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

by William Harvey

Now in these words Fabricius rather describes the process of defæcation or an abortion than a genuine and natural birth. For although in women, as a general rule, the membranes are ruptured before the escape of the fœtus, it is not universally so; nor does it hold in the case of other animals which bring forth their young enveloped in their membranes. This can be observed in the bitch, ewe, mare, and others, and more particularly in the viper, which conceives an ovum of an uniform colour and soft shell (resembling in fact the product of conception in the woman); this is retained until the fœtus is completely formed; it is then expelled entire, and, according to Aristotle,[368] is broken through by the young animal on the third day. It sometimes happens, however, that kittens, whilst yet in utero, gnaw through the membranes, and so come into the world uninvolved.

And so also, according to the observation of experienced midwives, women have occasionally expelled the child with the membranes unbroken. And this kind of birth, in which the fœtus is born enveloped in its coverings, appears to me by far the most natural; it is like the ripe fruit which drops from the tree without scattering its seed before the appointed time. But where it is otherwise, and the placenta, subsequently to birth, adheres to the uterus, there is great difficulty in detaching it, grave symptoms arise, fetid discharges, and sometimes gangrene occur, and the mother is brought into imminent peril.

Since then the process of parturition, as described by Fabricius, does not apply to all animals, but to women alone, and this not universally, but only where the labour is premature, and, as it were, forced, we must regard it not so much as a description of a natural as of a preternatural and hurried delivery, in fact, of an abortion.

In natural and genuine labour two things are required, which mutually bear upon and assist each other: these are, the mother which produces, and the child to be produced; and unless both are ready to play their part, the labour will hardly terminate favorably, requiring as it does the proper maturity of both. For if, on the one hand, the fœtus, from restlessness and over-desire to make its way out, does violence to the uterus, and thus anticipates the mother; or if, on the contrary, the mother, owing to feebleness of the uterus, or any other circumstance necessitating expulsion, is beforehand with the fœtus, this is to be looked upon rather as the result of disease than as a natural and critical birth. The same may be said of those cases where parts only of the product of conception escape, whilst others remain; for instance, if the fœtus itself is disposed to come away when the placenta is not yet separated from the uterus, or, on the other hand, if the placenta is separated when the fœtus is not rightly placed, or the uterus is not sufficiently relaxed to allow of its passage. Hence it is that midwives are so much to blame, especially the younger and more meddlesome ones, who make a marvellous pother when they hear the woman cry out with her pains and implore assistance, daubing their hands with oil, and distending the passages, so as not to appear ignorant in their art—giving besides medicines to excite the expulsive powers, and when they would hurry the labour, retarding it and making it unnatural, by leaving behind portions of the membranes, or even of the placenta itself, besides exposing the wretched woman to the air, wearying her out on the labour-stool, and making her, in fact, run great risks of her life. In truth, it is far better with the poor, and those who become pregnant by mischance, and are secretly delivered without the aid of a midwife; for the longer the birth is retarded the more safely and easily is the process completed.

Of unnatural labours, therefore, there are chiefly two kinds: either the fœtus is born before the proper time (and this constitutes an abortion), or else subsequently to it, when a difficult or tedious labour is the result, either from the due time and order not being preserved, or from the presence of dangerous symptoms; these arise either from failure of the expelling powers on the part of the mother, or from sluggishness on the part of the fœtus in making its way out; it is when both perform their proper parts that a safe and genuine labour results.

Fabricius ascribes the business of expelling the offspring to the uterus; and he adds, “the abdominal muscles and the diaphragm assist in the business.” It seems to me, however, on deep investigation, that the throes of childbirth, just as sneezing, proceed from the motion and agitation of the whole body. I am acquainted with a young woman who during labour fell into so profound a state of coma that no remedies had power to rouse her, nor was she in fact able to swallow. When called to her, finding that injections and other ordinary remedies had been employed in vain, I dipped a feather in a powerful sternutatory, and passed it up the nostrils. Although the stupor was so profound that she could not sneeze, or be roused in any way, the effect was to excite convulsions throughout the body, beginning at the shoulders, and gradually descending to the lower extremities. As often as I employed the stimulus the labour advanced, until at last a strong and healthy child was born, without the consciousness of the mother, who still remained in a state of coma.

We can observe the manner of labour-pains in other animals, as the bitch, sheep, and larger cattle, and ascertain that they do not depend on the action of the uterus and abdomen only, but on the efforts of the whole body.

The degree in which the offspring contributes to accelerate and facilitate birth is made clear from observations on oviparous animals; in these it is ascertained that the shell is broken through by the fœtus and not by the mother. Hence it is probable that in viviparous animals also the greater part of delivery is due to the fœtus—to its efforts, I mean, not to its gravity, as Fabricius would have it. For what can gravity do in the case of quadrupeds standing or sitting, or in the woman when lying down? Nor are the efforts of the fœtus to get out, the result, as he believes, of its own bulk or of that of the waters; the waters, it is true, when the fœtus is dead and decomposed, by their putrid and acrimonious nature, stimulate the uterus to expel its contents; but it is the fœtus itself which, with its head downwards, attacks the portals of the womb, opens them by its own energies, and thus struggles into day. Wherefore a birth of this kind is held the more speedy and fortunate; “it is contrary to nature,” says Pliny,[369] “for a child to be born with the feet foremost; hence those so born were called Agrippæ, i. e. born with difficulty”—(ægre parti), for in such the labour is tedious and painful. Notwithstanding this, in cases of abortion, or where the fœtus is dead, or, in fact, when any difficulty arises in the delivery so as to require manual aid, it is better that the feet should come first; they act as a wedge on the narrow uterine passages. Hence, when we chiefly depend upon the fœtus, as being lively and active, to accomplish delivery, we must do our best that the head escape first; but if the business is to be done by the uterus, it is advisable that the feet come foremost.

We are able to observe in how great a degree the fœtus contributes to delivery, not only in birds, which, as I have said above, break through the shell by their own powers, but also in many other animals. All kinds of flies and butterflies pierce the little membrane in which they lie concealed as “aureliæ;” the silkworm also, at its appointed time, softens by moistening, and then eats through the silken bag which it had spun round itself for protection, and makes its way out without any foreign aid. In the same manner wasps, hornets, all insects in fact, and fishes of every kind, are born by their own will and powers. This can be best seen in the skate, fork-fish, lamprey, and the cartilaginous fishes generally. These conceive a perfect two-coloured egg, made up, that is, of albumen and yelk, and contained in a strong quadrangular shell; from this, still retained within the uterus, the young fish is formed: it then breaks through the shell, and makes its way out. In an exactly similar manner the young viper eats through the egg-shell, sometimes whilst it remains in utero, sometimes when within the passages, at others two or three days after birth. Hence arose the fable of the young viper eating through the womb of its mother, and so avenging its father’s death; it does, in fact, nothing but what the young of every animal does, breaking though the membranes which envelope it, either in the delivery itself, or a short time subsequently to that event.

We learn moreover from positive observations how much the fœtus contributes to its own birth. A woman in my own neighbourhood, and I speak as having knowledge of the circumstance, died one evening, and the body was left by itself in a room; the next morning an infant was found between the thighs of the mother, having evidently forced its way out by its own efforts. Gregorius Nymmanus has collected several instances of a similar kind from trustworthy authors.