CLASS V.

GENETICA.

ORDER III.

CARPOTICA.

Diseases affecting the Empregnation.

THE ordinal term CARPOTICA, is derived from καρπος, fructus," whence xxxwσs, "fruitio."

In the Physiological Proem to the present Class, we have taken a brief survey of the laws and general process of generation so far as we are acquainted with them. Impregnation constitutes à part, and the most important part, of this wonderful economy, and, from the changes that the body undergoes during its action, it can never be surprizing that it should often give rise to various diseases. These diseases may be arranged under four genera; including, those which occur during the progress of pregnancy: those which occur during the progress of labour; conceptions misplaced; and spurious attempts at conception; the whole of which may be thus expressed:

In the preceding Physiological Proem, we have shown that, in order for impregnation to take place, it is necessary the semen of the male should pass from the vagina to the one or other of the ovaries by means of the Fallopian tubes which lay hold of the uterus by their very fine and sensible fimbriæ, or fringed extremities, with a sort of spastic grasp during the high-wrought shock of the embrace, and thus alone open a path-way for the semen to travel in.

The two ovaries are not merely intended to supply the place of each other, in the event of one being wanting or defective, but, like the testes in men, they seem to increase the extent of the productive power, and enable a female to bear a larger offspring than she would do, if she were possessed of one ovary alone. Mr. John

Hunter has put this to the test by comparing the number of young produced by a perfect sow with those of a sow spayed of one ovary, both of the same farrow, and impregnated by a boar of the same farrow also. The spayed sow continued to breed for four years, during which period she had eight farrows producing a total of seventy-six young. The perfect sow continued to breed for six years; during the first four of which she also had eight farrows producing a total of eighty-seven young and during the two ensuing years she had five more farrows producing a total of seventy-five young, in addition to those of the first four years.* So that, if we may judge from this single experiment, the use of two ovaries, in equal health and activity, enables an animal to breed both more numerously, and for a longer period of time, than the possession of one alone.

of

Among women, however, the extent of fecundation does not seem to be much interfered with by the defect of a single ovarium, or its means of communication with the uterus, according to a paper Dr. Granville read before the Royal Society, April 16, 1813, containing the case of a female whose uterus was found after death to have had but one set of the lateral appendages, and, consequently, a connexion with but one ovarium, and who, nevertheless, had been the mother of eleven children, several of each sex, with twins on one occasion.

After impregnation has taken place, the membranes produced in the uterus form a complete septum, and, consequently, a bar to the ascent of any subsequent flow of semen, so as to prohibit the possibility of two or more successive impregnations co-existing in any part of the uterus during the period of a determined gravidity. Children, indeed, have been born within a few weeks, or even months, of each other, and hence a colour has been given to the hypothesis that they may be conceived at different periods of a common parturition, and such births have, in consequence, been distinguished by the name of SUPERFETATIONS; but we shall have occasion hereafter, when treating of a plurality of children, to show that fetuses thus born in succession, however they may vary in size or maturity, are real twins, conceived at one and the same time, from the descent of a plurality of ovula into the uterus, instead of a single one, and that the difference of size or maturity depends upon some unknown cause in the dead or puny fetus, which has killed it or prevented its keeping pace with the other.

Women are in general capable of breeding as soon as they begin to menstruate, which is the ordinary proof that the organs of conception are fully developed and perfected: and since this discharge, as we have remarked in the Proem just referred to, commences sometimes in very early life, and particularly in hot climates, where it has occurred in girls of not more than nine years of age, so we have instances of conception and pregnancy having commenced as

* Animal Economy, p. 157.

early. Baron Haller* and professor Schmidt,† concur in examples of pregnancy at nine years old: and the medical records confirm these singular histories by numerous instances of a like kind.‡

Yet, though menstruation is the ordinary proof that the conceptive powers have acquired a sufficient finish and vigour for their proper function, menstruation itself is not absolutely necessary for impregnation. As there are circumstances that hurry on this secretion before its ordinary term of appearance, there are others that delay it, insomuch that some women pass through a long life without menstruating at all, while others only begin after reaching an adult age, and others again not till the period in which it usually ceases. Now, it may happen that a woman whose peculiar habit produces a peculiar retardation of menstruation, may marry before this secretion takes place for the first time; and, as we have just observed that she is able to breed as soon as ever she is able to menstruate, the former process may anticipate the latter, and postpone it till the term of pregnancy has been completed. A young woman," says Sir Everard Home, "was married before she was seventeen, and, although she had never menstruated, became pregnant: four months after her delivery she became pregnant a second time, and four months after the second delivery she was a third time pregnant, but miscarried: after this she menstruated for the first time, and continued to do so for several periods, and again became pregnant."§

There is much difference of opinion as to the period of pregnancy in the human female; for while other animals seem to observe great punctuality upon this subject, we meet with so many and such considerable varieties in women, that legislators, as well as physicians, have not agreed in assigning a common term. Hippocrates rules it that we should admit the possibility of a child being born at ten months, but not later, which is the common term assigned in the book of the Apocrypha entitled Wisdom of Solomon ; while Haller gives references to women who are said to have gone not only ten but eleven, twelve, thirteen, and even fourteen months; most of which, however, are of a suspicious kind. Twelve months, nevertheless is a term allowed by many physicians, as what may take place under peculiar weakness or delicacy of health; and yet it is most probable that in all these the mother is mistaken as to the

Vide Blumenbach, Bibl. 1. p. 558.

† Act. Helvet. IV. 162.

Eph. Nat. Cur. Dec. III. Ann. 11. Obs. 172.

Phil. Trans. 1817, p. 258.

|| Chap. vii. 2.

1 Büchner, Miscell. 1727, p. 170.

Enguin, Journ. de Med. Tom. LXI.

Brambilla, Abhandl. der Joseph. Acad. Band. 1. p. 102.

Telmout de St, Journ. de Med. Tom. XXVII.

Ploucquet, Von den physichen Erfordernifsen der Erbfähigheit der Kinder, p.

69. Treb.

proper time of her conception, and imagines herself to have commenced pregnancy for some weeks or even months before it actually takes place. The state of menstruation affords no full - proof; for as conception may occur without its appearance, so it may continue for many months or even during the whole term of pregnancy, though most commonly in a smaller quantity than usual. There is a singular case in the Histoire de l'Academie des Sciences, of a living child born after what is said to have been three years of pregnancy.* Few reports of this kind are worth attending to, or entitled to any kind of explanation: but it has sometimes happened, and probably did so in this last case that a woman conceits herself to be in a state of pregnancy, and has various symptoms that simulate it, for a twelvemonth or considerably more than a twelvemonth, and particularly towards the cessation of the catamenia, instances of which we shall have occasion to notice under the fourth genus of the present order, entitled PSEUDOCYESIS or spurious pregnancy and if, after such a simulation continued for a year or two, the woman should fall into a state of real pregnancy, she may persuade herself at the close of the process that she has been pregnant for the whole of this time.

By the code Napoleon, the legitimacy of a child born three hundred days after a dissolution of marriage may be questioned. In our own country the law is to this hour in an unsettled state; and much nicety of argument has frequently taken place; of which an example was afforded in the famous question of the Banbury peerage, upon a new raised distinction of access and generative access. There can be no doubt, however, that a considerable difference in duration may ensue from the state of the mother's health: for as the fetus receives its nourishment from the mother, there is a probability that various deviations from health may retard the maturity of the fetus. And it is probably on this account that different legislators have assigned different periods of legitimacy; one of the shortest of which is that determined upon by the faculty of Leipsic, who have been complaisant enough to decide, that a child born five months and eight days after the return of the husband, may be considered as legitimate; and that a fetus at five months is often a perfect and healthy child.

In the ordinary calculation of our own country, the allowed term does not essentially differ from that in the code Napoleon, for it extends to nine calendar months or forty weeks: but as there is often much difficulty in determining the exact day between any two periods of menstruation in which semination has taken effect, it is usual to count the forty weeks from the middle of the interval before it ceases; or, in other words, to give a date of forty-two weeks from the last appearance of the menses: and at the expiration of this term, within a few days before or after, the labour may confidently be expected.

Hist. de l'Academie des Sciences, 1753, p. 206.

In the progress of pregnancy the figure of the uterus, as well as its position, changes considerably. Before the end of the third month it has a tendency to dip towards the pelvis, at which period it may be felt to ascend: during the seventh month it forms a line with the navel; in the eighth month it ascends still higher, reaching mid-way between this organ and the sternum; and in the ninth it almost touches the ensiform cartilage; at the close of which, as though overwhelmed by its own bulk, it begins again to descend, and shortly afterwards, from the irritation produced by the weight of the child, or, more probably, from the simple law of instinct, it becomes attacked with a series of spasmodic contractions extending to the surrounding organs, which constitute the pains of labour, gradually increase in strength, enlarge the mouth of the organ, and protrude the child into the world.

In natural pregnancy, a strong hearty woman suffers little considering the great change which many of the most important organs of both the thorax and abdomen are sustaining; and in natural labour, though the returning pains are violent for several hours, there is little or no danger. But numerous unforeseen circumstances may arise from the constitution of the mother, the shape of the pelvis, the figure or position of the child, to produce difficulty, danger, and even death.

In describing the diseases which appertain to the whole of this period, it is not the author's design to do more than to take a general pathological survey, so as to communicate that kind of knowledge upon the subject which every practitioner of the healing art should be acquainted with, even though he may not engage in the obstetric branch of his profession. The minuter and more practical parts, and especially those which relate to the application of instruments and the mechanical means of assistance, must be sought for in books and lectures expressly appropriated to this purpose, with which it is not his intention to interfere.

GENUS I.

PARACYESIS.

Morbid Pregnancy.

THE PROGRESS OF PREGNANCY DISTURBED OR ENDANGERED BY THE SUPERVENTION OF GENERAL OR LOCAL DISORDER.

THE generic term is derived from xaga, "male," and sunois, "graviditas." The genus will conveniently embrace the three following species, according as the general system, or organs distinct from

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