _! prev5tion1 c4--,we reg>d ?is z an invaluable production1 ! mo/ useful1 9 _m respects1 :i* has yet emanat$ f ?is di/+ui%$ au?or & practition]4 ,x is j ! k9d ( "w :i* has ev] be5 want$1 & is j suitable to ! excell5t purpose = :i* x 0 int5d$2 ?is x accompli%es mo/ fully1 & its ext5sive circulation mu/ be productive ( va/ practical b5efit4 ,x is works ( ?is nature & ,,"* :i* really d good2 :i* exhibit pla9 facts 9 a pla9 mann]1 & record 9 language simple & intelligible1 k ( ! mo/ vital importance to ! heal? & consequ5t happ9ess ( e daught]1 si/]1 wife1 & "m 9 ! l&4 ,! "w is d$icat$ to ! ,,ladies ,,( ,,am]ica1 & we congratulate !m ^u ! possession ( a fri5d at once s able1 s s9c]e & valuable z ,dr4 ,hollick4 ,burgess1 ,/r+] ,co41 ( ?is city1 are ! publi%]s4 ,! ,new ,york ,sun says ( ?is ,book3 ,,burgess ,,/r+] h j issu$ a mo/ invaluable "w1 be+ a treatise ^u ! diseases ( wom51 by ! celebrat$ ,dr4 ,hollick4 ,we h ?or\ghly exam9$ ! "w1 & c say )\t hesitation1 t x %\ld be 9 ! h&s ( e "m :o c>es = ! heal? ( h] daught]s1 & e woman :o values physical & m5tal well-be+4 ,dr4 ,hollick & 8 publi%]s h done a public b5efit by issu+ su* a book4 ,f ! ,new ,york ,sunday ,times4 ,,dr4 ,,hollick',s great "w1 ,,! ,,diseases ,,( ,,woman1 :i* w be f\nd adv]tis$ 9 ano!r column1 is truly a valuable production1 & well su/a9s ! au?or's well-e>n$ reputation4 ,x is a complete practical treatise on female diseases1 sci5tific en\gh = a m$ical man1 & yet s pla9 t e body c und]/& x1 & s delicately writt5 t ev5 ! mo/ fa/idi\s _c object to a s+le passage4 ,mu* ( ! matt] x conta9s is q new 9 ?is c\ntry1 ev5 to m$ical m51 & ( ! greate/ int]e/ & importance4 ,! anatomical plates are sup]b1 & ! :ole book is excell5tly got up4 ,e adult female 9 ! l& %\ld read ?is book2 ! in=mation x gives w\ld prev5t an incalculable am\nt ( disease & suff]+1 if possess$ 9 "t2 or x w tea* ! be/ way to cure x :5 un=tunately e/abli%$4 ,,works ,,publi%$ ,,by ,,dr4 ,,hollick4 ,,outl9es ,,( ,,anatomy ,,& ,,physiology1 ,,by ,,fr$]ick ,,hollick1 ,m4 ,d4 ,?is is ! mo/ complete1 & at ! same "t mo/ simple "w ev] issu$ on ! subject4 ,x is illu/rat$ 9 a novel mann]1 by a l>ge color$ ,plate ( ! ,human ,organization1 :i* dissects by means ( sep>ate lay]s1 f ! surface ( ! ,abdom5 d[n to ! ,sp9e1 %[+ all ! ,organs 9 _! prop] places1 all connect$ toge!r1 & _m ( !m 9 sections6 ! :ole be+ color$ to life4 ,?is plate is on an entire new plan1 no?+ ( ! k9d hav+ ev] be=e be5 inv5t$2 x is almo/ z complete z a model1 & is invaluable = private /udy1 = tea*]s1 & = ,m$ical /ud5ts4 ,! explanations are famili>1 & dive/$ ( te*nicalities3 & x is /ill fur!r illu/rat$ by sep>ate wood-cuts ?r\gh\t ! "w1 & a beautifully engrav$ portrait on ,/eel ( ! au?or4 ,"o volume1 qu>to1 b\nd1 price ,"o ,doll>4 ,?ird ,edition4 ,,neuropa?y2 ,,or1 ,,! ,,true ,,pr9ciples ,,( ,,! ,,art ,,( ,,heal+ ,,! ,,sick4 ,,by ,,fr$]ick ,,hollick1 ,m4 ,d4 ,be+ a complete practical treatise on ! use ( ,,galvanism1 ,,electricity1 & ,,magnetism1 9 ! cure ( disease1 & a comp>ison betwe5 _! p[]s1 & ^? ( ,drugs or ,m$ic9es4 ,^! two works are publi%$ by ,t4 ,b4 ,,pet]son1 ,no4 #ih ,*e/nut-/41 ,philadelphia1 & = sale by ,booksell]s & ,news ,ag5ts g5]ally ?r\gh\t ! ,unit$ ,/ates4 ,,! ,,orig9 ,,( ,,life4 ,a complete popul> ,treatise on ! ,philosophy & ,physiology ( ,,reproduction1 9 ,plants & ,animals1 ) a detail$ description ( human g5]ation4 ,illu/rat$ by color$ plates ( ! male & female sy/ems4 ,new be+ at e /age1 c4 ,publi%$ by ,nafis ,corni%1 #bfh ,pe>l /reet1 ,new ,york4 ,price #a4 ,?irtie? ,edition1 ) additional ,plates & v>i\s improvem5ts4 ,n4 ,b4--,?is is ! only popul> & yet /rictly sci5tific "w on ! ,g5]ative ,functions ev] yet publi%$4 ,,! ,,diseases ,,( ,,woman1 ,,_! ,,causes ,,& ,,cure ,,famili>ly ,,expla9$2 ,) ,,practical ,,h9ts = _! prev5tion & = ! pres]vation ( ,female ,heal?4 ,by ,f4 ,,hollick1 ,m4 ,d4 ,especially design$ = e ,female's ,private ,use4 ,,burgess1 ,,/r+] ,,co41 corn] ( ,broadway & ,ann /reets1 ,new ,york1 & = ,sale by all ,booksell]s4 ,second ,edition4 ,price #a--cjj pages1 beautifully b\nd1 & illu/rat$ ) num]\s spl5did ,,anatomical ,,plates4 ,by remitt+ #a 9 a lett] to ,t4 ,w4 ,,/rong1 #ih ,nassau-/41 ,n4 ,york1 x w be =w>d$ to any "p ( ! ,c\ntry4 -- ,no ,female %\ld be )\t x4 ,! above works1 along ) ! pres5t "o1 con/itute a complete practical & popul> ,libr>y ( ,anatomy1 ,m$ic9e & ,physiology4 ,!y h all be5 purposely design$ = ! in/ruction ( non-pr(essional read]s1 b at ! same "t are s sci5tifically correct1 & s complete1 t !y w\ld s]ve z text books = ,m$ical /ud5ts4 ,! favor !y h already met )1 & ! ext5sive circulation !y h atta9$1 is pro( t !y bo? meet ! wants ( ! public & enjoy its approbation4 ,f ! ,bo/on ,mail1 ,m>* #g1 #ahdh4 ,,dr4 ,,hollick',s ,,sep>ate ,,lectures ,,to ,,ladies ,,& ,,g5tlem5 ,,on ,,physiology4--,! importance ( adult p]sons1 ( bo? sexes1 und]/&+ !mselves1 & _! natural relations1 mu/ be obvi\s to e ?9k+ m9d4 ,! pres5t ignorance on ^! matt]s is1 und\bt$ly1 ! *ief cause ( ! vices & suff]+s :i* s ext5sively prevail1 & our only hope ( a b5eficial *ange mu/ be f\nd$ on a prop] sy/em ( public in/ruction4 ,?is in/ruction is difficult to imp>t we admit1 & !re are b few m5 qualifi$ = imp>t+ x4 ,we h no hesitation1 h[ev]1 9 say+ t ,dr4 ,h4 is "o ( ^! m54 ,he kn[s h[ to pres]ve 9 8 subject all t int5se int]e/ :i* x intr9sically possesses1 & yet to dive/ x ( ev]y?+ 9 ! slighte/ degree obnoxi\s to c5sure1 or ev5 di/ru/4 ,he has a happy faculty ( mak+ e ?+ easy to be und]/ood1 & yet avoid+ ! slighte/ approa* to undue famili>ity4 ,all :o att5d1 express !mselves bo? surpris$ & delight$1 & unhesitat+ly recomm5d 8 ,lectures :]ev] !y g4 ,_m ( ! mo/ em95t ,ladies 9 our city 7 among 8 auditors la/ week1 & 7 unres]v$ 9 _! expressions ( approbation1 bo? = ! ,lecture itself1 & = ! becom+ mode/y & true ref9em5t t *>act]is$ its deliv]y4 ,! pres5t s]ies1 :i* comm5ce to-day1 has be5 anxi\sly expect$1 & w no d\bt be num]\sly att5d$ by bo? sexes1 b p>ticul>ly by ! ,ladies1 _m ( :om 7 unable to ga9 admission la/ week4 ,illu/ration3 ,,! ,,gold ,,m$al ,,pres5t$ ,,to ,,dr4 ,,hollick1 ,,by ,,! ,,ladies ,,( ,,philadelphia4 ,,important ,,notice ,,to ,,ladies6 ,,! ,,pat5t ,,ela/ic ,,& ,,m$icat$ ,,pess>y2 ,,= ,,! ,,relief ,,& ,,p]man5t ,,cure ,,( ,,prolapsus ,,ut]i1 ,,or ,,fall+ ,,( ,,! ,,womb2 ,prolapsus ,vag9a1 ,rupture ( ! ,bladd] or ,inte/9e into ! ,vag9a2 ,retrov]sion1 or ,antev]sion ( ! ,womb2 & also1 9 _m cases1 ( ,,leucorrh,a1 or ,fluor ,albus2 inv5t$ by ,,dr4 ,,hollick1 & fir/ describ$ 9 8 ,diseases ( ,woman4 ,?is ,in/rum5t is ,,c]ta9 ,,to ,,cure all ! above nam$ diseases1 ,,:]e ,a ,,cure ,,is ,,possible4 ,x c be worn ) p]fect ease by "y or old1 summ] or w9t]1 night or day1 )\t ! slighte/ inconv5i5ce4 ,x is made ( a s(t ela/ic mat]ial1 :i* nev] corrodes1 & :i* gives way to ! slighte/ motions ( ! body4 ,x c nev] become displac$1 nor fail to effectually support ! p>ts1 & is s light t x only weighs "o ounce4 -- ,?is is ! only ,in/rum5t ( ! k9d ev] inv5t$1 & c]ta9ly ! only "o t c ,,cure ,,fall+ ,,( ,,! ,,womb2 or be worn ) ease1 to relieve x1 :5 incurable4 ,,dr4 ,,hollick is ! only p]son :o keeps x1 z he has ,,no ,,ag5t ,,any ,,:]e1 at pres5t4 ,n4 ,b4--,! article is ,,pat5t$3 b1 besides ?is1 ,,no ,,imitations1 h[ev] simil>1 c be dep5d$ ^u1 because ! ,orig9al is impregnat$1 9 a peculi> mann]1 ,,kn[n ,,only ,,to ,,! ,,inv5tor1 ) a sub/ance :i* imp>ts its ,,m$ic9al ,p[]1 & )\t :i* x w\ld be comp>atively inefficaci\s4 ,all ! old fa%ion$ ,,trusses1 ,,support]s1 ,,pess>ies1 c41 are entirely sup]s$$ by ?is ,in/rum5t1 :i* c only be obta9$ f ,dr4 ,hollick1 ,new ,york1 :o w also give ! necess>y directions z to its use & application4 ,x may be s5t any di/ance4 ,price--,five ,doll>s4 ,,adv]tisem5t4 ,,dr4 ,,hollick is daily receiv+ num]\s ,lett]s f all p>ts ( ! c\ntry1 ! answ]+ ( :i* has hi!rto be5 a great tax on 8 "t1 already suffici5tly occupi$2 he is !re=e compell$ to ann\nce1 t 9 future he _c att5d to any :i* m]ely reque/ advice1 unless !y conta9 ! cu/om>y fee ( ,,five ,,doll>s4 ,address1 ,dr4 ,hollick1 ,new ,york4 99 99 99 99 99 ,transcrib]'s ,notes ,page #ci /ates1 ,9 ,plate ,,vii4 ! l9e m>k$ crosses ! upp] /rait1 or brim ( ! ,pelvis1 b !re is no 9 ! orig9al image4 ,on page #cda1 ,*apt] ,,xxiii 0 incorrectly label$ ,*apt] ,,xxii4 ,t has be5 correct$ "h4 ,m9or punctuation errors 7 correct$ on pages vi1 #d1 #ac1 #ai1 #ij1 #ada1 #aea1 #bjj1 #bjb1 #bjf1 #bae1 #beh1 #bga1 #cja1 #cac1 #cbc1 #cdf1 #deg1 #dfj1 #dfd4 ,inconsi/5cies 9 hyph5ation & capitalization h be5 reta9$4 ,orig9al spell+s h be5 reta9$ except 9 ! cases ( ^! app>5t typographical errors3 ,page #bi1 situate *ang$ to situat$4 7,?is is ! "p situat$ betwe54447 ,page #ec1 ?a *ang$ to t4 7,?us "s au?ors ass]t$ t4447 ,page #ef1 b>5ness *ang$ to b>r5ness4 7444or1 9 o!r words1 :i* produce b>r5ness4447 ,page #fd1 ,t9c *ang$ to ,t9c4 7,! ,os ,t9c1 or m\? ( ! ,womb47 ,page #aaf1 is *ang$ to 9 9 two in/ances4 7444,womb 9 a fir/ pregnancy1 & 9 a female4447 ,page #ach1 expeet$ *ang$ to expect$4 7444or be=e ! expect$ p]iod4447 ,page #aef1 foetal *ang$ to ftal4 7444& cov]$ ) ! ftal membranes4447 ,page #ahc1 rotale *ang$ to rotate4 7444! head is compell$ to turn1 or rotate4447 ,page #bjc1 cephalio *ang$ to cephalo4 7444x is call$ ! "r cephalo iliac position4447 ,page #bch1 lang\r *ang$ to languor4 7444falls into a quiet & pleas+ lang\r4447 ,page #bdj1 signs *ang$ to sign4 7444& if !re is no sign ( its com+4447 ,page #bdc1 subseqn5t *ang$ to subsequ5t4 7444be+ done 9 _! subsequ5t labors47 ,page #bdg1 asphyxat$ *ang$ to asphyxiat$4 7444are mo/ likely to become asphyxiat$4447 ,page #bec1 capble *ang$ to capable4 7444%e ?9ks h]self /rong]1 & m capable4447 ,page #bee1 pres5tati\s *ang$ to pres5tations4 7444v unfavorable pres5tations ( ! ftus4447 ,page #beg1 un=se5 *ang$ to un=ese54 7444al>m$ :5 un=ese5 difficulties occur4447 ,page #bha1 developem5t *ang$ to developm5t4 7,! developm5t ( ! head _c be asc]ta9$4447 ,page #cjg1 cause *ang$ to causes4 7,/ill su* pres5tation occasionally causes4447 ,page #caa1 pres5tatations *ang$ to pres5tations4 7444mo/ dang]\s ( all ! pres5tations4447 ,page #cac1 & *ang$ to any4 7444*ild & pelvis f any o!r cause47 ,page #cbc1 recommeuds *ang$ to recomm5ds4 7,mauriceau recomm5ds t wom54447 ,page #ccc1 cont9uanee *ang$ to cont9uance4 7444! cont9uance ( pregnancy to ! full p]iod4447 ,page #ccc1 inadmissable *ang$ to inadmissible4 7,! plug is "h totally inadmissible4447 ,page #cda1 honr *ang$ to h\r4 7444may be pres]v$ = an h\r or two4447 ,page #cda1 amni *ang$ to amnii4 7444& !n if ! liquor amnii4447 ,page #cdi1 introdue$ *ang$ to introduc$4 7,:5 ! fir/ blade is prop]ly introduc$4447 ,page #cga1 di/ate *ang$ to di/a/e4 7,?is means a complete di/a/e4447 ,page #chj1 meat *ang$ to neat4 7,a neat spoonful %\ld be drunk4447 ,page #che1 weaknes *ang$ to weakness4 7444a /ate ( weakness & exhau/ion47 ,page #che1 *lid *ang$ to *ild4 7444?an dang]\s1 except to ! *ild4447 ,page #cie1 unles *ang$ to unless4 7444unless v l>ge1 !y cause4447 ,page #cig1 truely *ang$ to truly4 7444z truly s z ^? on ! limbs4447 ,page #djh1 mattrass *ang$ to mattress4 7444lie on h] back1 on a h>d mattress4447 ,page #dji1 accummulate *ang$ to accumulate4 7444& makes x accumulate 9 ! womb4447 ,page #dac1 ocurr5ce *ang$ to occurr5ce4 7444:i* may acc\nt = ! con/ant occurr5ce4447 ,page #dah1 ccnclusion *ang$ to conclusion4 7,9 conclusion x %\ld be rem>k$4447 ,page #dbb1 tembl+s *ang$ to trembl+s4 7444!n foll[ trembl+s1 numbness ( ! limbs4447 ,page #dbf1 spmptoms *ang$ to symptoms4 7444aft] ! fir/ symptoms ( ! disease4447 ,page #dcf1 two *ang$ to too4 7444or too unremitt+ly1 p>ticul>ly4447 ,page #dda1 oocasional *ang$ to occasional4 7444occasional doses ( ,james's ,fev] ,p[d]4447 ,page #dda1 ,james' fev] p[d]s *ang$ to ,james's ,fev] ,p[d]4 7444occasional doses ( ,james's ,fev] ,p[d]4447 ,page #dde1 recomm5$ *ang$ to recomm5d$4 7,mesm]ism has be5 recomm5d$4447 ,page #dde1 develope *ang$ to develop4 7444w develop ! bones ( ! ftus4447 ,page #dej1 cr[$ *ang$ to cr[d$4 7444on ! op]at+ table ( a cr[d$ !atre4447 ,page #deb1 m9mtes *ang$ to m9utes4 7444! *ild 0 expell$ 9 fifty m9utes aft]w>ds47 ,page #dee1 ?rongh *ang$ to ?r\gh4 7444) unusual difficulty ?r\gh ! brim47 ,page #deg1 humau *ang$ to human4 7444natural p>turition 9 ! human "m47 ,page #dei1 coporeal *ang$ to corporeal4 7444pr9ciples ( our corporeal exi/5ce4447 ,page #dfj1 #ahdj *ang$ to #ahdf4 7,m>* #bj1 #ahdf7 ,page #dfd1 ,peansylvanian *ang$ to ,p5nsylvanian4 7,f ! ,p5nsylvanian1 7,philadelphia17 ,jan4 #bf1 #ahdg47 ,on page #bdj1 an extra an 0 remov$ f ! phrase 444to wait m ?an an h\r444 ,on page #def1 ! ^w ( 0 miss+ f ! phrase 444aft] a c>eful exam9ation ( all ! cases record$444 ,on page #deg1 an extra ( 0 remov$ f ! phrase ! sup]9duction ( an/hesia4