1000000031

fully; ;¡.,d

when

t\\'()

,¡rc intronu..:nl tugcthcr,

t!ie

patient

ncv... r

f•.

ph,

to cOlllpl.lin .

Thc ddign

touching

is to

inrormtd whether the wom ;¡n ¡s, or is nO( with chilJ

kn'ow how

Ole

is advanced in her

pn:gntlncy;

(he:

ís

in d,meer of a

mi!c.¡rrittge;

lhe

ldcri

be dilated ;

¡¡r.d

in tim::: of

L ..

hlhH

la form

right juJgment of [he

caf.:, f¡-om -he

0rcn1ng

of Ihe os internum. and (he pre[s–

ing down of

lhe

m-: mbranes \Vitll their w<\ters

and laft–

Iy.

diflingu;rh wh"

p.rt

of Ihe ehild is prerenl<d.

is gencral!y impr;¡éticable

difcover,

a toueh in

lhe vagina, whether or

nal

(he

utl!(US

is impregeatcd. till

after lhe founh month: th:n th e be(l time for examina–

tion is lhe morning, when [he waman is

ralling.

after [he

COOl ents of

the bladder

anJ rcélum

llave beeo difch:uged ;

and

(he::

ought, if

nec~fT.lrY,

to fubmil to lhe ioquiry in

a flanding porl\lre; oecaufc, in that cafe, the YlerUs hangs

]ower do...,n in lhe vagina,

ílnd

the weight i5 more Ctnfi–

ble to the tOl1ch than whcn O1e hes rccl! ned. One JJrin–

c:ir:\1

rearon of our uncertainty ¡s, when we try to feel the

neck, the womb riCes up

our preffing againfl

lhe

vagina,

,he

r.de

of Ihe os inlernum, (ree Plate

CXl.

lig. ,.)

and in fo:-nc, lhe vagina feds very lenre

bUI, when the

fun'dus lllcri is advanced neílr the navd, the pre(fure (rom

abuye k·.:eps down lhe os inler oum

mueh, th tlt

yOtl

ca o

generally feel both the neek, ando

a~lOve

that. the (lrctch–

¡n

of the undc:r pan of lhe ulaus. See

PLue.

ex!.

fil: o

3·

There

¡,

no eonfiderable variation to be felt io the

fi–

gure of the os intc!rnum, exeept in lhe latter eod of preg–

nancy, when it Cometimes grows h.rger aod Cofter, (Cee

PI.te

CX!.

r.g.

4.)

Dor do Ihe lips reem lO be more clo–

red in a woman with child than in another. efpecially in

the begioning

pregnancy: bar, in both caCes the os

uteri is feh like the mouth of a young puppy or teneh,

In fome the lips

are

vcry {mall ; in others, large

and

fometimes, though feldom, fmoothed ayer or pointeJ.

In nuoy \\'oman,

\lo

ho nave fornH:r1y n ...

children and

difficu ll Janours, the li ps are largc, and [o much feparat–

ed, as to adOlit the

(ip

of an orJinar)' finger

uut a litle

higher

up.

the neck CeeOls

be quite c1ofed.

In lhe ñrrl fuur momhs, lhe n::ck

lhe womb may

be fele

hanging do\\. n in the vagina, by pun,iog up (he

tlnger by the fiJe of (he os internum; but the llretchiog

(he utcrus and l1?pcr part of

(he

ncck c,,"onot

pt:r–

ceived til! the fifth, and COOletimcs lhe (¡xth month ; and

even then, the uterus mu{l be kcpt down by a

roog

p 'efTure upon Ihe belly.

The

fl-retching of lhe fundus is fometime!.

ft:1t

by lhe

fin gcr introduced into lhe retlum, before it

C:JO

pt.:r–

cci\~.ed

io the vagina; beeaure. in this

I.dl.

methoJ, lhe

u(erus rccede5 .from lhe toueh, and n el s tOo high to be

aCclHAtdy

dil1ingtl101ed; whereas the ¡¡:"Iger heir.g intro–

duted

10[0

fhe reélum , p,,(fcs alo:1g {he b",¡;k of the wl)lub

almol\ ro the up¡>er

pan

the fondo s, which, in

<lO

un–

impregn<ltcd (Lile,

reh fl ;¡t on Ihe b ,ck

p .11

t an,1jelllng

001

al the fiues; bUl lhe ,mpre&natl'd u(crlJs

rCTl.c.:i~

ved like

large round tuOlour.

About the lillh or ri xlh munth, the urrcr pan of the

u.teru~

fo Oluch Hrctchcd, as tO

nf¿

t111 ~C

or (uu r

in~h ·

n,abo\'c lhe os pubis, or to dIe OliJJle fp.tCt' buwccn

.hat and the navd; ro tll ...,

plc!!irs Ihe h"DJ on Ihe

ueJly, efpeeially of lean women,

is rreque'ntly percei–

ved;

anJ if, at the

fJ.me

time, the inJex. of rhe olhcr

h,md be introduecd in

thlo!

v3gina, the neck

wi ll

fee""

fhonened, particulotry al {he (or.:-part anJ fides, and

the \\.'ciflht will be (cllli llly rdt; but, if (he p..uietcs uf

the abdomen are Uretched <lfta eating. one mi!..y be dc ·

-ceivc.:d by the prdlure of

lhe

(

}oOltl.ch.

becaufe weíght

and prelrure are .the (..me. But all thefe

(j~ns

are more

perceptible towarJs the !alter end of pregn.l.llcy; aod

fome women the os inte roum is felt

i:I.

lntle open fome

weeks before lhe full time, thouUh geoerally it is oot

opened lill a few

d.ys

berore

I..

bour begins.

From the (ifth

(he n¡mh monlh, the neck lJf th(

u·

térus beeomes {horla, and H\Orter, and the {l¡e1ching of

the womb gro\Vs more and more perceptible. In rhe

fe–

venth month. the fuodus rifes as high as the navel

¡:l.

the eight month,

the middle {pace betwixt the oavel

and fcrobiculus cordís

and in the ninth, 'even to the

ferobieulus, exc<p' in pendulous bellies: See PI..e

CXI

fig

4. BUI

all thefe marRs may vary indiffe reot \Vomen:

for when the belly

penJulous" the parts below rhe: na·

vel are m ueh more nretched th an thoCe above, and hang

over the os pubIS

.the fundus will then be only equal

lO,

a..

¡Lltle highe r than the navel; at other times,

(he

terus will rire io the latter end or the (e\'enth or eighth.

montb tO the fcrobiculus cordis . The neck ofihe womb·

will,

fome, be felt as long in lhe eighlb, as in orhers

the.!ixth or (eventh mooth. ,..'his variation Cometimes

maL.:es the examLnatíon of the abdomen· more cert ..in thao

lhe touch of the vagina; and fo

viu vofa.

At other

times we mufl judge

boll,. See

Plato

CXI.

fig .

Oí Ih,jignt

0íCoNCEP Tl oN,

anllhuqllivocllljignJ

oJ'

pugnanl (l1Id

f)b)Jrufl~d

'UlfJIIJrfJ.

TH E

figns of pregnancy are to be di(linguifhed from .

thore th:t,t bl.'long to

obnru~hons,

by lhe touch in the va–

gina and motion of the child , in (he fifth or (ix<h month;

Cometimes, by lhe: touch io the retlum. before and after

the rifth mon!h. when the tumour of tbe abdomen

is.

plainly pereeived .

Mofl womcn. a day or [wo before the irruption of

[he c:n 301enia, labou r uoder complainu proceo:ding from

pl~lhora

; Cuch as Hretching p:.dns

the b:'\ck anJ loi os,

iofid~

of the

thi~hs,

brean anJ htad; a (iekne[s and op–

preffinn at lhe flom.1t.:h, and a fulnc[s of alJ'\he virce ra of

lhe abdomen; aod al l thefe fymplonHi abate, and

g~adual

Iy \'anLrh, wl¡¡;n the difcharge hegins aod conuoues to

{]¡IW.

Bur, if lhe woman be

ob(l~u

...

~('d

30y

aecident

01'

error in the nan natur"ls,

all

'hofe

compr~lnts

conti–

nuo! and ¡ncreare, and.

.He

hardly difliogui(hablt' from the

rymptoms of rrcgnaocy, til! the

enJ

or t!H! founh monlh;

which pl'riod, \Vomcn w;th chil,J grow better, anJ all

the: cumpJ.tints of fulloefs gradu.dly wo!..lr off; whereas,..

thnre who are ooly ohOruélcd, grow wOlfe and wode.

Thc

rllud tlS uu:ri. in the obltl uél ed patient, is not (l retch–

cd ; Iht: lIiroruer in the fl:omlch is nOl ro viulent as in a

p.t:.!~n

woman, ano fcldom accompanied with rt.1chings;

whire the women \l/i tu cllIld is affiJéleJ with a rcaching

every moroiog, and

fu¡'je~l

to longl ngs bt:l:dt's. The

firfl

I.d.hours unJer a fnllncCs

the

\'l..fl~ls;

the

!JO.

o~e:r

aDd abor e

tlliS

eOOlrlainl, ruff." aD

aud.deDJI

01l< froO!

lhe