Fortify and invigorate the general health, observing at the same time the strictest “temperance in all things.” These are the means by which to overcome that, to many, unfortunate state, barrenness.
You, then, who may be in the condition we have been considering, if you wish to be cured of it, leave none of the tonic means, none of the good rules of health untried. If you are faithful in every thing, so may you expect to succeed. But if it should be found that it is not possible for you to conceive, you will yet have the satisfaction of knowing that your toils have not been in vain; your health will become so much improved as to reward you a thousand-fold for every good thing you do.
I ought to remark also, before closing, that when a woman who has been for a time barren becomes again pregnant, she must be very careful of herself during this period, as with a little imprudence abortion is very likely to occur.
LETTER XXII.
THE PELVIS AND ITS ORGANS.
General Description—Differences between the Male and Female Pelvis—The Bladder and Urethra—The Vagina—The Uterus and its Appendages.
Before entering upon the subject of labor and its phenomena, it is proper that I should give you some idea of the parts more immediately concerned in parturition. In doing this, I propose for the most part to adopt the plain and concise description of these structures given by Mr. Erasmus Wilson, of London, whose work on anatomy stands as high as any other that has ever been written.
THE PELVIS.
The pelvis, considered as a whole, is divisible into a false and true pelvis; the former is the expanded portion, bounded on each side by the ossa ilii, and separated from the true pelvis by the linea iliopectinea. The true pelvis is all that portion which is situated beneath the iliopectinea. This line forms the margin or brim of the true pelvis, while the included area is called the inlet. The form of the inlet is heart-shaped, obtusely pointed in front at the symphysis pubis, expanded on each side, and encroached upon behind by a projection of the upper part of the sacrum, which is named the promontory. The cavity is somewhat encroached upon at each side by a smooth quadrangular plane of bone, corresponding with the internal surface of the acetabulum, and leading to the spine of the ischium. In front are two fossæ around the obturator foramina, for lodging the obturator internus muscle, at each side. The inferior termination of the pelvis is very irregular, and is termed the outlet. It is bounded in front by the convergence of the rami of the ischium and pubes, which constitute the arch of the pubes; on each side by the tuberosity of the ischium, and by two irregular fissures formed by the greater and lesser sacro-ischiatic notches; and behind by the lateral borders of the sacrum, and by the coccyx.
A FEMALE PELVIS.
1. The last lumbar vertebra. 2, 2. The intervertebral substance connecting the last lumbar vertebra with the fourth and sacrum. 3. The promontory of the sacrum. 4. The anterior surface of the sacrum, on which its transverse lines and foramina are seen. 5. The tip of the coccyx. 6, 6. The iliac fossæ, forming the lateral boundaries of the false pelvis. 7. The anterior superior spinous process of the ilium; left side. 8. The anterior inferior spinous process. 9. The acetabulum. a. The notch of the acetabulum. b. The body of the ischium. c. Its tuberosity. d. The spine of the ischium seen through the obturator foramen. e. The os pubis. f. The symphysis pubis. g. The arch of the pubes. h. The angle of the os pubis. i. The spine of the pubes; the prominent ridge between h and i is the crest of the pubes. k, k. The pectineal line of the pubes. l, l. The ilio-pectineal line; m, m. The prolongation of this line to the promontory of the sacrum. The line represented by h, i, k, k, l, l, and m, m, is the brim of the true pelvis. n. The ilio-pectineal eminence. o. The smooth surface which supports the femoral vessels. p, p. The great sacro-ischiatic notch.