MORE THAN TWO CHILDREN AT A BIRTH.

Cases of the birth of more than two children at a time are still less

frequently met with than twins. They are scarcely ever encountered,

excepting in women who have passed their thirtieth year. Such cases are

all more or less unfortunate both for the mother and the children.

THREE AT A BIRTH.

The births of triplets are not exclusively confined to women above

thirty years, but in those younger they are so rare as to be great

curiosities. Neither are they apt to occur in the first pregnancy. In

this respect they differ from twins, who, as has just been said, are

peculiarly prone to make their appearance at the first childbirth. Only

four cases of treble births occurred among the 36,000 accouchements

which have taken place in the Hospice de Maternité of Paris in a

determined time. Out of 48,000 cases of labor in the Royal Maternity

Charity in London, only three triplets occurred. History informs us that

the three Roman brothers, the Horatii, were triplets. They fought and

conquered the three Curiatii of Alba (667 B. C.) who were likewise

triplets.

As an interesting fact in connection with this subject, we may mention

that in the St. Petersburg Midwives' Institute, between 1845-59, there

were three women admitted, who, in their fifteenth pregnancies, had

triplets, and each had triplets three times in succession. Happily, the

fifteenth pregnancy is not reached by most women.

FOUR AT A BIRTH.

Instances of quadruplets are fewer than triplets. But four vigorous

infants have been born at one birth.

FIVE AT A BIRTH.

The birth of _five_ living children at a time is very exceptional, and

is usually fatal to the offspring. A remarkable case of this kind is

reported in a late medical journal. A woman aged thirty, the wife of a

laborer, and the mother of six children, was taken in labor about the

seventh month of her pregnancy. Five children, and all alive, were given

birth to,--three boys and two girls. Four of the children survived an

hour, and died within a few moments of each other. The fifth, a female,

and the last born, lived six hours, and was so vigorous that,

notwithstanding its diminutive size, hopes were entertained of its

surviving.

Another case is reported in a recent French medical journal. The woman

was forty years old. She had had twins once, and single children five

times. On her seventh pregnancy, when five months gone, she was as large

as women usually are at the end of their full term. At the close of the

month she was delivered of five children. They were all born alive, and

lived from four to seven minutes. All five children were males, well

built and as well developed as foetuses of five and one-half months

usually are in a single birth. The woman made a good recovery. Other

cases of five at a birth might be quoted. They are known to medical

science as very singular and noteworthy occurrences.

INCREDIBLE NUMBERS.

Some books speak of seven, eight, nine, ten, and more, children at a

birth. But these statements are so marvelous, so incredible, and

unsupported by proper testimony, that they do not merit any degree of

confidence. The climax of such extraordinary assertions is reached, and

a good illustration of the credulity of the seventeenth century

furnished, by a writer named Goftr. This traveller, in 1630, saw a

tablet in a church at Leusdown (Lausdunum), about five miles from the

Hague, with an inscription stating that a certain illustrious countess,

whose name and family he records, brought forth at one birth, in the

fortieth year of her age, in the year 1276, 365 infants. They were all

baptized by Guido, the Suffragan. The males were called John, and the

females Elizabeth. They all, with their mother, died on the same day,

and were buried in the above-mentioned church. This monstrous birth was

said to have been caused by the sin of the countess in insulting a poor

woman with twins in her arms, who prayed that her insulter might have at

one birth the same number of children as there were days in the year. Of

course, notwithstanding the story being attested by a tablet in a

church, it must be placed among the many other instances of superstition

afforded by an ignorant and credulous era.

We may remark, in closing this subject, that fewer plural births come to

maturity than pregnancies with single children. Miscarriages are

comparatively more frequent in such pregnancies than in ordinary ones.

PREGNANCY

_VENERATION FOR THE PREGNANT._

We have been considering woman hitherto as maiden and wife. She now

approaches the sacred threshold of maternity. She is with child. In no

period of her life is she the subject of an interest so profound and

general. The young virgin and the new wife have pleased by their grace,

spirit, and beauty. The pregnant wife is an object of active benevolence

and religious respect. It is interesting to note how, at all times and

in all countries, she has been treated with considerate kindness and

great deference. She has been made the subject of public veneration, and

sometimes even of religious worship. At Athens and at Carthage the

murderer escaped from the sword of justice if he sought refuge in the

house of a pregnant woman. The Jews allowed her to eat forbidden meats.

The laws of Moses pronounced the penalty of death against all those who

by bad treatment or any act of violence caused a woman to abort.

Lycurgus compared women who died in pregnancy to the brave dead on the

field of honour, and accorded to them sepulchral inscriptions. In

ancient Rome, where all citizens were obliged to rise and stand during

the passage of a magistrate, wives were excused from rendering this mark

of respect, for the reason that the exertion and hurry of the movement

might be injurious to them in the state in which they were supposed to

be. In the kingdom of Pannonia all enceinte women were in such

veneration, that a man meeting one on the road was obliged, under

penalty of a fine, to turn back and accompany and protect her to her

place of destination. The Catholic Church has in all times exempted

pregnant wives from fasts. The Egyptians decreed, and in most Christian

countries the law at the present time obtains, that if a woman shall be

convicted of an offence the punishment of which is death, the sentence

shall not be executed if it be proved that she is pregnant.

SIGNS AND SYMPTOMS OF PREGNANCY.

1. The sign most commonly relied upon is the _cessation of the monthly

sickness_. The wife who misses the expected return of her illness, is

apt to conclude that conception has taken place. This sign is far from

being an infallible one.

It should be borne in mind that young married women sometimes have a

slight show for two or three periods after their first impregnation.

Ignorance of this fact has very frequently led to a miscalculation of

the time of confinement. On the other hand, the menses will sometimes

become arrested soon after marriage, and continue so for one or two

months, without there existing any pregnancy. The temporary

disappearance of the monthly sickness in such cases is due to the

profound impression made upon the system by the new relations of the

individual.

It not unfrequently happens that menstruation continues with regularity

during the whole period of pregnancy. Exceptional cases are given by

distinguished writers on midwifery, of women menstruating during their

pregnancy, and at no other time.

As a general rule, when a healthy wife misses her monthly sickness, she

is pregnant. But this symptom, though a strong one, must be supported by

others before it can be regarded as establishing anything.

2. _Morning sickness_ is a very common, a very early, and, in the

opinion of most mothers, a very conclusive symptom of pregnancy. We have

already had occasion to remark that it sometimes makes its appearance

almost simultaneously with conception. It usually comes on in the first

few weeks, and continues until the third or fourth month or until

quickening. This symptom is apt to be a troublesome one. Often the

vomiting is slight, and immediately followed by relief. But it may

produce violent and ineffectual straining for some time. It is, however,

not to be called a disease: unless it proceeds to an exhausting degree,

it must be looked upon as favorable and salutary. There is an old and

true proverb, that 'a sick pregnancy is a safe one.' The absence of

nausea and vomiting is a source of danger to the mother and child. Women

who habitually fail to experience them, are exceedingly apt to miscarry.

In such cases medical skill should be invoked to bring about the return

of these symptoms, of such importance to healthful pregnancy.

Morning sickness is therefore a very general, almost constant,

accompaniment of the pregnant condition; and great dependence may be

placed upon it as a sign.

3. _Changes in the breasts_ are valuable as symptoms. They become larger

and firmer, and the seat of a pricking or stinging sensation. The

nipples are swollen, prominent, and sometimes sore or painful. The veins

beneath the skin appear more conspicuous, and of a deeper blue than

ordinary. The peculiar circles of rose-coloured skin which surround the

nipples increase in extent, change to a darker color, and become covered

with a number of little elevations. Subsequently, numerous mottled

patches, or round spots of a whitish hue, scatter themselves over the

outer part of this circle.

The time at which these changes make their appearance is variable. They

may begin to develope themselves in two or three weeks, oftener not

until the second or third month, and in women of a delicate build,

sometimes not until the latter end of pregnancy. Occasionally no

alteration whatever occurs in the breasts until after confinement, in

which cases the secretion of milk is delayed for several days after the

birth of the child. In some rare instances the breasts never assume

maternal proportions, and the mother is debarred from the pleasure and

duty of nursing her own child.

4. _Quickening_ is the next symptom we will consider. By this term is

meant the arrival of that time when the mother first becomes conscious

by the movements of the child of its presence. The ancients thought that

then life was imparted to the new being. Modern physiology emphatically

condemns this absurdity. The embryo is as much alive in the very

earliest moments of pregnancy as at any future stage of its existence.

Let every woman therefore remember that she who produces abortion is

equally guilty in the eyes of science and of Heaven, whether the act be

committed before or after the period of quickening.

How is quickening produced? Undoubtedly by the movements of the child.

So soon as its nervous and muscular systems become sufficiently

developed to enable it to move its limbs, the mother, if the movements

be sufficiently active, is rendered sensible of her situation. But the

muscular contractions may not be strong enough to impart any sensation

to the mother. In many cases in which they are too feeble to be noticed

by herself, the skilled accoucheur is capable of recognizing them. And

the movements of the foetus may be excited in various ways known to

physicians.

_Time of quickening._--This symptom usually occurs about the middle of

pregnancy, near the eighteenth week. Some women feel the movements of

the foetus as early as the third month of pregnancy, others not till the

sixth month. Cases occur in which no movement whatever is felt until the

eighth or ninth month, or even not at all. It has been suggested that a

foetus which does not indicate its presence in this way is a kind of

'Lazy Lawrence,' too indolent to move. Certainly, many of both sexes

exhibit after birth such indomitable love of repose, that it can readily

be supposed they were equally passive in foetal life.

The non-occurrence of this sign may, however, be due to the debility of

the young child, or to a want of sensibility in the walls of the womb

itself.

A woman may be deceived, and suppose she has quickened, when her

sensations are to be traced to flatulence of the bowels, or perhaps a

dropsical effusion. Many ludicrous instances of self-deception are on

record. The historian Hume states that Queen Mary, in her extreme desire

to have issue, so confidently asserted that she felt the movements of

the child, that public proclamation was made of the interesting event.

Despatches were sent to foreign courts; national rejoicings were had;

the sex of the child was settled, for everybody was certain it was going

to be a male; and Bonner, Bishop of London, made public prayers, saying

that Heaven would pledge to make him beautiful, vigorous, and witty. But

all those high hopes and eager expectations were destined never to be

realized. The future disclosed that the supposed quickening was merely a

consequence of disordered health, and commencing dropsy.

Some women possess the power of imitating the movements of a foetus, by

voluntary contraction of the abdominal muscles. A well-known colored

woman of Charleston, 'Aunt Betty,' had a great reputation as having

'been pregnant for fifteen years.' She made a good deal of money, by

exhibiting to physicians and medical students who were curious, the

pretended movements of her unborn child. She was repeatedly presented to

the medical classes in the city. No pregnancy existed, as was revealed

by a _post-mortem_ examination. She imposed upon the credulous by the

habit she had acquired of jerking her muscles at pleasure, and thus

closely simulating the movements of an embryo.

5. _Changes in the abdomen._--In the first two months of pregnancy the

abdomen is _less_ prominent than usual: it recedes, and presents a flat

appearance. The navel is also drawn in and depressed. About the third

month a swelling frequently shows itself in the lower part of the

abdomen, and then diminishes, thus leading the wife to suppose that she

was mistaken in her condition, for she finds herself at the fourth month

smaller than at the third. After this, however, there is a gradual

increase in the size and hardness of the abdomen. What is of more value,

is the peculiar form of the swelling. It is pear-shaped, and is thus

distinguished from the swelling of dropsy and other affections. The

navel begins to come forward, and finally protrudes. The pouting

appearance it then presents is very characteristic.

In this connection it may be remarked that, towards the change of life,

childless married women often think they perceive that 'hope deferred'

is about to be gratified. An enlargement of the abdomen takes place at

this time, from a deposit of fatty matter. The nervous perturbations and

the cessation of the menses, which are natural to this period, are

looked upon as confirmations of the opinion that pregnancy exists. But

the day of generation with them has passed. These symptoms herald the

approach of the winter of life, which brings with it death to the

reproductive system.

6. _Changes in the skin._--The alterations occurring in the skin are

worth observing. Those women who have a delicate complexion and are

naturally pale take a high color, and vice versâ. In some cases a

considerable quantity of hair appears on those parts of the face

occupied by the beard in men; it disappears after labor, and returns on

every subsequent pregnancy. Oftentimes the skin becomes loose and

wrinkled, giving a haggard, aged air to the face, and spoiling good

looks. Women who ordinarily perspire freely, have now a dry, rough skin;

whereas those whose skin is not naturally moist, have copious

perspiration, which may be of a peculiarly strong odor. Copper-colored

or yellow blotches sometimes appear upon the skin, mole spots become

darker and larger, and a dark ring developes itself beneath the eyes.

The whole appearance is thus in many cases altered. On the other hand,

obstinate, long-existing skin affections sometimes take their departure

during pregnancy, perhaps never to return. These alterations do not

occur in all women, nor in all pregnancies of the same woman.

7. We may now group together a number of less important and less

constant signs, such as _depraved appetite_, _longings for unnatural

food_, _excessive formation of saliva in the mouth_, _heartburn, loss of

appetite_ in the first two or three months, succeeded by a voracious

desire for food, which sometimes compels the woman to rise at night in

order to eat, _toothache_, _sleepiness_, _diarrhoea_, _palpitation of the

heart_, _pain in the right side_, etc. These, when they occur singly,

are of little value as evidence.

Among these, that of _depraved appetite_ is by far the most important,

and may be regarded as quite significant. A married woman in her

ordinary health, suddenly feeling this morbid taste for chalk, charcoal,

slate pencil, and other unusual articles of food, may look upon it as a

strong presumptive evidence of impregnation.

When any or all of this group of symptoms accompany the ceasing to be

'regular,' the morning sickness, the changes in the breasts and the

other signs which have been enumerated, the wife may be quite sure that

she is pregnant.

8. _Changes in the mind._--The most wonderful of all the changes which

attend pregnancy are those in the nervous system. The woman is rendered

more susceptible, more impressible. Her character is transformed. She is

no longer pleasant, confiding, gentle, and gay. She becomes hasty,

passionate, jealous, and bitter. But in those who are naturally fretful

and bad-tempered a change for the better is sometimes observed, so that

the members of the household learn from experience to hail with delight

the mother's pregnancy as a period when clouds and storms give place to

sunshine and quietness. In some rare cases, also, pregnancy confers

increased force and elevation to the ideas, and augmented power to the

intellect.

As this book is written for women only, we do not mention any of the

signs or symptoms of pregnancy which medical men alone can recognize. We

will merely state that there are many other signs besides these referred

to, of great value to the doctor. One, the sound of the heart of the

child, which the practised ear can detect at about the fifth month, is

positive and conclusive.

MISCARRIAGE.

Miscarriage is a fruitful source of disease, and often of danger, to

wives. It also causes a frightful waste of human life. Unborn thousands

annually die in this manner.

_Frequency._--Miscarriage is by no means a rare occurrence. Statistics

show that thirty-seven out of one hundred mothers miscarry before they

attain the age of thirty years. But this accident is much more apt to

occur during the latter than during the first half of the child-bearing

period; and therefore it is estimated that ninety out of one hundred of

all women who continue in matrimony until the change of life, miscarry.

_Influence of age of mother._--A woman who marries at forty is very much

disposed to miscarry; whereas, had she married at thirty, she might have

borne children when older than forty. As a mother approaches the end of

her child-bearing period, it is likely that she will terminate her

career of fertility with a premature birth. The last pregnancies are not

only most commonly unsuccessful, but there is also reason to believe

that the occurrence of idiocy in a child may be associated with the

circumstance of its being the last-born of its mother. It has been

asserted, in this connection, that men of genius are frequently the

first-born. First pregnancies are also fraught with the danger of

miscarriage, which occurs more often in them than in others, excepting

the latest. A woman is particularly apt to miscarry with her first

child, if she be either exceedingly nervous or full-blooded.

_Influence of period of pregnancy._--Miscarriage is most frequent in the

earlier months of pregnancy--from the first to the third. It is also

very prone to happen about the sixth month. Habit makes itself felt

here; for women who have many times experienced this sad accident,

encounter it nearly always at the same epoch of their pregnancy.

_How early can the child live?_--The infant is incapable, as a rule, of

an independent existence, if brought into the world before the end of

the sixth month. The law of France regards a child born one hundred and

eighty days after wedlock as not only capable of living, but as

legitimate and worthy of all legal and civil rights. There are many

cases mentioned, by the older medical writers, of children born previous

to this period living. One of the most curious is that recorded by Van

Swieten. The boy Fortunio Liceti was brought into the world before the

sixth month, in consequence of a fright his mother had at sea. When

born, it is said, he was the size of a hand, and his father placed him

in an oven, for the purpose, probably, it has been suggested, of making

him _rise_. Although born prematurely, he died late, for we are told

that he attained his seventy-ninth year. Professor Gunning S. Bedford of

New York records the case of a woman in her fourth confinement, who,

before she had completed her sixth month, was delivered of a female

infant weighing two pounds nine ounces. The surface of the body was of a

scarlet hue. It breathed, and in a short time after birth cried freely.

After being wrapped in soft cotton, well lubricated with warm sweet-oil,

it was fed with the mother's milk, by having a few drops at a time put

into its mouth. At first it had great difficulty in swallowing, but

gradually it succeeded in taking sufficient nourishment, and is now a

vigorous, healthy young woman.

_Dangers to mother._--Wives are too much in the habit of making light of

miscarriages. They are much more frequently followed by disease of the

womb than are confinements at full terms. There is a greater amount of

injury done to the parts than in natural labor. While after confinement

ample time is afforded by a long period of repose for the bruised and

lacerated parts to heal, after a miscarriage no such rest is obtained.

Menstruation soon returns; conception may quickly follow. Unhappily,

there is no custom requiring husband and wife to sleep apart for a month

after a miscarriage, as there is after a confinement. Hence, especially

if there be any pre-existing uterine disease, or a predisposition

thereto, miscarriage is a serious thing.

_Causes._--The irritation of hemorrhoids or straining at stool will

sometimes provoke an early expulsion of a child. Excessive intercourse

by the newly married is a very frequent cause. Bathing in the ocean has

been known to produce it. Nursing is exceedingly apt to do so. It has

been shown by a distinguished medical writer, that, in a given number of

instances, miscarriage occurred in seventeen per cent. of cases in which

the woman conceived while nursing, and in only ten per cent. where

conception occurred at some other time. A wife, therefore, who suspects

herself to be pregnant, should wean her child. The extraction of a

tooth, over-exertion and over-excitement, a fall, a blow, any violent

emotion, such as anger, sudden and excessive joy, or fright, running,

dancing, horseback exercise, or riding in a badly-built carriage over a

rough road, great fatigue, lifting heavy weights, the abuse of purgative

medicines, disease or displacement of the womb, small-pox, or a general

condition of ill-health, are all fruitful and well-known exciting causes

of this unfortunate mishap, in addition to those which have been before

mentioned.

_Prevention._--The eminent practitioner, Dr. Tilt, says, 'The way to

prevent miscarriage is to lead a quiet life, particularly during those

days of each successive month when, under other circumstances, the woman

would menstruate; and to abstain during those days not only from long

walks and parties, but also from sexual intercourse.'

It is especially desirable to avoid a miscarriage in the first

pregnancy, for fear that the habit of miscarrying shall then be set up,

which it will be very difficult to eradicate. Therefore newly-married

women should carefully avoid all causes which are known to induce the

premature expulsion of the child. If it should take place in spite of

all precautions, extraordinary care should be exercised in the

subsequent pregnancy, to prevent its recurrence. Professor Bedford of

New York has said he has found that an excellent expedient in such cases

is, as soon as pregnancy is known to exist, 'to interdict sexual

intercourse until after the fifth month; for if the pregnancy pass

beyond this period, the chances of miscarriage will be much diminished.'

If the _symptoms of miscarriage_, which may be expressed in the two

words _pain_ and _flooding_, should make their appearance, the doctor

ought at once to be sent for, the wife awaiting his arrival in a

recumbent position. He may even then be able to avert the impending

danger. At any rate, his services are as necessary, and often even more

so, as in a labor at full term.

MOTHER'S MARKS.

It is a popular belief that the imagination of the mother affects the

child in the womb. It is asserted that infants are often born with

various marks and deformities corresponding in character with objects

which had made a vivid impression on the maternal mind during pregnancy.

This is a subject of great practical interest. We shall therefore give

it the careful attention which it deserves.

We have already discussed the operation of the laws of inheritance. It

was then stated that the whole story of maternal influence had not been

told--that the mother could communicate qualities she never possessed.

The potency of imagination at the time of conception over the child has

been mentioned. It is now our design to consider its effects, during the

period of pregnancy, upon the physical structure and the mental

attributes of the offspring. We shall have occasion hereafter, in

speaking of nursing, to illustrate the manner in which the child may be

affected by maternal impressions acting through the mother's milk. What

can be more wonderful than this intimate union between the mother and

her child? It is only equaled by that mysterious influence of the

husband over the wife, by which he so impresses her system that she

often comes in time to resemble him both in mental and physical

characteristics, and even transmits his peculiarities to her children by

a second marriage. Father, mother, and child are one.

We wish here to premise that our remarks will be based upon the

conclusions of skilled and scientific observers only, whose position and

experience no medical man will question. All the instances to be related

are given upon unimpeachable authority. They are not the narrations of

ignorant, credulous people; they are all fully vouched for. We record

here, as elsewhere, only the sober utterances of science. The great

importance and utility of an acquaintance with them will be patent to

every intelligent man and woman.

The effect of the mind upon the body is well known. Strong,

long-continued mental emotion may induce or cure disease. Heart disease

may be produced by a morbid direction of the thoughts to that organ.

Warts disappear under the operation of a strong belief in the efficacy

of some nonsensical application. In olden time, scrofula, or the 'king's

evil', was cured by the touch of the king. The mind of the patient, of

course, accomplished the cure. Under the influence of profound mental

emotion, the hair of the beautiful Marie Antoinette became white in a

short time. During the solitary voyage of Madame Condamine down the wild

and lonely Amazon, a similar change took place. Many other instances

might be adduced; but those given are sufficient to show that strong and

persistent mental impressions will exert a mysterious transforming power

over the body. These facts will pave the way to the consideration of

corresponding effects, through the mother's mind, upon the development

of the unborn child, forming a part of herself _in utero._

_Influence of mind of mother on form and color of infant._--There are

numerous facts on record which prove that _habitual_, long-continued

mental conditions of the mother at an early period of pregnancy, induce

deformity or other abnormal development of the infant.

Professor William A. Hammond of New York relates the following striking

case, which occurred in his own experience, and which scarcely admits of

a doubt as to the influence of the maternal mind over the physical

structure of the foetus.

A lady in the third month of her pregnancy was very much horrified by

her husband being brought home one evening with a severe wound of the

face, from which the blood was streaming. The shock to her was so great

that she fainted, and subsequently had a hysterical attack, during which

she was under Dr. Hammond's care. Soon after her recovery she told him

that she was afraid her child would be affected in some way, and that

even then she could not get rid of the impression the sight of her

husband's bloody face had made upon her. In due time the child, a girl,

was born. She had a dark red mark upon the face, corresponding in

situation and extent with that which had been upon her father's face.

She also proved to be idiotic.

Professor Dalton of New York states that the wife of the janitor of the

College of Physicians and Surgeons of that city, during her pregnancy,

dreamed that she saw a man who had lost a part of the ear. The dream

made a great impression upon her mind, and she mentioned it to her

husband. When her child was born, a portion of one ear was deficient,

and the organ was exactly like the defective ear she had seen in her

dream. When Professor Dalton was lecturing upon the development of the

foetus as affected by the mind of the mother, the janitor called his

attention to the foregoing instance. The ear looks exactly as if a

portion had been cut off with a sharp knife.

Professor J. Lewis Smith of Bellevue Hospital Medical College, New York,

has met with the following cases:--An Irishwoman, of strong emotions and

superstitions, was passing along a street, in the first months of her

pregnancy, when she was accosted by a beggar, who raised her hand,

destitute of thumb and fingers, and in 'God's name' asked for alms. The

woman passed on, but, reflecting in whose name money was asked, felt

that she had committed a great sin in refusing assistance. She returned

to the place where she had met the beggar, and on different days, but

never afterwards saw her. Harassed by the thought of her imaginary sin,

so that for weeks, according to her statement, she was distressed by it,

she approached her confinement. A female infant was born, otherwise

perfect, but lacking the fingers and thumb of one hand. The deformed

limb was on the same side, and it seemed to the mother to resemble

precisely that of the beggar. In another case which Professor Smith met,

a very similar malformation was attributed by the mother of the child to

an accident occurring, during the time of her pregnancy, to a near

relative, which necessitated amputation. He examined both of these

children with defective limbs, and has no doubt of the truthfulness of

the parents. In May, 1868, he removed a supernumerary thumb from an

infant, whose mother, a baker's wife, gave the following history:--No

one of the family, and no ancestor, to her knowledge, presented this

deformity. In the early months of her pregnancy she sold bread from the

counter, and nearly every day a child with a double thumb came in for a

penny roll, presenting the penny between the thumb and the finger. After

the third month she left the bakery, but the malformation was so

impressed upon her mind, that she was not surprised to see it reproduced

in her infant.

In all these cases the impression was produced in the early months of

pregnancy; but many have been recorded in which malformations in the

infant appeared distinctly traceable to strong mental emotions of the

mother only a few months previous to confinement, these impressions

having been persistent during the remaining period of the pregnancy, and

giving rise to a full expectation on the part of the mother that the

child would be affected in the particular manner which actually

occurred. Professor Carpenter, the distinguished physiologist, is

personally cognisant of a very striking case of the kind which occurred

in the family of a near connection of his own.

All the above instances have been those of the effects of persistent

mental emotion. But it is also true that _violent and sudden emotion_ in

the mother leaves sometimes its impress upon the unborn infant, although

it may be quickly forgotten.

It is related on good authority that a lady, who during her pregnancy

was struck with the unpleasant view of leeches applied to a relative's

foot, gave birth to a child with the mark of a leech coiled up in the

act of suction on the intended spot.

Dr. Delacoux of Paris says that, in the month of January 1825, he was

called to attend a woman in the village of Batignoles, near Paris, who

the evening before had been delivered of a six months' foetus, horribly

deformed. The upper lip was in a confused mass with the jaw and the

gums, and the right leg was amputated at the middle, the stump having

the form of a cone. The mother of this being, who was a cook, one

morning, about the third month of her pregnancy, on entering the house

where she was employed, was seized with horror at the sight of a porter

with a hare-lip and an amputated leg.

At a meeting of the Society of Physicians at Berlin, in August 1868,

Herr Dupré stated that a woman saw, in the first weeks of her third

pregnancy, a boy with a hare-lip; and not only was the child she then

carried born with a frightful hare-lip, but also three children

subsequently. Another one, a woman in the fifth week of pregnancy, saw a

sheep wounded, and with its bowels protruding. She was greatly shocked,

and did not recover her composure for several days. She was delivered at

term of a child, in other respects well developed, but lacking the walls

of the abdomen.

Many remarkable instances have been collected of the power of

_imagination_ over the unborn offspring.

Ambrose Paré, the illustrious French surgeon of the sixteenth century,

in one of his treatises devotes a chapter to the subject of 'monsters

which take their cause and shape from imagination,' and was evidently a

strong believer in this influence.

A black child is generally believed to have been born to Marie Thérèse,

the wife of Louis XIV., in consequence of a little negro page in her

service having started from a hiding-place and stumbled over her dress

early in her pregnancy. This child was educated at the convent of Moret,

near Fontainebleau, where she took the veil, and where, till the shock

of the Revolution, her portrait was shown.

Examples are given by authors of the force of _desires_ in causing

deformities in infants, and the formation upon them of fruits, such as

apples, pears, grapes, and others, which the mother may have longed for.

The following is related upon excellent medical authority:--A woman gave

birth to a child with a large cluster of globular tumours growing from

the tongue, and preventing the closure of the mouth, in color, shape,

and size exactly resembling our common grapes; and with a red

excrescence from the chest, as exactly resembling in figure and

appearance a turkey's wattles. On being questioned before the child was

shown to her, she answered, that while pregnant she had seen some

grapes, longed intensely for them, and constantly thought of them; and

that she was also once attacked and much alarmed by a turkey-cock.

Dr. Demangeon of Paris quotes, in his work on the Imagination, the

_Journal de Verdun_, as mentioning the case of a child, born at Blois,

in the eyes of which the face of a watch was distinctly seen. The image

was situated around the pupil, and the figures representing the hours

were plainly perceived. The mother had experienced a strong desire to

see a watch while she was pregnant with this child.

Professor Dalton says, in his _Human Physiology_, that 'there is now

little room for doubt that various deformities and deficiencies of the

foetus, conformably to the popular belief, do really originate in certain

cases from nervous impressions, such as disgust, fear, or anger,

experienced by the mother.' We will now consider the

_Influence of the mind of the mother on the mind of the infant_; which

subject we have not yet touched upon, having confined ourselves to the

influence of the maternal mind over the form and color of the unborn

child. It will not be necessary to illustrate at length this branch of

our topic. Instances are sufficiently common and well known. Dr. Seguin

of New York, in his work on Idiocy, gives several cases in which there

was reason to believe that fright, anxiety, or other emotions in the

mother, had produced idiocy in the offspring. As he remarks,

'Impressions will sometimes reach the foetus in its recess, cut off its

legs or arms, or inflict large flesh wounds before birth,--inexplicable

as well as indisputable facts, from which we surmise that idiocy holds

unknown though certain relations to maternal impressions.'

We have given many strong cases and most excellent authority for the

doctrine that the _purely mental_ influence of the mother may produce

bodily and mental changes in the unborn infant. But the child is also

affected by _physical impressions_ made upon the mother.

Dr. Russegger reports that a woman, who had already borne four healthy

children, was, in the seventh month of her pregnancy, bitten in the

right calf by a dog. The author saw the wound made by the animal's

teeth, which wound consisted of three small triangular depressions, by

two of which the skin was only slightly ruffled; a slight appearance of

blood was perceptible in the third. The woman was at the moment of the

accident somewhat alarmed, but neither then nor afterwards had any fear

that her foetus would be affected by the occurrence. Ten weeks after she

was bitten, the woman bore a healthy child, which, however, to the

surprise of every person, had three marks corresponding in size and

appearance to those caused by the dog's teeth in the mother's leg, and

consisting, like those, of one large and two smaller impressions. The

two latter, which were pale, disappeared in five weeks; the larger one

had also become less, and was not so deep colored as it was at birth. At

the time of writing, the child was four months old.

Dr. S. P. Crawford of Greenville, Tennessee, reports in a recent number

of the _Nashville Journal of Medicine_, the following sad case:--A lady,

in the last stage of pregnancy, was burned by the explosion of a

kerosene-oil can. She lived twelve hours after the accident. The face,

legs, arms, and abdomen were badly burned. The movements of the child

were felt three or four hours after the accident. A short time before

the death of the mother she gave birth to the child at full maturity,

but still-born. It bore the mark of the fire corresponding to that of

the mother. Its legs, arms, and abdomen were completely blistered,

having all the appearance of a recent burn.

These instances of a decided influence exerted upon the body and mind of

the child in the womb, by physical and mental impressions made upon the

mother, might be doubled or trebled. They are as numerous as they are

wonderful. Physiologists of the present day do not hesitate to admit the

existence of the influence we have been discussing. Reason also comes to

the support of facts, to demonstrate and establish its reality. For, if

a sudden and powerful emotion of the mind can so disturb the stomach and

heart as to cause vomiting and fainting, is it not probable that it can

affect the womb and the impressible being within it? Pregnancy is a

function of the woman as much as digestion or pulsation of the heart;

and if the latter are controlled by moral and mental impressions, why

should not the former be also?

_In what manner does this influence of the maternal mind act?_--Through

the blood of the mother. Only a very delicate membrane separates the

vital fluid of the mother from that of the infant in her womb. There is

a constant interchange of the blood in its body with that in hers

through this exceedingly thin membrane; and thus all nervous impressions

which have produced an alteration of either a temporary or permanent

character in the circulating fluid of the mother, are communicated to

the child. Since the mother, as has been shown, can transmit through her

blood certain characteristics of mind and body not her own,--for

instance, a disease peculiar to a male from her father to her son, or

the physical and mental traits of her first husband to the children by

her second,--it does not seem at all strange that she should through

this same medium, her blood, impart other peculiarities which have made

a strong impression upon her mind. Anatomy and physiology therefore

fully explain and account for this seemingly mysterious influence.

The view here stated, and indorsed by modern science, is one which ought

to have great weight with the mother, her relatives and friends. The

_practical conclusion_ which it suggests is, that as during pregnancy

there is unusual susceptibility to mental impressions, and as these

impressions may operate on the fragile structure of the unborn being,

this tendency should be well considered and constantly remembered, not

only by the woman herself, but by all those who associate or are thrown

in contact with her. Upon the care displayed in the management of the

corporeal and mental health of the mother during the whole period of

pregnancy, the ultimate constitution of the offspring greatly depends.

All the surroundings and employments of the pregnant woman should be

such as conduce to cheerfulness and equanimity. Above all, she should

avoid the presence of disagreeable and unsightly objects. Vivid and

unpleasant impressions should be removed as soon as possible by quiet

diversion of the mind. All causes of excitement should be carefully

guarded against.

In leaving the subject of maternal impressions, we will call attention

to the manifest difference in extent and degree between the influence of

the father and that of the mother over the offspring. That of the father

ceases with impregnation. That of the mother continues during the whole

term of pregnancy, and, as we shall shortly see, even during that of

nursing.

EDUCATION OF THE CHILD IN THE WOMB.

The outlines drawn by the artist Flaxman are esteemed the most perfect

and graceful in existence. From earliest childhood he manifested a

delight in drawing. His mother, a woman of refined and artistic tastes,

used to relate that for months previous to his birth she spent hours

daily studying engravings, and fixing in her memory the most beautiful

proportions of the human figure as portrayed by masters. She was

convinced that the genius of her son was the fruit of her own

self-culture. What a charming idea is this! What an incentive to those

about to become mothers, to cultivate refinement, high thoughts, pure

emotions, elevated sentiments! Thus they endow their children with what

no after education can give them.

The plastic brain of the foetus is prompt to receive all impressions. It

retains them, and they become the characteristics of the child and the

man. Low spirits, violent passions, irritability, frivolity, in the

pregnant woman, leave indelible marks on the unborn child. So do their

contraries; and thus it becomes of the utmost moment that during this

period all that is cheerful, inspiring, and elevating should surround

the woman. Such emotions educate the child: they form its disposition,

they shape its faculties, they create its mental and intellectual

traits. Of all education, this is the most momentous.

CAN A WOMAN BECOME AGAIN PREGNANT DURING PREGNANCY?

Can a woman during pregnancy conceive, and add a second and younger

child to that already in the womb?

It is not uncommon in the canine race for a mother to give birth at the

same time to dogs of different species, showing conclusively the

possibility, in these animals, of one conception closely following

another. So a mare has been known to produce within a quarter of an

hour, first a horse, and then a mule. And in the human race cases are

on record in which women have had twins, of which the one was white and

the other colored, in consequence of intercourse on the same day with

men of those two races. Dr. Henry relates that in Brazil a Creole woman,

a native, brought into the world at one birth three children of three

different colors,--white, brown, and black,--each child exhibiting the

features peculiar to the respective races.

In all such instances the two conceptions followed each other very

rapidly, the offspring arriving at maturity together, and being born at

the same accouchement. But more curious and wonderful examples of second

and concurrent pregnancies have been published than these--as, for

instance, those in which a child bearing all the attributes of a foetus

at full term is born two, three, four, and even five, months after the

first, which appeared also to have been born at full term. Marie Anne

Bigaud, aged thirty-seven, gave birth, April 30, 1748, to a living boy

at full term, and on the ensuing September 16, to a living girl, which

was recognised, by the size and well-developed condition of its body and

limbs, to have been also carried until full term. This fact was observed

by Professor Eisenman, and by Leriche, surgeon-major of the military

hospital of Strasbourg. It will be noticed that there was an interval of

four and a half months between the two accouchements. The first child

lived two and a half months, and the second a year. In this instance

there was not a double womb, as might perhaps be supposed, for after

the mother's death an examination proved that the uterus was single.

Another case of this kind is the following:--Benoite Franquet of Lyons

brought into the world a girl on January 20, 1780, and five months and

six days afterwards a second girl, also apparently at term, and well

nourished. Two years later these two children were presented, with their

certificates of baptism, to two notaries of Lyons, MM. Caillot and

Desurgey, in order that the fact might be placed on record and vouched

for, because of its value in legal medicine.

The number of the entirely authenticated cases now known of the birth of

fully developed children within from two to five months of each other,

can leave no doubt as to the possibility of such an occurrence. The only

question which remains is in regard to the periods of conception. Are

the two children in such cases twins, conceived at the same time, but

the growth of the last-born so retarded that it did not arrive at

maturity until a number of months after its fellow? or, Has a second

conception taken place at an interval of several months after the first?

If this latter view be true, then, in the instance of Marie Anne Bigaud,

above related, the second child must have been conceived after the first

had quickened. Then, also, two children of different ages, the offspring

of different fathers, may exist in the womb at the same time. The weight

of scientific observation and authority has now established the fact

that, in very rare instances, a second conception may take place during

pregnancy. It must not be understood as necessarily following from this

statement, that when two children are born at the same time,--one fully

developed, and the other small and apparently prematurely born,--the two

were conceived at different times. The smaller may have been blighted

and its growth hindered by the same causes which bring about such

effects in cases of single births of incompletely developed children. A

similar supposition may account for the birth of a second child within a

month or two after the first, for the first may have been prematurely

born, and the second carried to full term. But no such supposition can

explain the cases referred to, and others which might be mentioned, in

which the interval has been five or six months, each child presenting

every indication of perfect maturity. The only explanation possible in

such instances, which, as has been said, are well authenticated,

although few in number, is, that a second pregnancy has occurred during

the first.

The above facts would seem sufficiently wonderful. There are others,

however, of the same nature still more so. In some instances, the

product of the second conception, instead of developing independently of

the first, has become attached to it, and the phenomenon has been

presented of the growth of a child within a child--a foetus within a

foetus. Such a singular occurrence has been lately recorded in a German

journal. A correspondent of the _Dantzic Gazette_ states that on Sunday,

February 1, 1869, at Schliewen, near Dirschau, 'a young and blooming

shepherd's wife was delivered of a girl, otherwise sound, but having on

the lower part of her back, between the hips, a swelling as big as two

good-sized fists, through the walls of which a well-developed foetus may

be felt. Its limbs indicate a growth of from five to six months, and its

movements are very lively. The father called in the health commissioner,

Dr. Preuss, from Dirschau, and begged him to remove the swelling

together with the foetus. The doctor, however, after a careful

examination, declared that there was a possibility in this extraordinary

case of the child within the swelling coming to fruition. Its existence

and active motions were palpable to all present. No physician could be

justified in destroying this marvelous being. It ought rather to be

protected and cherished. The new-born girl, notwithstanding her strange

burden, is of unusual strength and beauty, and takes the breast very

cheerfully.'

We find something further in regard to this singular birth in the _Weser

Zeitung_ of February 20, 1869. It quotes from the _Dantzic Gazette_ some

remarks by the health commissioner, Dr. Preuss of Dirschau, in which the

doctor declares the facts contained in the report given above to be

correct. He was summoned on the 1st of February to the child, and saw

the vigorous movements, and felt the members of a foetus within the

swelling, as described. It was evidently a double creation. The case

thus far, though rare, is not unique. 'But what is novel, and hitherto

perfectly unnoticed in medical literature, is the fact that not only the

girl, which has been carried its full term, is alive to-day, but the

foetus within the swelling has also, in the eleven days after birth,

further developed, and palpably increased in size. The swelling is now

four and a half inches long, three and a half inches wide, and high and

pear-shaped; the head lies underneath on the left, the body towards the

right.'

Further particulars and the latest intelligence we have concerning the

progress of this case are to the effect that the child was brought by

special request before the Natural History Society of Dantzic, and

thence the mother went to Berlin for medical advice.

MORAL ASPECTS OF THIS QUESTION.

Upon proper judgment and discrimination in the application of the facts

we have just been dwelling upon, may depend a wife's honor, and the

happiness of the dearest social relations. We will suppose an example. A

husband, immediately after the impregnation of his wife, is obliged to

quit her, and remains absent a year. In the meanwhile she gives birth to

two children, at an interval of a number of weeks. The question will

then come up, Whether, under such circumstances, it is possible for her

to do so consistently with conjugal purity.

It will be recollected that, in speaking of twins, we remarked that it

was not very uncommon for an interval of days or weeks to elapse between

the births, and it has just been stated that impregnation during

pregnancy is extremely rare. The presumption, therefore, in the case

supposed, is as very many to one that the two births were the result of

a twin pregnancy. In the absence of any other evidence against the

wife's chastity, it should not even be called in question. This decision

receives the support of the maxim in law that a reasonable doubt is the

property of the accused, and of the Christian principle that it is

better that ninety-nine guilty should escape than that one innocent

should be condemned. Hence the teachings of science and of human and

divine law all coincide to protect the sacred rights and the precious

interests at stake against an unjust suspicion, which even the doctrine

of chances would render untenable.

CAN A CHILD CRY IN THE WOMB?

There are some cases, recorded on undoubted authority, in which the

child has been heard to cry while in the womb. These are very

exceptional. Under ordinary circumstances, it is impossible for the

child either to breathe or cry, because of the absence of air. It is

only when the bag of membranes has been torn, and the mouth of the child

is applied at or near the neck of the uterus, that this can take place.

The infant is not unfrequently heard to cry just before birth, after

labor has commenced, but before the extrusion of the head from the womb,

in consequence of the penetration of air into the uterine cavity.

IS IT A SON OR DAUGHTER?

It is a common saying among nurses, that there is a difference in the

size and form of the pregnant woman, according to the sex she carries.

This may well be doubted. Neither is it true that one sex is more

active in its 'movements' than the other. It is quite possible, however,

for a wife to know the sex of the foetus, if she can tell about what time

in her month conception took place. If it occurred directly after a

monthly sickness, the child is a girl; if directly before, it is a boy.

When a woman is 'out' in her reckoning, and goes beyond the period of

her expected confinement, it will ordinarily turn out to be a boy. The

skilful doctor can, in the later months of pregnancy, settle the

question of sex in some cases. The beats of the foetal heart are more

frequent in females than in males. The average frequency of pulsations

of twenty-eight female foetuses has been found to be one hundred and

forty-four in the minute, the lowest figure being one hundred and

thirty-eight; of twenty-two male foetuses, one hundred and twenty, the

lowest figure being one hundred and twelve. Therefore, when the

pulsations of the heart of the child in the womb are counted,--as can

easily be done by a practised medical ear during the last months of

pregnancy,--and are found to be over one hundred and thirty in a minute,

it is a daughter; if under one hundred and thirty, a son. In this

manner, the sex of an unborn child can be predicted with tolerable

accuracy, excepting only when illness of the foetus has deranged the

action of its heart.

ARE THERE TWINS PRESENT?

Certain signs lead to the suspicion of twins, such as being unusually

large, and the fact that the increase in size has been more than

ordinarily rapid. Sometimes also the abdomen is divided into two

distinct portions by a perpendicular fissure. In other cases the

movements of a child can be felt on each side at the same time. And in

twin pregnancies the morning sickness is apt to be more distressing, and

all the other discomforts incident to this condition increased. But

these signs and symptoms, when present in any given case, are not

conclusive, for they may be noticed when there is only one child. The

doctor has one characteristic and infallible sign by which he can

ascertain whether the woman be pregnant with twins. It is furnished to

him again by the art of listening,--or auscultation, as it is

technically called,--the same that, as we have already seen, may enable

him to determine the sex of the child. When the beatings of two foetal

hearts are heard on opposite portions of the abdomen, the nature of the

pregnancy is apparent.

LENGTH OF PREGNANCY.

What is the ordinary duration of pregnancy? Almost every woman considers

herself competent to make the answer--nine months. She may be surprised

to learn, however, that such an answer is wanting in scientific

precision. It is too indefinite, and is erroneous. There is a great

difference between the calendar and the lunar month. Each lunar month

having twenty-eight days, the period of nine lunar months is two hundred

and fifty-two days. Nine calendar months, including February, represent,

on the contrary, two hundred and seventy-three days. Now the average

duration of pregnancy is two hundred and eighty days, that is forty

weeks, or ten lunar months.

While most extended observations have shown that as a general rule,

forty weeks, or two hundred and eighty days, is the true period of

pregnancy, are we justified in the conclusion that this is its

invariable duration? This important question, upon the answer to which

so often depend the honor of families, the rights of individuals, and

sometimes the interests of nationalities, has been in all times the

subject of careful research by physicians, philosophers, and

legislators. On the one side, have been those who contend that the laws

of nature are invariable, and that the term of pregnancy is fixed and

immutable. On the other side, have been those who assert that the epoch

of accouchement can be greatly advanced or retarded by various causes,

some of which are known, and others not yet appreciated. Abundant and

satisfactory testimony has proved that the prolongation of pregnancy

beyond the ordinary period of two hundred and eighty days, or forty

weeks, is possible. Nor is this contrary to what is observed in regard

to other functions of the human body. There is no process depending upon

the laws of life which is absolutely invariable either as to the period

of its appearance or duration. It is known, as we have already pointed

out, that puberty may be advanced or retarded; the time at which the

change of life occurs in women, as we shall have occasion hereafter to

show, is also subject to variation; and it is a matter of common

observation with mothers, that the period of teething is sometimes

strangely hurried or delayed. A certain degree of variability,

therefore, being frequently observed, and entirely compatible with

health, in the various other natural processes, why should that of

pregnancy form an exception, and be invariably fixed in its duration?

And observation upon the lower animals affords most convincing evidence

that nature is not controlled by any uniform law in reference to the

length of pregnancy. In the cow, the usual period of whose pregnancy is

the same as in the human female, instances of calving six weeks beyond

the ordinary term are not at all uncommon.

As an illustration of the great interest sometimes attaching to the

inquiry under discussion, we may cite the celebrated Gardner Peerage

Case, tried by the House of Lords in 1825. Allen Legge Gardner

petitioned to have his name inscribed as a peer on the Parliament Roll.

He was the son of Lord Gardner by his second wife. There was another

claimant for the peerage, however,--Henry Fenton Iadis,--on the ground,

as alleged, that he was the son of Lord Gardner by his first and

subsequently divorced wife. Medical and moral evidence was adduced to

establish that the latter was illegitimate. Lady Gardner, the mother of

the alleged illegitimate child, parted from her husband on the 30th of

January, 1802, he going to the West Indies, and not again seeing his

wife until the 11th of July following. The child whose legitimacy was

called in question was born on the 8th of December of that year. The

plain medical query therefore arose, Whether this child born either

three hundred and eleven days after intercourse (from January 30th to

December 8th), or one hundred and fifty days (from July 11th to December

8th), could be the son of Lord Gardner. As there was no pretence that

there was a premature birth, the child having been well developed when

born, the conception must have dated from January 30th. The medical

question was therefore narrowed down to this: Was the alleged protracted

pregnancy (three hundred and eleven days) consistent with experience?

Sixteen of the principal obstetric practitioners of Great Britain were

examined on this point. Eleven concurred in the opinion that natural

pregnancy might be protracted to a period which would cover the birth of

the alleged illegitimate child. Because, however, of the moral evidence

alone, which proved the adulterous intercourse of Lady Gardner with a

Mr. Iadis, the House decided that the title should descend to the son of

the second Lady Gardner.

There is on record one fact, well observed, which establishes beyond

cavil the possibility of the protraction of pregnancy beyond two hundred

and eighty days, or forty weeks. The case is reported by the learned Dr.

Desormeaux of Paris, and occurred under his own notice in the Hôpital de

Maternité of that city. A woman, the mother of three children, became

insane. Her physician thought that a new pregnancy might re-establish

her intellectual faculties. Her husband consented to enter on the

register of the hospital each visit he was allowed to make her, which

took place only every three months. So soon as evidence of pregnancy

showed itself, the visits were discontinued. The woman was confined two

hundred and ninety days after conception.

The late distinguished Professor Charles D. Meigs of Philadelphia

published a case, which he deems entirely trustworthy, of the

prolongation of pregnancy to four hundred and twenty days, or sixty

weeks. Dr. Atlee reports two cases, which nearly equaled three hundred

and fifty-six days each. Professor Simpson of Edinburgh records, as

having occurred in his own practice, cases in which the period reached

three hundred and thirty-six, three hundred and thirty-two, three

hundred and twenty-four, and three hundred and nineteen days. In the

Dublin _Quarterly Journal of Medical Science_ a case of protracted

pregnancy is related by Dr. Joynt. The evidence is positive that the

minimum duration must have been three hundred and seventeen days, or

about six weeks more than the average. Dr. Elsässer found, in one

hundred and sixty cases of pregnancy, eleven protracted to periods

varying from three hundred to three hundred and eighteen days.

In treating of the subject of miscarriage, we mentioned instances,

recorded by physicians of skill and probity, proving beyond a shade of

doubt that a woman may give birth to a living child long before the

expiration of the forty weeks. The Presbytery of Edinburgh, Scotland,

some time since decided in favor of the legitimacy of an infant born

alive, within twenty-five weeks after marriage, to the Rev. Fergus

Jardine.

One of the most enlightened countries in Europe has, in view of the

facts in reference to the extreme limits of pregnancy, enacted, in the

Code Napoléon, that a child born within three hundred days after the

departure or death of the husband, or one hundred and eighty days after

marriage, shall be considered legitimate. The law further states that a

child born after more than three hundred days shall not be necessarily

declared a bastard, but its legitimacy may be contested. The Scotch

legislation on this subject is very similar to the French.

CAUSES OF PROTRACTED PREGNANCY.

It has been asserted by some that an infant is born at ten or eleven

months because at nine months it has not acquired the growth which

is necessary in order to induce the womb to dislodge it. The popular

notion is, that a child carried beyond the usual term must necessarily

be a large one. Rabelais has reflected this common opinion in his

celebrated romance entitled 'Gargantua,' in which he represents the

royal giant of that name as having been carried by his mother,

Gargamelle, eleven months. When born, the child was so vigorous that he

sucked the milk from ten nurses. He lived for several centuries, and at

last begot a son, Pantagruel, as wonderful as himself. Such reasoning

cannot, however, be seriously maintained, as many children carried

longer than nine months have not been more fully developed than some

born a few weeks prematurely; and the size of the child has nothing to

do with the bringing on of labor, as we shall show hereafter. Protracted

pregnancies are caused by a defect in the energy of the womb, induced

by moral as well as physical influences. As a rule, a woman who leads a

regular life, and observes the physiological laws of her being, which

laws it has been our aim to point out, will be confined at the term that

nature usually marks out, that is, at the expiration of two hundred and

eighty days, or forty weeks, from conception.

This brings us to the consideration of the question,

HOW TO CALCULATE THE TIME OF EXPECTED LABOR.

Many rules for this purpose have been laid down. We shall merely give

one, the most satisfactory and the most easily applied. It was suggested

by the celebrated Professor Naëgelè of Heidelberg, and is now generally

recommended and employed by physicians. The point of departure in making

the calculation is _the day of the disappearance of the last monthly

sickness_; three months are subtracted, and seven days added. The result

corresponds to the day on which labor will commence, and will be found

to be two hundred and eighty days from the time of conception, if that

event has occurred, as ordinarily, immediately after the last menstrual

period. Suppose, for instance, the cessation of the last monthly

sickness happened on the 14th day of January; subtract three months, and

we have October 14; then add seven days, and we obtain the 21st day of

the ensuing October (two hundred and eighty days from January 14) as the

time of the expected confinement. This method of making the 'count' may

be relied upon with confidence, and only fails, by a few days, in those

exceptional cases in which conception takes place just before the

monthly period, or during the menstrual flow.

CARE OF HEALTH DURING PREGNANCY.

This subject, the proper management of the health from conception to

childbirth, is worthy of careful consideration. The condition of

pregnancy, though not one of disease, calls for peculiar solicitude,

lest it should lead to some affection in the mother or in the child. For

it ought to be remembered that the welfare of a new being is now in the

balance. The woman has no longer an independent existence. She has

entered upon the circle of her maternal duties. She became a mother when

she conceived. The child, though unborn, lives within her; its life is a

part of her own, and so frail, that any indiscretion on her part may

destroy it. The danger to the child is not imaginary, as the large

number of miscarriages and still-births proves.

All mothers desire to have healthy, well-formed, intelligent children.

How few conduct themselves in such a manner as to secure a happy

development of their offspring! Puny, deformed, and feeble-minded

infants are daily ushered into the world because of a want of knowledge,

or a sinful neglect of those special measures imperatively demanded in

the ordering of the daily life, by the changed state of the system

consequent upon pregnancy. We shall therefore point out those laws which

cannot be infringed with impunity, and indicate the diet, exercise,

dress, and, in general, the conduct most favorable to the mother and

child during this critical period, in which the wife occupies, as it

were, an intermediate state between health and sickness.

FOOD.

The nourishment taken during pregnancy should be abundant, but not, in

the early months, larger in quantity than usual. Excess in eating or

drinking ought to be most carefully avoided. The food is to be taken at

shorter intervals than is common, and it should be plain, simple, and

nutritious. Fatty articles, the coarser vegetables, highly salted and

sweet food, if found to disagree, as is often the case, should be

abstained from. The flesh of young animals--as lamb, veal, chicken, and

fresh fish--is wholesome, and generally agrees with the stomach. Ripe

fruits are beneficial. The diet should be varied as much as possible

from day to day. The craving which some women have in the night or early

morning may be relieved by a biscuit, a little milk, or a cup of coffee.

When taken a few hours before rising, this will generally be retained,

and prove very grateful, even though the morning sickness be

troublesome. Any food or medicine that will confine or derange the

bowels is to be forbidden. The taste is, as a rule, a safe guide, and it

may be reasonably indulged. But inordinate, capricious desires for

improper, noxious articles, should of course, be opposed. Such longings,

however, are not often experienced by those properly brought up. It is a

curious fact, that the modification in the digestive system during

pregnancy is sometimes so great that substances ordinarily the most

indigestible are eaten, without any inconvenience, and even with

benefit, while the most healthful articles become hurtful, and act like

poison.

As pregnancy advances, particularly after the sixth month, a larger

amount of food, and that of a more substantial character, will be

required. The number of meals in the day should then be increased,

rather than the quantity taken at each meal.

CLOTHING.

The dress during pregnancy should be loose and comfortable, nowhere

pressing tightly or unequally. The word _enceinte_, by which a pregnant

woman is designated, meant, originally, without a cincture,--that is,

unbound. The Roman matrons, so soon as they conceived, were obliged to

remove their girdles. Lycurgus caused the enactment of the Spartan law,

that pregnant women should wear large dresses, so as not to prejudice

the free development of the precious charges of which nature had

rendered them the momentary depositaries. Stays or corsets may be used,

in a proper manner, during the first five or six months of pregnancy,

but after that they should either be laid aside, or worn very loosely.

Any attempt at concealing pregnancy, by tight lacing and the application

of a stronger busk, cannot be too severely condemned. By this false

delicacy the mother is subjected to great suffering, and the child

placed in jeopardy. The shape of the stays should be moulded to that of

the changing figure, and great care should be taken that they do not

depress the nipple or irritate the enlarging breasts.

The amount of clothing should be suited to the season, but rather

increased than diminished, owing to the great susceptibility of the

system to the vicissitudes of the weather. It is especially important

that flannel drawers should be worn during advanced pregnancy, as the

loose dress favors the admission of cold air to the unprotected parts of

the body. A neglect of this precaution sometimes leads to the

establishment of the painful disease known as rheumatism of the womb.

Pressure upon the lower limbs, in the neighborhood of the knee or the

ankle joint, should be avoided, more particularly towards the last

months. It is apt to produce enlargement and knotting of the vein,

swelling and ulcers of the legs, by which many women are crippled during

their pregnancies, and sometimes through life. Therefore the garters

should not be tightly drawn, and gaiters should not be too closely

fitted, while yet they should firmly support the ankle.

EXERCISE.

Moderate exercise in the open air is proper and conducive to health

during the whole period of pregnancy. It should never be so active nor

so prolonged as to induce fatigue. Walking is the best form of exercise.

Riding in a badly-constructed carriage, or over a rough road, or upon

horseback, as well as running, dancing, and the lifting or carrying of

heavy weights, should be scrupulously avoided, as liable to cause

rupture, severe flooding, and miscarriage. During the early months, in

particular, extraordinarily long walks and dancing ought not to be

indulged in. Journeys are not to be taken while in the pregnant state.

Railway travelling is decidedly objectionable. The vibratory motion of

the cars is apt to produce headache, sickness at the stomach, faintness,

and premature labor. All these precautions are especially to be observed

in the first pregnancy.

We must not be understood as condemning exercise and fresh air. They are

of the greatest importance to mother and child. But the amount of

exercise should be regulated by the dictates of common sense and the

woman's own sensations. If she can only walk a short distance each day

with comfort, let that suffice. She should not force herself to go to a

certain place nor to promenade during a certain time in the twenty-four

hours. So soon as fatigue is felt, the walk should cease. Let the walks

be frequent and short, rather than few and long. They should also be

made as pleasant as possible, by companionship and surroundings that

will occupy the feelings and imagination in an agreeable manner with new

and cheerful impressions. A tendency to indolence is to be combated. A

gently active life is best calculated to preserve the health of the

mother and her unborn child. But with even the most robust a moderation

of the ordinary pursuits and avocations is called for. The nervous and

delicate cannot make with safety their customary daily exertions in the

performance of their household or social duties and pleasures.

Towards the end of pregnancy the wife should economize her forces. She

should not remain long standing or kneeling, nor sing in either of these

postures.

BATHING.

Those who have not been accustomed to bathing should not begin the

practice during pregnancy, and in any case great care should be

exercised during the latter months. It is better to preserve cleanliness

by sponging with tepid water than by entire baths. Foot-baths are always

dangerous. Sea-bathing sometimes causes miscarriage, but sea air and the

sponging of the body with salt water are beneficial. The shower-bath is

of course too great a shock to the system, and a very warm bath is too

relaxing. In some women of a nervous temperament, a lukewarm bath taken

occasionally at night during pregnancy has a calming influence. This is

especially the case in the first and last month. But women of a

lymphatic temperament and of a relaxed habit of body are always injured

by the bath.

VENTILATION.

We have spoken of the benefits of outdoor air during pregnancy.

Attention should also be directed to keeping the atmosphere in the

sitting and sleeping rooms of the house fresh. This can only be

accomplished by constantly changing it. The doors and windows of every

room, while unoccupied, should be kept thrown open in the summer-time,

and opened sufficiently often in the winter to wash out the apartments

several times a day with fresh air. The extremes of heat and cold are

to be, with equal care, avoided. The house should be kept light. Young

plants will not grow well in the dark. Neither will the young child nor

its mother flourish without sunlight. The ancients were so well aware of

this, that they constructed on the top of each house a solarium, or

solar air-bath, where they basked daily, in thin attire, in the direct

rays of the sun.

SLEEP.

During pregnancy a large amount of sleep is required. It has a sedative

influence upon the disturbed nervous system of the mother. It favors, by

the calmness of all the functions which attends it, the growth of the

foetus. Neither the pursuit of pleasure in the evening, nor the

observance of any trite maxims in regard to early rising in the morning,

should be allowed to curtail the hours devoted to slumber. Pregnant

women have an instinctive desire to lie abed late, which, like the other

promptings of nature during this period, should not be disregarded. At

least eight hours out of the twenty-four can be profitably spent in bed.

No night-watching ought ever to be undertaken during pregnancy.

Feather beds should be avoided. The heat which they maintain about the

body is inconvenient and dangerous, predisposing to flooding and

exhausting perspirations. The hair or sponge mattress is to be

preferred. The bed-clothing should not be too heavy. Blankets are to be

employed rather than coverlids, as they are lighter and more permeable

to perspiration. The mattress and cover should be well aired during the

day. The sleeping-room should be capacious and well ventilated, and no

curtains permitted about the bed.

Occasional rest is also necessary in the daytime. A nap of an hour or

two upon a sofa or lounge will then prove very refreshing. In the

earlier months of pregnancy it will tend to prevent miscarriage, and in

the latter months to relieve the distress consequent upon the increased

size of the womb. It is not unusual, as the close of pregnancy

approaches, for a feeling of suffocation to ensue when the woman

attempts to lie down. This may be overcome by supporting the back and

shoulders with cushions and pillows. Or a bed-chair may be employed.

This, if well constructed and covered, will often be found very grateful

at night, in the last few weeks of pregnancy.

THE MIND.

A tranquil mind is of the first importance to the pregnant woman. Gloomy

forebodings should not be encouraged. Pregnancy and labor are not, we

repeat, diseased conditions. They are healthful processes, and should be

looked upon as such by every woman. Bad labors are very infrequent. It

is as foolish to dread them, as it is for the railway traveller to give

way to misgivings in regard to his safety. Instead of desponding,

science bids the woman to look forward with cheerfulness and hope to the

joys of maternity.

The bad effects of fear upon the mother's mind are illustrated by

Plutarch, who, in his Life of Publicola, mentions that, 'at a time when

a superstitious fear overran the city of Rome, all the women then

pregnant brought forth imperfect children, and were prematurely

delivered.' But we have already spoken, in treating of mothers' marks,

of the influence of mental emotions over the unborn child, and the

necessity of avoiding their exciting causes.

Because of their deleterious tendency, severe study as well as arduous

and protracted manual labor ought to be avoided. The nervous systems of

many women are also injuriously affected during pregnancy by perfumes,

which at other times are agreeable and innocuous. It is therefore

prudent not only to exclude all offensive scents, but also to abstain

from the strong odors of various strong perfumes, eau-de-cologne, and of

flowers. Large bouquets often cause feelings of faintness, and sometimes

temporary loss of consciousness. The extreme liability of the nervous

system of the pregnant woman to be affected injuriously to herself and

child by scenes of suffering or distress, and by disgusting or frightful

objects, cannot be too strongly impressed upon every one. She should be

protected from all that will disturb her, and should be constantly

treated with soothing and encouraging kindness. Her manifestations of

irritability, her caprices, her melancholy anticipations, are not to be

scoffed at, but combated with a mixture of reasoning and patient

forbearance. On her part, she should endeavour to co-operate with those

around her, in sedulously shunning all injurious influences, and in

banishing as quickly as possible all improper longings. She should

remember that, although she herself may escape mischief from them, her

child may suffer. She is the custodian of interests dearer to her than

her own.

RELATION OF HUSBAND AND WIFE DURING PREGNANCY.

During those days when the wife, if she were not pregnant, would have

been 'unwell,' marital intercourse should be abstained from. It is then

injurious to the mother, and dangerous to the life of the child, as it

is liable to excite miscarriage. But if this habitual epoch of the

monthly sickness be avoided, there is no reason why passion should not

be gratified in moderation and with caution during the whole period of

pregnancy. There is one exception to be made to this general course of

conduct. In those cases in which a miscarriage has occurred in the first

pregnancy, every precaution should be employed--for reasons which have

been dwelt upon in a previous article--to prevent its happening again

after the second conception. Under such exceptional circumstances,

therefore, the husband and wife should sleep apart during the first five

months of pregnancy. After that period their ordinary relations may be

resumed. When a miscarriage has taken place, intercourse should not be

permitted within a month of the accident. The observance of this

direction is of the utmost importance. Its neglect is the frequent cause

of severe and intractable diseases of the womb.

EFFECT OF PREGNANCY ON HEALTH.

We have had occasion to remark that pregnancy is not a condition of

disease. It is not only an evidence of health, but during its

continuance it confers increased physical vigor. As a rule, a woman

enjoys _better health_ during her pregnancy than at any other time; she

is less liable to contagious and other maladies; she is less apt to die

than at any other period of her life; and her general constitution seems

also then to receive a favorable impress, for wives and mothers live

longer than celibates. It is wisely decreed that when woman is engaged

in this, to her, anxious stage of reproduction, she shall not be exposed

to the pains and dangers of disease, and that those great covenants of

nature--marriage and child-bearing--shall be rewarded by added strength

and length of days.

There are certain disorders incident, in exceptional cases, to

pregnancy, of which we shall shortly speak. In general, however, we

repeat that this condition is one of extraordinary health. More than

this, in numerous instances it exerts an ameliorating influence upon

pre-existing diseases, suspending their march, or bringing about a

decidedly curative effect. Thus, various obstinate chronic affections of

the skin, of the womb and ovaries, and of the brain and nervous system,

frequently get well during pregnancy; and it is well known to every

physician, that by the judicious management of this state, and of the

lying-in period, troublesome displacements of the womb may be arrested.

It should nevertheless ever be recollected that the condition of

pregnancy is one of excitement and enhanced susceptibility to

impressions of all kinds. For this reason a change in the habits of

life is necessary; and the importance of the directions laid down for

the care of the health during this period, cannot be too strongly

insisted upon.

The diseases to which the wife is exposed during pregnancy will be

treated of in the chapter on 'Health in Marriage.'

CONFINEMENT.

_PREPARATIONS FOR CHILDBIRTH._

Certain foolish preparations are sometimes made by wives, with the best

intentions. Perhaps one of the most common and absurd of these is the

local use of sweet oil, in order to facilitate the dilatation of the

parts, for which purpose it is perfectly inert. There are, however, some

wise and even necessary precautions which every wife should know and

employ, to guard against unpleasant and dangerous complications in

childbirth.

In particular, _the condition of the breasts_ towards the close of

pregnancy demands attention. Scarcely any pain in the lying-in chamber

is greater or more difficult to bear than that which the young mother

suffers from excoriated nipples. This troublesome and often very

intractable affection is nearly always the consequence of the want of

care previous to confinement. During the latter part of pregnancy the

nipples sometimes become sunken or flat, being retracted as the breasts

increase in size, because of the want of elasticity on the part of the

milk tubes. In order to remedy this fault, we have known a breast-pump

or puppy to be applied. Such treatment is dangerous, as it may excite

premature contraction of the womb, and miscarriage. Nipple-shields,

with broad bases and openings, should always be obtained. They are safe,

and effectually secure the prominence of the nipples, when worn

constantly, day and night, during the last month or so of pregnancy.

Wives who have never had children ought to take special care to

ascertain before labor whether this depressed condition of the nipples

exists, and to correct it in the manner indicated.

In the first pregnancy it is also important to _harden the nipples_.

This may be done by occasionally gently rubbing them between the thumb

and finger, and by bathing them twice a day during the last six weeks

with tincture of myrrh, or with a mixture of equal parts of brandy and

water, to which a little alum has been added. This procedure will render

the surfaces less sensitive to the friction of the child's mouth, and

thus avert the distress so often occasioned in the first confinement by

tenderness of the nipples.

If the nipples be rough or nodulated in appearance, like a strawberry or

a raspberry, they are more apt to become excoriated or fissured than if

they present a smooth surface. Under such circumstances, make a solution

of the sulphate of zinc, of the strength of one grain to the ounce of

rose water, in a wide-mouthed bottle, then tilt the bottle upon the

nipple, and allow it to remain there for a few minutes several times a

day. Simple tenderness of the nipples and slight fissures may be averted

by the application either of a lotion of borax (two scruples of borax in

three ounces of water, and an ounce of glycerine), of the honey of

borax, or of the tincture of catechu, and by protecting the parts from

the pressure of the stays and the friction of the flannel vest.

It is of the greatest moment to the comfort of the mother, that all

affections of the nipples should be prevented or remedied before labor;

for the treatment of sore nipples when the child is at the breast is

often unsatisfactory, while the suffering they occasion is very great,

even sometimes giving rise to mammary abscess.

There are certain _articles of clothing_ and _dressings for the bed_

which should be cared for in advance, in order that they may be ready

when required.

The mother should be provided with short-gowns, to be worn over the

chemise instead of the ordinary night-gowns. It is of consequence to

procure a proper _bandage_. It should be made of heavy muslin, neither

too coarse nor too fine; an ordinarily good quality of unbleached muslin

is the best. The material is to be cut bias, about one and a quarter

yard in length, and from twelve to eighteen inches in breadth, varying,

of course, with the size of the person. It should be just large enough

to encircle the body after confinement, with a margin of a couple of

inches, and to extend down below the fulness of the hips. The

measurement should be taken, and the bandage made to fit, when four and

a half months advanced. It should be narrow above, wider below, and

gored in such a manner that it will be a little narrower at the lower

extremity than a few inches above, so as to prevent it, when adjusted,

from sliding upwards. A bandage constructed in this manner will be very

comfortable; and is not apt to become displaced, after application, as

is invariably the case when a towel or a straight piece of muslin is

used. The way in which it is to be applied will be detailed hereafter.

The _child's clothing_ should consist first of a piece of flannel or

some woollen material for a binder. This should be from four to six

inches in width, and from twelve to sixteen inches in length; that is to

say, wide enough to extend from the armpits to the lower part of the

abdomen, and long enough to go once and a half times around the child,

having the double fold to come over the abdomen. There should be no

embroidery about this. A shirt, which it is desirable should be woollen,

is to be provided to place over the binder. It should be made to come up

tolerably high in the neck, and to extend down the arm. Neither it nor

any other portion of the child's clothing should be starched. The

petticoat, which may be open its whole length behind, is to be put over

the shirt; two may be used--a short and a long one. Next comes the

child's ordinary frock or slip, and above this an apron to protect the

dress from the frequent discharges from the stomach. Then a shawl, of

flannel or any other warm material, is to be provided, to throw over the

shoulders if the weather be cold. Socks, and pieces of old soft linen,

free from stiffening, for napkins or diapers, complete the child's

outfit.

For the _permanent and temporary dressing of the bed_ there should be

provided a piece of impervious cloth (oiled silk is the neatest) about a

yard square; a piece of ordinary table oil-cloth or rubber-cloth; a

number of old sheets and comfortables, and a piece of thick carpet. The

manner in which these are to be used will be explained shortly.

A pair of small rounded scissors; a package of large pins, one and a

half inches in length, for the bandage of the mother, and smaller ones

for that of the child; some good linen bobbin for the doctor to tie the

navel-string; good toilet soap and fine surgical sponge for washing the

child; a piece of soft linen or muslin for dressing the navel; a box of

unirritating powder; and a pile of towels,--should all be had and laid

aside many weeks before they are wanted. These, together with the

material for dressing the bed, the child's clothing, and the mother's

bandage, ought to be placed together in a basket got for the purpose, in

order that they may all be easily and certainly found at a time when

perhaps the hurry and excitement of the moment would render it difficult

otherwise to collect them all immediately.

SIGNS OF APPROACHING LABOR.

One of the earliest of the preliminary signs of the coming on of

confinement occurs about two weeks before that event. It is a dropping

or subsidence of the womb. The summit of that organ then descends, in

most cases, from above to below the umbilicus, and the abdomen becomes

smaller. The stomach and lungs are relieved from pressure, the woman

breathes more freely, the sense of oppression which troubled her

previously is lost, and she says she feels 'very comfortable.' This

sensation of lightness and buoyancy increases, and a few days before the

setting in of labor she feels so much better that she thinks she will

take an extra amount of exercise. The mother of a number of children is

acquainted with this sign, but the wife with her first child may exert

herself unduly in the house or outdoors, and induce labor when in the

street or away from home. Hence the importance of a knowledge of this

premonitory symptom.

A second precursory sign of labor is found in the increased fulness of

the external parts, and an augmented mucous secretion, which may amount

even to a discharge resembling whites, and requiring the wearing of a

napkin. This symptom is a good one, indicating a disposition to

relaxation, and promising an easy time.

The third preliminary sign which we shall mention, is the change in the

mental state of the pregnant woman. She has a feeling of anxiety and of

fidgetiness, sometimes accompanied with depression of spirits. This

condition of emotional distress, modified in particular cases by reason,

self-control, and religion, may continue for several days, perhaps, when

THE SYMPTOMS OF ACTUAL LABOR

make their appearance. The first of these is generally the 'show.' It is

the discharge of the plug of mucus which has occupied the neck of the

womb up to this time, and is ordinarily accompanied by a little blood.

Perhaps before this, or perhaps not for some hours after, the 'pains'

will develope themselves. These recur periodically, at intervals of an

hour or half an hour at the outset, and are 'grinding' in character.

_True_ labor pains are distinguished from _false_ by the fact that they

are felt in the back, passing on to the thighs, while false pains are

referred to the abdomen; by their intermittent character, the spurious

pains being more or less continuous; and by the steady increase in their

frequency and severity. In case of doubt as to their exact nature, the

doctor should be summoned, who will be able to determine positively

whether labor has begun.

The other symptoms which point to the actual commencement of labor are a

frequent desire to empty the bowels and bladder, nausea and vomiting,

which, in the early part of confinement, is a good sign; shiverings,

unattended with any sensation of cold; and, finally, the rupture and

discharge of the contents of the 'bag of waters.'

Before passing on to the consideration of the management of the

confinement into which the wife has now entered, a few words may be

appropriately said upon the

CAUSE OF LABOR.

Neither the size nor the vigor of the child has any influence in

bringing about delivery at full term. The ancient theory--which received

the support of the distinguished naturalist Buffon--that the infant was

the active agent in causing its own expulsion, is an exploded one. It

was asserted by some that hunger excited the foetus to struggle to free

itself from the womb; others were disposed to attribute its efforts to

accomplish its entrance into the world, to the need of respiration which

it experienced. But all these ingenious theories, which presupposed the

embryo to be actuated by the same feelings which would influence a grown

person if shut up in such a confined abode, are unsatisfactory, and not

tenable. It is well known that the child may die in the womb, without

retarding or interfering in any way with the coming on of the process of

labor. This fact alone shows that the foetus is, or at any rate may be,

absolutely passive either in regard to the induction or advancement of

delivery. The determining cause of labor is seated in the womb itself.

The contractions of this organ occasion the 'pains' and expel the child,

assisted by the muscles of the abdomen and the diaphragm. That the

assistance of the latter forces is not necessary, is conclusively proved

by the occurrence of childbirth after the decease of the mother. For

instance, a case is on record in which labor commenced and twins were

born after the mother had been dead for three days.

CARE DURING LABOR.

We will suppose labor to have commenced. The _preparation of the bed_

for the occupancy of the mother is now to be attended to. As she is to

lie on the _left side_ of the bed, this is the side, and the only one,

which is to be dressed for the occasion. In order to do so, remove the

outer bed-clothes one at a time, folding them neatly on the right side

of the bed so that they can easily be drawn over when desired. The

_permanent dressing_ is to be placed beneath the lower sheet and upon

the mattress. A soft impervious cloth--which, in speaking of the

preparation for confinement, we directed to be procured--is placed next

to the surface of the bed. The upper edge should be nearly as high as

the margin of the bolster, and it should extend down to a distance at

least a foot below the level of the hips, so as to certainly protect the

bed from the discharges. Upon the top of this a blanket or sheet is

laid, and the whole fastened by pins. The lower sheet of the bed, which

had been turned over to the right side, to permit the application of the

dressing, is now to be replaced. Over the position of this permanent

dressing, on the top of the bed-sheet, a neatly-folded sheet, with the

folded edge down, is adjusted and pinned in its place. It is upon this

sheet that the patient is to be drawn up after her confinement, which

will take place upon the _temporary dressing_ of the bed now to be

arranged. It consists of an oil-cloth, which should extend up beyond the

lower edge of the permanent dressing, overlapping the folded sheet which

has been placed above it, and should fall over the side and bottom of

the bed. A comfortable or any soft absorbent material is placed over

this impervious cloth and covered with a folded sheet, completing the

temporary dressing. The bed-clothes may now be adjusted, concealing the

dressings from view until they are wanted. The valances at the foot of

the bed should be raised, and a piece of carpet placed on the floor. The

bed should have no foot-board, or a very low one.

_The dress of the mother._--Either a folded sheet should be adjusted

around the waist as the only skirt, so as not to interfere with the

walking, or a second chemise should be put on, with the arms outside the

sleeves, to extend from the waist to the feet. Then the chemise next the

body should be drawn up and folded high up around the breast. It should

be plaited neatly along the back, and brought forward and fastened by

pins. This should be thoroughly done, so that the linen may not be found

wet nor soiled when it is drawn down after confinement. A wrapper or

dressing-gown may be worn during the first stage of labor, before it is

necessary to go to bed. When, however, that time comes, the wife will

take her place on her left side on the temporary dressing, with a sheet

thrown over her, her head on a pillow so situated that her body will be

bent well forward, and her feet against the bed-post. A sheet should be

twisted into a cord and fastened to the foot of the bed, for her to

seize with her hands during the accession of the 'bearing-down pains.'

Care should be taken to have a number of napkins, a pot of fresh lard,

and the basket containing the scissors, ligature, bandage, etc.--which

have been previously enumerated in the remarks on preparations for

childbirth--at hand, for the use of the doctor.

We have now noted all that it is useful for the wife to know in regard

to the preparation for and management of confinement, when a physician

is in attendance, as, for obvious reasons, he should always be. In some

instances, however, the absence of the doctor is unavoidable, or the

labor is completed before his arrival. As a guide to the performance of

the necessary duties of the lying-in room under such circumstances, we

give some

HINTS TO ATTENDANTS.

The room during confinement should be kept quiet. Too many persons must

not be allowed in it, as they contaminate the air, and are apt by their

conversation to disturb the patient, either exciting or depressing her.

So soon as the head is born, it should be immediately ascertained

whether the neck is encircled by the cord; if so, it should be removed

or loosened. The neglect of this precaution may result fatally to the

infant, as happened a short time since in our own practice; the infant,

born a few minutes before our arrival, being found strangled with the

cord about its neck. It is also of importance at once to allow of the

entrance of air to the face, to put the finger in the mouth to remove

any obstruction which may interfere with respiration, and to lay the

babe on its right side, with the head removed from the discharges. The

cord should not be tied until the infant is heard to cry. The ligature

is to be applied in the following manner:--A piece of bobbin is thrown

around the navel-string, and tied with a double knot at the distance of

three fingers' breadth from the umbilicus; a second piece is tied an

inch beyond the first, and the cord divided with the scissors between

the two, care being taken not to clip off a finger or otherwise injure

the unsuspecting little infant, as has occurred in careless hands more

than once. When the child is separated from the mother, a warm blanket

or a piece of flannel should be ready to receive it. In taking hold of

the little stranger, it may slip out of the hands and be injured. To

guard against this accident, which is very apt to occur with awkward or

inexperienced persons, always seize the back portion of the neck in the

space bounded by the thumb and first finger of one hand, and grasp the

thighs with the other. In this way it may be safely carried. It should

be transferred, wrapped up in its blanket, to some _secure_ place, and

never put in an arm-chair, where it may be crushed by some one who does

not observe that the chair is already occupied. The head of the child

should not be so covered as to incur any danger of suffocation.

ATTENTION TO THE MOTHER.

When the after-birth has come away, the mother should be drawn up a

short distance--six or eight inches--in bed, and the sheet which has

been pinned around her, together with the temporary dressing of the bed

removed, a clean folded sheet being introduced under the hips. The parts

should be gently washed with warm water and a soft sponge or a cloth,

after which an application of equal parts of claret wine and water will

prove pleasant and beneficial. We have also found the anointing of the

external and internal parts with goose grease, which has been thoroughly

washed in several hot waters, to be very soothing and efficient in

speedily allaying all irritation. This ought all to be done under cover,

to guard against the taking of cold. The chemise pinned up around the

breast should now be loosened, and the woman is ready for the

application of the bandage, which is to be put on next the skin. If

properly and nicely adjusted, it will prove very grateful. The

directions for making it have already been given. In order to apply it,

one half of its length should be folded up into plaits, and the mother

should lie on her left side; lay the plaited end of the bandage

underneath the left side of the patient, carrying it as far under as

possible, and draw the loose end over the abdomen; then let the mother

roll over on her back upon the bandage, and draw out the plaited end. If

the abdominal muscles are much relaxed and the hip-bones prominent, a

compress of two or three towels will be wanted. The bandage should be

first tightened in the middle by a pin applied laterally, for strings

should never be employed. The pins should be placed at intervals of

about an inch. The lower portion of the bandage should be made quite

tight, to prevent it slipping up. The mother is now ready to be drawn up

in bed upon the permanent dressing: this should be done without any

exertion on her part. A napkin should be laid smoothly _under_ the hips

(never folded up), to receive the discharges. If she prefer to lie on

her left side, place a pillow behind her back.

ATTENTION TO THE CHILD.

The baby may now be washed and dressed. Before beginning, everything

that is wanted should be close at hand, namely a basin of warm water, a

large quantity of lard or some other unctuous material, soap, fine

sponge, and a basket containing the binder, shirt, and other articles of

clothing. First rub the child's body thoroughly with lard. The covering

can only be removed in this way; the use of soap alone will have no

effect unless the friction be so great as to take off also the skin. The

nurse should take a handful of lard and rub it in with the palm of the

hand, particularly in the flexures of the joints. In anointing one part,

the others should be covered, to prevent the child from taking cold. If

the child is thus made perfectly clean, do not use any soap and water,

because the skin is left in a more healthful condition by the lard, and

there is risk of the child's taking cold from the evaporation of the

water. But the face may be washed with soap and water, great care being

taken not to let the soap get into the child's eyes, which is one of the

most frequent causes of sore eyes in infants. The navel-string is now to

be dressed. This is done by wrapping it up in a circular piece of soft

muslin, well oiled, with a hole in its centre. The bandage is next to be

applied. The object of its use is to protect the child's abdomen against

cold, and to keep the dressing of the cord in its position. The nature,

shape, and size of the binder have been described. It should be pinned

in front, three pins being generally sufficient. The rest of the

clothing before enumerated is then put on.

The child is now to be _applied to the breast at once_. This is to be

done, for three reasons. First, it very often prevents flooding, which

is apt otherwise to occur. Secondly, it tends to prevent milk fever, by

averting the violent rush of the milk on the third day, and the

consequent engorgement of the breast and constitutional disturbance.

The third reason is, that there is always a secretion in the breast from

the first, which it is desirable for the child to have; for it acts as a

cathartic, stimulating the liver, and cleansing the bowels from the

secretions which fill them at the time of birth. There is generally

sufficient nourishment in the breasts for the child for the first few

days. The mother may lie on the one side or the other, and receive the

child upon the arm of that upon which she is lying. If the nipple be not

perfectly drawn out so that the child can grasp it in its mouth, the

difficulty may be overcome by filling a porter-bottle with hot water,

emptying it, and then placing the mouth of the bottle immediately over

the nipple. This will cause, as the bottle cools, a sufficient amount of

suction to elevate the sunken nipple. The bottle should then be removed

and the child substituted,--a little sugar and water or sweetened milk

being applied, if necessary, to tempt the child to take the breast.

FURTHER ATTENTION TO THE MOTHER.

The patient should be cleansed every _four or five hours_. A soft

napkin, wet with warm soap and water, should for this purpose be passed

underneath the bed-clothing, without exposing the surface to a draft of

air. After using the soap and water, apply again the dilute claret wine

and the goose grease. Much of the safety of the mother depends upon the

observation of cleanliness. The napkin should not be allowed to remain

so long as to become saturated with the discharges.

The mother should maintain rigidly the recumbent position for the first

few days, not raising her shoulders from the pillow for any purpose, and

should abstain from receiving visitors, and from any social conversation

for the first twenty-four hours.

For the first three or four days, until the milk has come and the milk

fever passed, the mother should live upon light food,--oatmeal gruel,

tea and toast, panada, or anything else of little bulk and unstimulating

character. Afterwards the diet may be increased by the addition of

chicken, lamb, mutton or oyster broth, buttered toast, and eggs. The

object of light nourishment at first is to prevent the too rapid

secretion of milk, which might be attended with evil local and

constitutional effects. If, however, the mother be in feeble health, it

will be necessary from the outset that she shall be supported with

nourishing concentrated food. _Beef-tea_ will then be found very

serviceable, particularly if made according to the following

recipe:--Take a pound of fresh beef from the loins or neck. Free it

carefully from all fat. Cut it up into fine pieces, and add a very

little salt and five grains of unbroken black pepper. Pour on it a pint

of cold water, and _simmer_ for forty minutes. Then pour off the liquor,

place the meat in a cloth, and, after squeezing the juice from it into

the tea, throw it aside. Return to the fire, and boil for ten minutes.

After the first week, the diet of the lying-in woman should always be

nutritious, though plain and simple. The development of the mammary

glands, the production of the mammary secretion, and the reduction which

takes place in the size of the womb, all require increased nourishment,

that they may be properly performed.

After the third or fourth day _the dress should be changed_. The dress

worn during labor, if our directions have been carried out, will not

have been soiled. The clothing should be changed without uncovering the

person, and without raising the head from the pillow. Pull the bed-gown

from over each arm, and draw it out from under the body. Then unfasten

the chemise in front and draw it down underneath her so that it can be

removed from below, as it should not be carried over the head. Place her

arms in the sleeves of the clean chemise, throw its body over her head,

and, without lifting her shoulders from the bed, draw it down. Then

change the bed-gown in the same manner.

In changing the upper sheet, it should be pulled off from below, and the

clean one carried down in its place from above, underneath the other

clothing, which can be readily accomplished by plaiting the lower half.

In introducing a clean under-sheet, one side of it should be plaited and

placed under the patient, lying on her left side; when she turns on her

back, the plaits can then be readily drawn out. These directions, though

apparently trivial, are important. The object is to guard against the

great danger to which the mother is exposed by sitting up in bed for

even a few minutes during the first week.

_Cathartic medicine_ should not be administered the first, the third, or

any other day after confinement, unless it is needed. If the patient is

perfectly comfortable, has no pain in the abdomen, no headache, and is

well in every respect, she should be let alone, even if her bowels have

not been moved. If a laxative be called for, citrate of magnesia is much

pleasanter and equally as efficacious as the castor-oil so frequently

administered on this occasion.

TO HAVE LABOR WITHOUT PAIN.

Is it possible to avoid the throes of labor, and have children without

suffering? This is a question which science answers in the affirmative.

Medical art brings the waters of Lethe to the bedside of woman in her

hour of trial. Of late years chloroform and ether have been employed to

lessen or annul the pains of childbirth, with the same success that has

attended their use in surgery. Their administration is never pushed so

as to produce complete unconsciousness, unless some operation is

necessary, but merely so as to diminish sensibility and render the pains

endurable. These agents are thus given without injury to the child, and

without retarding the labor or exposing the mother to any danger. When

properly employed, they induce refreshing sleep, revive the drooping

nervous system, and expedite the delivery.

They should never be used in the absence of the doctor. He alone is

competent to give them with safety. In natural, easy, and short labor,

where the pains are readily borne, they are not required. But in those

lingering cases in which the suffering is extreme, and, above all, in

those instances where instruments have to be employed, ether and

chloroform have a value beyond all price.

MORTALITY OF CHILDBED.

_The number of the pregnancy_ affects the danger to be expected from

lying-in. It has been declared by excellent authority, that the

mortality of first labors, and of childbed fever following first labors

is about twice the mortality attending all subsequent labors

collectively. After the ninth labor the mortality increases with the

number. A woman having a large family, therefore, comes into greater and

increasing risk as she bears her ninth and successive children.

_The age of the woman_ also affects the mortality accompanying

confinement. The age of least mortality is near twenty-five years. On

either side of this, mortality increases with the diminution or increase

of age. The age of the greatest safety in confinement therefore

corresponds to the age of greatest fecundity. And during the whole of

child-bearing life, safety in labor is directly as fecundity, and _vice

versâ_. Hence modern statistics prove the correctness of the saying of

Aristotle, that 'to the female sex premature wedlock is peculiarly

dangerous, since, in consequence of anticipating the demands of nature,

many of them suffer greatly in childbirth, and many of them die.' As the

period from twenty to twenty-five is the least dangerous for childbirth,

and as first labors are more hazardous than all others before the ninth,

it is important that this term of least mortality be chosen for entering

upon the duties of matrimony. This we have already pointed out in

speaking of the age of nubility.

_The sex of the child_ is another circumstance affecting the mortality

of labor. Professor Simpson of Edinburgh has shown that a greater

proportion of deaths occurs in women who have brought forth male

children.

_The duration of labor_ also influences the mortality of lying-in. The

fatality increases with the length of the labor. It must be recollected,

however, that the duration of labor is only an inconsiderable part of

the many causes of mortality in childbirth.

WEIGHT AND LENGTH OF NEW-BORN CHILDREN

The average weight of infants of both sexes at the time of birth is

about seven pounds. The average of male children is seven and one-third

pounds; of female, six and two-thirds pounds. Children which at full

term weigh less than five pounds are not apt to thrive, and usually die

in a short time.

The average length at birth, without regard to sex, is about twenty

inches, the male being about half an inch longer than the female.

In regard to the relation between the size of the child and the age of

the mother, the interesting conclusion has been arrived at, that the

average weight and length of the mature child gradually increases with

the age of the mother up to the twenty-fifth year. Mothers between the

ages of twenty-five and twenty-nine have the largest children. From the

thirtieth year they gradually diminish. The first child of a woman is of

comparatively light weight. The first egg of a fowl is smaller than

those which follow.

The new-born children in our Western States seem to be larger than the

statistics show them to be in the various States of Europe, and

apparently even than in our Eastern States. In the Report on Obstetrics

of the Illinois State Medical Society for 1868, it is stated that

Quincy, Ill., produced during the year six male children whose average

weight at birth was thirteen and a quarter pounds, the smallest weighing

twelve pounds, and the largest seventeen and a half, which was born at

the end of four hours' labor, without instrumental or other

interference. A recent number of a Western medical journal reports the

birth at Detroit, in February last, of a well-formed male infant

twenty-four and a-half inches long, weighing sixteen pounds. The woman's

weight, _after labor_, is stated as only ninety-two pounds. An English

physician delivered a child by the forceps which weighed seventeen

pounds twelve ounces, and measured twenty-four inches. These are the

largest well-authenticated new-born infants on record.

DURATION OF LABOR.

The length of a natural labor may be said to vary between two and

eighteen hours. The intervals between the pains are such, however, that

the actual duration of suffering, even in the longest labor, is

comparatively very short. The first confinement is much longer than

subsequent ones.

The _sex_ of the child has some influence on the duration of labor.

According to Dr. Collins of the Lying-in Hospital of Dublin, the average

with _male_ births is one hour and four minutes longer than with

_female_. The _weight_ of the child also affects the time of labor.

Children weighing over eight pounds average four hours and eight minutes

longer in birth than those of less than eight pounds weight.

STILL-BIRTHS.

The statistics of nearly fifty thousand deliveries which occurred at the

Royal Maternity Charity, London, show a percentage of nearly five

still-born, or one in twenty-seven.

There are more boys still-born than girls. We have already spoken of the

fact that male births are more tedious, and that a larger number of

males die in the first few years of life than females. This series of

misfortunes has been attributed to the large size which the male foetus

at birth possesses over the female.

IMPRUDENCE AFTER CHILDBIRTH.