3. Weight. From the 1st of August, 1829, to the 1st of January, 1836, a period of six years and five months, every child was weighed even the miscarriages when the children were viable. But these, together with the twin labors, we have excluded from the calculation; as the object to be obtained was a fair average for children born at full term in Baltimore. The whole number calculated is eight hundred and eleven-423 males, and 388 females. The smallest weight was three and a half pounds-the largest was twelve pounds. Of the twins, the greatest weight given, was that of male children-one weighing eight and a half, the other seven pounds; together, equal to the average weight of ordinary children. In the following table the fractions of a pound have been omitted, but have been carefully calculated in the total weight given. The table will be read thus:-One child weighed three pounds and was a female. Five weighed four pounds-one male and four females, and so on:

The entire weight of the 811 children was 6,138 pounds-being an average of 7.5 pounds, or seven pounds eight ounces less a fraction, for each. Of these 423 were males whose united weight was 3,254 pounds-being for each, an average of 7.6 pounds, or seven pounds eleven ounces and a fraction-388 were femalestotal weight 2,883.5 pounds-average for each, 7.4 pounds, or seven pounds six ounces and a fraction; giving an average preponderance in favor of the males of five ounces. This is a smaller average weight than that obtained from nearly a similar number of children at Mendon, by Dr. Medcalf. His average for the whole was eight pounds five ounces and a fraction. But it compares favorably with the result of observations for the city of Brussels, as published in the London Med. Gazette, for 1828, which gives for male children an average of six and a quarter pounds, and for females a fraction less than six, pounds.

Finding that the interesting statistics before us might be carried to an almost unlimited extent, by means of comparisons, and the suggestive import of the facts they embody, we will in brief terms sum up, what remains for the child and the placenta :

4. Dead. Of the 2520 children, the product of 2503 labors prior to 1829-2460 were alive when born.

The proportion is different for the series of cases from 1829 to 1845.

This is not to be received as the average proportion of deaths which occur in ordinary private practice, without repeating the remark, that Dr. Chatard was frequently called in consultation in difficult labors, all of which are included amongst his records. This also applies to the frequent use of the obstetrical instruments.

5. Instrumental Deliveries,-Commenting upon his book of practice after thirty years, Dr. C., says, "as to the application of the forceps they are evidently very numerous. The use of this instrument might have been reduced to the three-fourths, but feeling certain of not injuring the children, and desirous of abridging the sufferings of the mother, I did not hesitate to make use of them."

In 4,290 labors the forceps were employed in 144 cases, or once in every 36.7 cases.

In the same number of labors (4,290,) craniotomy was performed in seven instances or once in every 613 cases.

6. Abortions and Miscarriages.-Ninety eight deliveries are recorded as having occured before the full term in the following months of pregnancy-one in the first month, eight in the second, and so on:

Month,.

..1 2 3 4
8 8 8

5 6 7 8
6 24 28 15

No. of Deliveries, ........................................1

The whole number being ninety-eight, the number of deliveries will correspond to the per centage within a very small fraction. So far as this number of cases will warrant a conclusion, it is shown, that abortion, or more properly speaking premature delivery, is more likely to occur with us between the sixth and seventh months of pregnancy than in the third or fourth, as is generally supposed.

7. Diseased or Deformed. Of the 1,790 children nine were defective in form or health, or one in every two hundred; of these there were of hydrocephalus two; spina bifida one; hare lip one; cleft palate one; club feet one; left leg broken in the womb one; recorded "diseased" two: without a more particular description of the deformity or disease.

8. Illegitimate. Of the 1,787 women, eighteen are supposed to have given birth to illegitimate offspring. Should this be even an approximation to the proportion of illegitimate children occurring with us, it would speak highly for the female virtue of the community. Our number of cases and data, however, are insufficient to give one in the hundred, as the standard of our illegitimate births in ordinary practice amongst all classes of society. This being the first attempt to arrange in statistical form the valuable records to be derived from obstetrical practitioners with us, the proportion here. presented for our city, (as also the rest of the per centages,) may hereafter be verified or altered, as the numbers collected may prove them rules or exceptions. There is reason to believe that the amount of immorality bears a certain proportion to the enlargement of cities and the crowding together of inhabitants, and this can be shown in no more positive manner, than by the faithful record of medical statistics.

CASES RELATING ESPECIALLY TO THE CHILD.

XIX.

Arm Presentation.—Mrs. D-, 5th birth, had been passing the waters for 24 hours when her accouchers requested me to see her. The whole of the right arm was out of the vulva-was swollen twice its size and of a violet black color. Notwithstanding the rather favorable conformation of the mother, it was impossible to reach the feet. The child being dead, I detached the two arms in order to facilitate the evolution of the body, which I accomplished by pulling on it with the crochet, sustained by the hand. The child was a girl, and very large.

XX.

Arm Presentation.-Four of my brother physicians sent for me to finish a difficult case of a negress, in labor with her tenth child. The unfortunate woman had been suffering three or four days without help. I learned that at the commencement of the labor the child presented the right arm, which was so swollen when I came that it was three times the size of the left. The strong, and now uninterrupted contractions of the uterus, and a very great projection of the sacrum, would not permit me to insert more than half the hand in the superior strait to seek the feet, situated at the extremity of the uterus. The certainty that the child no longer lived, determined me to separate the swollen right arm from the body-then the left arm, which I could not bring down except with the blunt crochet. Notwithstanding this sacrifice, it was impossible to reach the feet, I thought that by implanting the crochet towards the vertebral column, I should effect the evolution of the body by pulling on the trunk. This succeeded perfectly-the woman was happily delivered, and after a time left pretty well upon her miserable bed.

XXI.

Arm Presentation.-One of my colleagues sent for me to terminate a case of arm presentation up to the shoulder. The waters had been broken for more than four hours, and the unfortunate woman left to her unhappy fate. Having introduced the right hand the length of the arm, and found the head strongly engaged in the

left side of the pelvis, I removed it with the aid of the left hand, with which I succeeded in ten minutes in seizing a foot, after which the evolution of the fœtus was effected with great ease. was dead—a male, and weighed seven pounds.

XXII.

The child

3d

Transverse Presentation of the Face. Mrs. McK birth, a female child weighing seven pounds. When I first saw this lady I was informed that she had been in labor several hours -probably but slight, for the nurse had been summoned but a few moments before my arrival. I saw from the form of the water-sae, and from the impossibility of feeling the fœtus even when pressing strongly, that the position must be vicious; and so it was. After rupture of the membranes, which soon occurred, I recognized a transverse presentation of the face, the front on the right side of the pelvis-2d position of Dewees.

As many authors on the art of delivery, of great, and almost equal merit, have very different opinions as to the mode of acting in such cases, I sided with those who prefer the action of nature, and I saw with great satisfaction that the delivery was very successful, and its course was clearly that described by Dr. Boer-Velpeau, 2 vols. page 497.

XXIII.

Presentation of the Face.-I was called to terminate a case of presentation of the face; the head had been during the space of five or six hours in that position. The large labia were very much tumified, and the woman almost exhausted. Not being able to apply the forceps properly, I used its two blades as levers, one placed behind the occiput, the other behind the chin; acting in concert with the uterine contractions, I accomplished the expulsion of the fœtus in the space of an hour. The child was a male, weighing nine pounds-I left both in tolerably good condition.

XXIV.

JULY 28th, 1831.-Mrs. L-, 9th labor, of more than 24 hours-child a female, at the term of eight months, weighing 3 pounds-1st position of the vertex. This child lived until the fifteenth year of her age.