The Works of William Harvey M.D. / Translated from the Latin with a life of the author

by William Harvey

But all experienced obstetricians know that the watery fluid of the secundines is of no great use either in lubricating the parts or in facilitating the progress of parturition in the way Fabricius would have it. For the parts surrounding the vulva are relaxed of themselves, and by a kind of proper maturity at the full time, without any assistance from the uterine waters; and particularly those that offer the greatest obstacles to the advance of the fœtus, namely, the ossa pubis and the os coccygis, to which the attention of the midwife is especially directed in assisting the woman in labour. For midwives are much less studious to anoint the soft parts with any emollient salves, lest they tear, than careful to pull the os coccygis outwards, a business in which, if the fingers do not suffice, they have recourse to the uterine speculum, applied by the hand of the experienced surgeon, an instrument having three sides or branches, one of which bearing on the os coccygis, the other two on the ossa pubis, the business of distension is effected by force. For the head of the child that is about to be born, when it makes the turn, and is forced downwards, relaxes and opens the os uteri; but coming down he will stick fast, and scarcely be brought forth if he chance to abut upon the point of the os coccygis, and immediately the case is one not without danger both to the child and mother. But nature’s intention was obviously to relax and soften all the parts concerned; and the attendant knows that when the uterine orifice is discovered in a soft and lax condition, by the finger introduced, it is an infallible sign that the delivery is at hand even though the waters have not broken. Indeed—and I do not speak without experience—if anything remains in the uterus for expulsion, either after delivery or at any other time, and the uterus make efforts to get rid of it, the orifice both descends lower and is found soft and relaxed. If the uterine orifice recedes, and is found somewhat hard after delivery, it is a sign of the woman’s restoration to health.

Taught by like experience, I assert that the ossa pubis frequently become loosened during labour, their cartilaginous connexion being softened, and the whole hypogastric region enlarged in the most miraculous manner, not, however, by any pouring out of watery fluids, but spontaneously, as ripe fruit gapes that the included seed may find an exit. The degree in which the coccyx may impede delivery, however, is apparent among quadrupeds having tails, which can neither bring forth, nor even discharge the excrement from their bowels, unless the tail be raised; if you but depress the tail with your hand, you prevent the exit of the dung.

Moreover, the most natural labour of all is held to be that in which the fœtus and afterbirth, the waters inclusive, or the ovum, is expelled entire. Now if the membranes have not given way, and the waters have not escaped, it comes to pass that the surrounding parts are more than usually distended and dilated by the labour pains, in consequence, to wit, of the entire and tense state of the membranes, by which it happens that the fœtus is produced more speedily, and with a less amount of effort, although with more suffering to the mother. In cases of this kind we have known women who were suffering much in their travail in consequence of the too great distension, immensely relieved by the rupture of the membranes and the sudden escape of the waters, the laceration being effected either with the nails of the midwife or the use of a pair of forceps.

Experienced midwives are farther aware that if the waters come away before the orifice of the uterus is duly dilated, the woman is apt to have a lingering time and a more difficult delivery, contrary to Fabricius’s notion of the waters having such paramount influence in softening and lubricating the parts.

Moreover, that the fluid which we have called colliquament is not the sweat of the fœtus is made obvious, both from the history of the egg and of the uterogestation of other animals: it is present before the fœtus is formed in any way, before there is a trace of it to be seen; and whilst it is still extremely small and entirely gelatinous, the quantity of water present is very great, so that it seems plainly impossible that so small a body should produce such a mass of excrementitious fluid.

It happens besides that the ramifications of the umbilical veins are distributed over and terminate upon the membrane which incloses this fluid, precisely as on the membranes of the albumen and yelk of the egg, a circumstance from which, and the thing being viewed as it is in fact, it appears to be clearly proclaimed that this fluid is rather to be regarded as food than as excrement.

To me, therefore, the opinion of Hippocrates appears more probable than that of Fabricius and other anatomists, who look on this liquid as sweat, and believe that it must prove detrimental to the fœtus. I am disposed, I say, to believe that the fluid with which the fœtus is surrounded may serve it for nourishment; that the thinner and purer portions of it, taken up by the umbilical veins, may serve for the constitution and increase of the first formed parts of the embryo; and that from the remainder or the milk, taken into the mouth by suction, passed on to the stomach by the act of deglutition, and there digested or chylified, and finally absorbed by the mesenteric veins, the new being continues to grow and be nourished. I am the more disposed to take this view from certain not impertinent arguments, which I shall proceed to state.

As soon as the embryo acquires a certain degree of perfection it moves its extremities, and begins to prove the actions of the organs destined to locomotion. Now I have seen the chick in ovo, surrounded with liquid, opening its mouth, and any fluid that thus gained access to the fauces must needs have been swallowed; for it is certain that whatever passes the root of the tongue and gains the top of the œsophagus, cannot be rejected by any animal with a less effort than that of vomiting. This fact is acted upon every day by veterinary practitioners, who in administering medicated drinks and pills or boluses to cattle, seize the tongue, and having put the article upon its root beyond the protuberant part, the animal cannot do otherwise than swallow it. And if we make the experiment ourselves, we find that a pill carried between the finger and thumb as far as the root of the tongue and there dropped, immediately the action of deglutition is excited, and unless vomiting be produced the pill is taken down. If the embryo swimming in the fluid in question, then, do but open his mouth, it is absolutely necessary that the fluid must reach the fauces; and if the creature then move other muscles, wherefore should we not believe that he also uses his throat in its appropriate office and swallows the fluid?

It is further quite certain that in the crop of the chick,—and the same thing occurs in reference to the stomach of other embryos—there is a certain matter having a colour, taste, and consistence, very similar to that of the liquid mentioned, and some of it in the stomach digested to a certain extent, like coagulated milk; and further, whilst we discover a kind of chyle in the upper intestines, we find the lower bowels full of stercoraceous excrements. In like manner we perceive the large intestines of the fœtuses of viviparous animals to contain excrements of the same description as those that distend them when they feed on milk. In the sheep and other bisulcated animals we even find scybala.

Towards the seventeenth day we find dung very obviously near the anus of the chick; and shortly before the extrusion I have seen the same matter expelled and contained within the membranes. Volcher Coiter, a careful and experienced dissector, states that he has observed the same thing.