necessary to employ great force to effect the delivery, notwithstanding the child-a little girl-was only of ordinary size. She came into the world living, and is now well. The rheumatism, after the delivery, again returned to the extremities, and I left the woman in much pain. The tumor already mentioned appeared to me to be the same after the delivery was effected, and seemed to be formed of the substance of the womb itself-probably an injury caused by a corset during the first months of pregnancy. XII. Procidentia Uteri-JANUARY 22d, 1836.-Mrs. H ́, primipara-male infant of ordinary size. This woman had been in labor 31 hours when her accoucher sent for me. The head of the fœtus presented with the vertex to the vulva scarcely covering the orifice of the womb, which offered very little dilatation, was very thick at the anterior portion, and opposed a great resistance to the reiterated efforts of the uterus to expel the fœtus. It seems that this woman had had a procidentia of the uterus during all her pregnancy, and the neck of this organ was hardened, and so to speak, shrivelled, by the contact of the air. It had lost all its elasticity and suppleness, which caused the Doctor to mistake it for the vagina, doubled on itself, and he thought that the uterine orifice had already yielded the head which now presented. My son and myself not being of his opinion, we prescribed two warm baths, the first in one hour, the second in two hours, after which the dilatation of the orifice having somewhat increased, permitted the application of the forceps with all the desired success, and only caused an insignificant tear. Excepting this, the Doctor did during the course of the labor all that could be done to facilitate delivery; copious bleeding, cataplasms, fomentations, embrocations, and even the administration of ergot were employed. The woman was very well 24 hours after delivery, and had urinated twice. XIII. Impacted feces during Labor—JULY 9th, 1839.-Mrs. Capt. D. fourth labor. This lady had been in labor 24 hours, and the delivery made no progress. In examining whence proceeded this delay, I perceived that the rectum was full of indurated fecal matter, I prescribed an injection, then a second-then a third, until the bowels were entirely empty; immediately afterwards the pains returned, and the uterine contractions being sufficient to expel the fœtus, the delivery was terminated at the end of two hours. The presentation was the first of the vertex, and the child a female. of three-quarters of an hour, was delivered of a girl of ordinary size, occupying the left cotyloid cavity of the pelvis. JUNE 7th, 1836.-Mrs. W XV. , primipara, was delivered after 24 hours of labor, of a male child weighing 11 pounds, occupying the left cotyloid cavity. This child is the beginning of the fifth generation now living. XVI. JANUARY 5th, 1840.-Mrs. Sullavin, second labor, which was so quick that the child fell on the floor as the woman was yet going about. Male child of ordinary size. XVII. Twin Prenancy with large accumulation of Water.-Mrs. B., mother of a great number of children, thought herself in the 7th month of pregnancy, and it was evident that dropsy existed. An examination left no doubt of the dropsy; but its nature was unknown, and the pregnancy was not very certain: the family physician thought it might be hydatids. Uterine pains having supervened at the end of a few days, the patient was delivered of twins of very different dimensions, though there was but one placenta for the two. The larger weighed 18 ounces, 10 grains, and was 9 inches and 4 lines in length: the smaller weighed 11 ounces, 21 grains, and was 6 inches and 11 lines in length. The first was without life, and, to judge from the decompositiou of the epidermis over the whole body, had been dead a long time-the smaller had the epidermis entire. The woman insisted that the dropsy had only existed six weeks, but when I examined her a few days previous to the miscarriage, the parieties of the abdomen were so distended, and the existence of water so sensible by palpation, that I was far from imagining it to be a simple dropsy. The quantity of water evacuated during the miscarriage was not less than 25 or 30 pounds. XVIII. F— 4th Gestation of 315 days duration.—Mrs. R― birth; male child weighing 7 pounds. This lady carried her child 315 days-that is, ten months and a half, or nearly so-counting from the time of feeling the first motion of the child, and the suppression of the catamenia. Her calculation was certainly as exact as possible, and I do not doubt that the gestation was prolonged to that term. STATISTICS OF THE CHILD. 1st Presentations. Of the 1,787 cases, 38 were abortions under seven months, leaving 1,749 presentations to be analysed. But as these differ very little from the group of 2,522 cases, collected prior to 1829, we will not separate them in the statistics. Of the 4,309 births the presentation is recorded in 4,192. These being arranged in the following table, (still following Dr. Medcalf's order and tables,) will be read thus:-4,024 were presentations of the vertex, and so on : In the 4,192 births, the Vertex presented in 4,024, or 1 in 1.04 The per centage of vertex presentations is greater than that given by most authors. The first (occipito-anterior,) position of the vertex, is given by Naegele as 69 per cent.-in our cases it is 91 per cent. of the whole. Of the vertex in the three positions, Merriman gives 1,664 in 1,800 cases; Bland, 1,792 in 1,897; Boivin, 19,730 in 20,357; Lachapelle, 14,677 in 15,652, and 20,698 in 22,243; Naegele, 1,210 in 1,296; Lovati, 61 in 67; Velpeau, 392 in 400; Smellie, 920 in 1,000; Siebold, 132 in 137; Kluge, 257 in 298; Mazzini, 439 in 452; Ramoux, 266 in 275; Pacord, 49 in 53; P. Dubois, 10,262 in 10,742; Riecke, 214,134 in 219, 258;* Chatard, 4,024 in 4,192. 2. Sex of 4,291 births, there were males,......2,226 Or a preponderance of males of 10 per cent. 1,771 of these were counted, to ascertain the different months in their order in which the greatest number of labors occurred. Thus in December, there were 10 per cent. of the whole number of births, and so on for the first column. The order of the months for the males and females were found somewhat different, and are given in the separate columns : Whole Births in the fol- Male Births in the fol- Female Births in the following proportions : lowing proportions : ....10.0 December, lowing proportions: March, December, ..5.0 .5.0 4.9 January, ..4.8 January, ...9.3 July, .4.6 December, .4.7 October, 8.7 March, .4.3 October, .4.4 .4.3 September, ..4.1 July, ...8.3 November, .4.3 August, ..4.1 .4.2 February, ...3.9 August, ..7.9 September,.. ..4.2 | April, ..3.6 May,. 7.6 August, ..4.0 May, ..3.6 February, 7.6 October, November, .7.4 February, ..4.0 June, .3.4 April, .7.0 April, Whole number,.....1,771 Males,. ....906 Females, ...865 Another table has been prepared for the different years from 1829 to 1845, (seventeen years,) showing the excess of either sex during those years. It is supposed to be established by statistics as a law *T. F. Cock, Manual of Obstetrics. of generation, that when causes exist which tend to lessen or depress the vital forces of the individual, an increased proportion of female births occur. This was thought to be the case by Dr. Emerson of Philadelphia, in his "vital statistics" for that city, (Amer. Jour. Med. Sciences,) as a consequence of the epidemic cholera, which prevailed there in 1832 and 1834. The same epidemic prevailed here 1832 and 1833, but it will be seen by the following table, that an excess of male births for these years is shown, as well as for the three subsequent years, excepting 1834 when a small excess of females occurred. May not this different result have been caused by the fact, that the more affluent as a class, were but little affected by the ravages of the cholera? On the contrary, they fled the city, and may have been invigorated by travel, and rural residences. We find, however, a very considerable excess of females from 1837 to 1841; and when we consider that this was an epoch of a great financial crisis, affecting our mercantile and business classes so severely, and as this was the class from which a large majority of these statistics were compiled, they may yet be considered as corroboratve of the law above expressed. Table showing the proportion of Male and Female Births during seventeen years : |