ON PARTURITION.
On generation follows parturition, that process, viz. by which the fœtus comes into the world and breathes the external air. I have, therefore, thought it well worth while, and within the scope of my design, to treat briefly of this subject. With Fabricius, then, I shall consider the causes, the manner, and the seasons of this process, as well as the circumstances which both precede and follow it. The circumstances which occur immediately previous to birth, and which, in women especially, indicate that the act of parturition is not far distant, are, on the one hand, such a preparation and arrangement on the part of the mother as may enable her to get rid of her offspring; and on the other, such a disposition of the fœtus as may best facilitate its expulsion.
With respect to the latter, viz. the position of the fœtus, Fabricius says,[353] “that it is disposed in a globular form and bent upon itself, in order that its extremities and prominent points generally may not injure the uterus and the containing membranes; another reason being that it may be packed in as small a space as possible.” For my own part, I cannot think that these are the reasons why the limbs of the fœtus are always kept in the same position. Swimming and moving about, as it does, in water, it extends itself in every direction, and so turns and twists itself that occasionally it becomes entangled in a marvellous manner in its own navel-string. The truth is, that all animals, whilst they are at rest or asleep, fold up their limbs in such a way as to form an oval or globular figure: so in like manner embryos, passing as they do the greater part of their time in sleep, dispose their limbs in the position in which they are formed, as being most natural and best adapted for their state of rest. So too the infant in utero is generally found disposed after this manner: the knees are drawn up towards the abdomen, the legs flexed, the feet crossed, and the hands directed to the head, one of them usually resting on the temples or ears, the other on the chin, in which situation white spots are discernible on the skin as the result of friction; the spine, moreover, is curved into a circle, and the neck being bowed, the head falls upon the knees. In such a position is the embryo usually found, as that which we naturally take in sleep; the head being situated superiorly, and the face usually turned towards the back of the mother. A short time, however, before birth the head is bent downwards towards the orifice of the uterus, and the fœtus, as it were, in search of an outlet, dives to the bottom. Thus Aristotle:[354] “All animals naturally come forth with the head foremost; but cross and foot presentations are unnatural.” This, however, does not hold universally; but as the position in utero varies, so too does the mode of exit; this may be observed in the case of dogs, swine, and other multiparous animals. The human fœtus even has not always the same position; and this is well known to pregnant women, who feel its movements in very different parts of the uterus, sometimes in the upper part, sometimes in the lower, or on either side.
In like manner the uterus, when the term of gestation is completed, descends lower (in the pelvis), the whole organ becomes softer, and its orifice patent. The “waters” also, as they are vulgarly called, “gather;” that is, a portion of the chorion, in which the watery matter is contained, gets in front of the fœtus, and falls from the uterus into the vagina; at the same time the neighbouring parts become relaxed and dilatable; in addition to which the cartilaginous attachments of the pelvic bones so lose their rigidity that the bones themselves yield readily to the passage of the fœtus, and thus greatly increase the area of the hypogastric region. When all these circumstances concur, it is quite clear that delivery is not far distant. Nature, in her provident care, contrives this dilatation of the parts in order that the fœtus may come into the world like the ripe fruit of a tree; just as she fills the breasts of the mother with milk that the being who is soon to enjoy an independent existence may have whereon to subsist. These, then, are the circumstances which immediately precede birth; and thus it happens that the presence of milk has especially been regarded as a sign of approaching delivery—milk, I mean, of a character suitable for the sustenance of the offspring; and this, according to Aristotle,[355] is only visible at the period of birth; it is therefore never observed before the seventh month of pregnancy.
Fabricius[356] maintains that on the subject of parturition there were two special heads of inquiry, viz. the time at which and the manner in which the process took place. Under the first of these heads he considers the term of utero-gestation; under the second, the way in which the fœtus comes into the world.
Aristotle[357] thought that the term of utero-gestation varied much. “There is,” he says, “a certain definite term to each animal, determined in the majority of cases by the animal’s duration of life; for it follows of necessity that a longer period is required for the production of the longer-lived animals.” He attributes, however, the chief cause to the size of the animal; “for it is scarcely possible,” he continues, “that the vast frames of animals or of aught else can be brought to perfection in a short period of time. Hence it is that in the case of mares and animals of cognate species, though their duration of life is small, their term of utero-gestation is considerable; and thus the elephant carries its young for the space of two years, the reason being its enormous size, for each animal has a definite magnitude, beyond which it cannot pass.” I would add, that the material of which each is formed has also its fixed limit in point of quantity. He says, moreover, “There is good reason why animals should have the periods of gestation, generation, and duration of life in certain cycles—I mean by cycle, a day, night, month, and year, and the time which is described by these; also the motions of the moon—for these are the common origin of generation to all. For it is in accordance with reason that the cycles of inferior things should follow those of the higher.” Nature, then, has decreed that the birth and death of animals should have their period and limit after this manner.
Just as the birth of animals depends on the course of the sun and moon, so have they various seasons for copulation and different terms of utero-gestation, these last being longer or shorter according to circumstances. “In the human species alone,” says the philosopher in the same part of his works, “is the period of utero-gestation subject to great irregularity. In other animals there is one fixed time, but in man several; for the human fœtus is expelled both in the seventh and tenth months, and at any period of pregnancy between these; moreover, when the birth takes place in the eighth month, it is possible for the infant to live.” In the majority of animals there is a distinct season for bringing forth their young; this is generally found to be in the spring, when the sun returns, but in many species it is in the summer, and in some in the autumn, as is the case with the cartilaginous fishes. Hence it is that animals, as the time of labour approaches, seek their accustomed haunts, and provide a safe and comfortable shelter where they may bring forth and rear their young. Hence, too, the title “bird-winds,” applied to those gales which prevail toward the beginning of spring, the word owing its origin to the fact of certain birds at that period of the year availing themselves of these winds to accomplish their migrations. In like manner stated seasons are observed by those fishes which congregate in myriads in certain places for the purpose of rearing their young. Moreover, in the spring, as soon as caterpillars fall under our notice (their ova, as may be observed by the way, like to invisible atoms, being for the most part carried by the winds, and not owing their origin, as commonly supposed, to spontaneous generation, or to be looked upon as the result of putrefaction), straightway the trees put forth their buds, soon to be devoured by these creatures; and these in their turn fall victims to birds innumerable, and are carried to the nest as food for the young brood. So constantly does this hold, that whenever strange species of caterpillars fall under notice, at the same time we are sure to see some rare and foreign birds, as if the latter had chased the former from some remote corner of the earth. Now in both of these classes of creatures the time for bringing forth their young is the same. Physicians, too, when these phenomena occur, are enabled to predict the approach of sundry strange diseases. Bees bring forth in the month of May, when honey abounds; wasps in the summer, when the fruit is ripe; and this is analogous to what takes place in viviparous animals, who produce their young at the period when their milk is best adapted for their offspring. But other animals of the non-migratory classes, in the same way, at stated seasons seek a place to deposit their young as they do a store of food. And thus it results that the countryman is able to decide what are the proper seasons for ploughing, sowing, and getting in his harvest, forming his opinion chiefly from the approach of flocks of birds, and especially of the seminivora. There are, however, some animals in whom there is no fixed time for production, and this is chiefly the case with those which are called domestic, and live with the human species. These both copulate and produce their young at uncertain seasons, and the reason probably is to be sought for in the larger quantity of food they consume, and the consequent inordinate salacity. But in these, as in the human species, the process of parturition is often difficult and dangerous.
There are other animals also on whom the course of the moon has influence, and which consequently copulate and bring forth their young at certain periods of the year—rabbits, mice, and the human female may be instanced. “For the moon,” observes Plutarch,[358] “when half full, is represented as greatly efficacious in shortening the pains of labour, and this she effects by moderating and relaxing the humours—hence, I think, those surnames of Diana are derived, Locheia, i. e. the tutelar deity of childbirth, and Eilytheia, otherwise Lucina; for Diana and the moon are synonymous.”
“In all other animals,” says Pliny,[359] “there are stated seasons and periods for production and utero-gestation; in man alone are they undetermined.” And this is, to a great extent, true; for in his case, although nature has laid down for the most part certain boundaries, yet there is sometimes a vast difference in individuals, and instances are recorded of women bringing forth viable children, some in the seventh, and others in the fourteenth month. Further, although Aristotle[360] asserts “that the majority of eight months’ children in Greece die,” he still admits “that they survive in Egypt and in some other countries, where the women have easy labours;” and although he says “that children born before the seventh month can under no circumstances survive, and that the seventh month is the first in which anything like maturity exists, and that the feebleness of children born even then is such as to make it necessary to wrap them in wool,” he still allows “that these are viable.” Franciscus Valesius tells us of a girl in his time, who, although a five months’ child, had arrived at the age of twelve years. Adrianus Spigelius[361] also records the case of a certain courier, “who proved to the satisfaction of all, on the public testimony of the city of Middleburgh, that he was born at the commencement of the sixth month, and that his frame was so slight and fragile that his mother found it necessary to wrap him up in cotton until such times as he was able to bear the ordinary dress of infants.” Avicenna[362] also states that a sixth months’ child is very capable of surviving. In like manner it is proved, both by ancient and modern authorities, that children may live who are born after the completion of the eleventh month. “We are told,” says Pliny,[363] “by Massurius, that when his inheritance was claimed by the next heir, Lucius Papyrius the prætor gave the decision against the claimant, although, by his mother’s account, Massurius was a thirteen months’ child—the ground of the judgment being that the term of utero-gestation had not been as yet accurately determined. There was indeed, not so long since, a woman in our own country who carried her child more than sixteen months, during ten of which she distinctly felt the movements of the fœtus, as indeed did others, and at last brought forth a living infant. These are rare contingencies, I will allow; and therefore it is hardly fair of Spigelius to blame Ulpianus the lawyer because he regarded as legitimate no child born after the completion of the tenth month. Both laws and precepts of art, we must remember, have reference to the general rules of vital processes. Besides, it is impossible to deny that many women, either for purposes of gain or from fear of punishment, have simulated pregnancy, and not hesitated to swear to the truth of their assertion:—others again have frequently been deceived, and fancied themselves pregnant, whilst the uterus has contained no product of conception. On this point Aristotle’s[364] words may be quoted: “The exact period at which conception takes place in the case of those born after the eleventh month can scarcely be ascertained. Women themselves do not know the time at which they conceive; for the uterus is often affected by flatulent disorders, and if under these circumstances conception takes place, women imagine this flatulency to mark the period of conception, because they have recognized certain symptoms which accompany actual conception.”
In the case of other women in whom the fœtus has died in the third or fourth month, then putrefied, and come away in the form of fetid lochial discharges, we have known superfœtation to take place; and yet these same women have persisted that they have brought forth their children after the completion of the fourteenth month. “It happens sometimes,” says Aristotle,[365] “that an abortion takes place, and ten or twelve products of superfœtation come away. But if the (second) conception takes place soon after (the first), the woman goes to the full time with the second, and brings forth both as twins. This was said to have been the case in the fable of Iphicles and Hercules. And it is a subject which admits of proof; for it is known of a woman that she brought forth one child resembling her husband, and another like a man with whom she had had adulterous intercourse. Another woman became pregnant of twins, and conceived another by superfœtation. Her labour came on, and she brought forth the twins well formed and at their proper time, whilst the third child was at the fifth month, and so died immediately.”