A certain maid-servant being gotten with child by her master, to conceal her disgrace, fled to London in the month of September; here she was delivered, and returned home with her health restored. In December, however, the birth of another child, conceived by superfœtation, proclaimed to the world the fault she had committed. “It happened to another woman,” adds the philosopher, “to be delivered of a seven months’ child, and afterwards of twins at the full term, the single child dying, the twins surviving. Other women also, having become pregnant of twins, have miscarried of one, and borne the other to the full term.” It is very easy to understand how, if the earlier or later product of superfœtation come away after three or four months have elapsed, that mistakes may be made in calculating the subsequent months, especially by credulous and ignorant women. We have sometimes observed, both in women and other animals, the product of conception perish, and come away gradually in the form of a thin fluid, somewhat resembling fluor albus. Not long since a woman in London, after an abortion of this kind, conceived anew, and brought forth a child at the proper period. Subsequently, however, after a lapse of some months, as she was engaged in her ordinary duties, without any pain or uneasiness, there came away piecemeal some dark bones belonging to the fœtus of which she had formerly miscarried. I was able to recognize in some of the fragments portions of the spine, femur, and other bones.
I am acquainted with a young woman, the daughter of a physician with whom I am very intimate, who experienced in her own person all the usual symptoms of pregnancy; after the fourteenth week, being healthy and sprightly, she felt the movements of the child within the uterus, calculated the time at which she expected her delivery, and when she thought, from further indications, that this was at hand, prepared the bed, cradle, and all other matters ready for the event. But all was in vain. Lucina refused to answer her prayers; the motions of the fœtus ceased; and by degrees, without inconvenience, as the abdomen had increased so it diminished; she remained, however, barren ever after. I am acquainted also with a noble lady who had borne more than ten children, and in whom the catamenia never disappeared except as the result of impregnation. Afterwards, however, being married to a second husband, she considered herself pregnant, forming her judgment not only from the symptoms on which she usually relied, but also from the movements of the child, which were frequently felt both by herself and her sister, who occupied the same bed with her. No arguments of mine could divest her of this belief. The symptoms depended on flatulence and fat. Hence the best ascertained signs of pregnancy have sometimes deceived not only ignorant women, but experienced midwives, and even skilful and accurate physicians—so that as mistakes are liable to arise, not only from deception on the part of the women themselves, but also from the erroneous tokens of pregnancy, I should say that no rule is to be rashly laid down with respect to births taking place before the seventh or after the fourteenth month.
Unquestionably the ordinary term of utero-gestation is that which we believe was kept in the womb of his mother by our Saviour Christ, of men the most perfect; counting, viz. from the festival of the Annunciation, in the month of March, to the day of the blessed Nativity, which we celebrate in December. Prudent matrons, calculating after this rule, as long as they note the day of the month in which the catamenia usually appear, are rarely out of their reckoning; but after ten lunar months have elapsed, fall in labour, and reap the fruit of their womb the very day on which the catamenia would have appeared, had impregnation not taken place.
As regards the causes of labour, Fabricius, besides that of Galen[366] (who held “that the fœtus was retained in utero until it was sufficiently grown and nourished to take food by the mouth,” according to which theory weakly children ought to remain in utero longer than others, which they do not), gives another and a better reason, viz. “the necessity the fœtus feels for more perfectly cooling itself by respiration, since the child breathes immediately on birth, but does not take food by the mouth. This is not only the case,” he continues, “in man and quadrupeds, but has been particularly observed in birds: these, small as they are, and furnished as yet with but tender bills, peck through the egg-shell at the point where they have need of respiration; and they do this rather through want of breath than of food, since the instant they quit the shell the function of respiration begins, whilst they remain without eating for two days, or longer.” This point, however, whether the object of respiration be really to “cool” the animal, shall be discussed elsewhere at greater length.
In the mean time I would propose this question to the learned—How does it happen that the fœtus continues in its mother’s womb after the seventh month? seeing that when expelled after this epoch, not only does it breathe, but without respiration cannot survive one little hour; whilst, as I before stated, if it remain in utero, it lives in health and vigour more than two months longer without the aid of respiration at all. To state my meaning more plainly—how is it that if the fœtus is expelled with the membranes unbroken, it can survive some hours without risk of suffocation; whilst the same fœtus, removed from its membranes, if air has once entered the lungs, cannot afterwards live a moment without it, but dies instantly? Surely this cannot be from want of “cooling,” for in difficult labours it often happens that the fœtus is retained in the passages many hours without the possibility of breathing, yet is found to be alive; when, however, it is once born and has breathed, if you deprive it of air it dies at once. In like manner children have been removed alive from the uterus by the Cæsarean section many hours after the death of the mother; buried as they are within the membranes, they have no need of air; but as soon as they have once breathed, although they be returned immediately within the membranes, they perish if deprived of it. If any one will carefully attend to these circumstances, and consider a little more closely the nature of air, he will, I think, allow that air is given neither for the “cooling” nor the nutrition of animals; for it is an established fact, that if the fœtus has once respired, it may be more quickly suffocated than if it had been entirely excluded from the air: it is as if heat were rather enkindled within the fœtus than repressed by the influence of the air.
Thus much, by the way, on the subject of respiration; hereafter, perhaps, I may treat of it at greater length. As the arguments on either side are very equally balanced, it is a question of the greatest difficulty.
To return to parturition. Besides the reasons alluded to above, viz. “the necessity for respiration and the want of nourishment,” Fabricius gives another; he says, “that the weight of the fœtus becomes so great as to exert considerable pressure, and the bulk such that the uterus is unable to retain it, added to which the quantity of excrementitious matter is so much increased that it cannot be contained by the membranes.”[367]
Now it has been shown above that the uterine humours are not excrementitious. Nor do the weight and bulk of the fœtus help us to a more probable explanation; for the fœtus suspended in water weighs but slightly on the placenta or uterus; besides which some nine months’ children are very small, much less in fact than many fœtuses of eight months, nevertheless they do not abide longer in the womb. And as to weight, any twins of eight months are far heavier than a single nine months’ child; yet they are not expelled before nine months are completed. Nor do we find a better reason in “want of nutriment;” twins, and even more children, are abundantly supplied with support up to the full term; and the milk which after delivery is sufficient for the nourishment of the child, could equally well, if transferred to the uterus, nourish the fœtus there.
I should rather attribute the birth of the child to the following reason—that the juices within the amnion, hitherto admirably adapted for nutriment, at that particular period either fail or become contaminated by excrementitious matter. I have touched on this subject before. The variation in the term of utero-gestation, occurring as it does chiefly in the human species, I believe to depend on the habits of life, feebleness of body, and on the various affections of the mind. And thus in the case of domesticated animals, owing to their indolence and overfeeding, the seasons both of copulation and production are less fixed and certain than in the wilder tribes. So women in robust health usually experience easy and rapid labours; the contrary holding good in those whose constitutions are shattered by disease. For the same thing befalls them that happens to plants, the seeds and fruits of which come later and less frequently to perfection in cold climates than in those where the soil is good and the sun powerful. Thus oranges in this country usually remain on the tree two years before they arrive at maturity; and figs, which in Italy ripen two or three times annually, scarcely come to perfection in our climate:—the same thing happens to the fruit of the womb; it depends on the abundance or deficiency of nutriment, on the strength or weakness of body, and on the right or wrong ordering of life with reference to what physicians call the “non-naturals,” whether the child arrives sooner or later at maturity, i. e. is born.
Fabricius describes the manner of parturition as follows: “The uterus having been so enlarged by the bulk of the fœtus that it will admit of no further distension without risk, and thus excited to expulsion, is drawn into itself by the action of the transverse fibres, and diminishes its cavity. Thus whilst previously neither the excrementitious matters from their quantity, nor the fœtus from its bulk, could be contained within it, the uterus, contracted and compressed as it is now, becomes still less able to retain them. Wherefore, first of all, the membranes, as being the weaker parts, and suffering most pressure, are ruptured, and give exit to the waters, which are of a very fluid consistence, for the purpose of lubricating the passages. Then follows the fœtus, which tends towards, and, as it were, assaults the uterine aperture, not only by the force of its own gravity as no longer floating in water, but compressed and propelled by the action of the uterus: the abdominal muscles and the diaphragm also assist mightily in the entire process.”