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Professional ASP NET 3 5 in C Sharp and Visual Basic
Bill Evjen Digital Instant Download
Author(s): Bill Evjen, Scott Hanselman, Devin Rader
ISBN(s): 9780470187579, 0470187573
Edition: Pap/Pas
File Details: PDF, 38.53 MB
Year: 2008
Language: english
 Evjen ffirs.tex V2 - 01/28/2008 4:55pm Page iii

Professional
ASP.NET 3.5
In C# and VB

Bill Evjen
Scott Hanselman
Devin Rader

Wiley Publishing, Inc.

 Evjen ffirs.tex V2 - 01/28/2008 4:55pm Page iv

Professional ASP.NET 3.5

In C# and VB
Published by
Wiley Publishing, Inc.
10475 Crosspoint Boulevard
Indianapolis, IN 46256
www.wiley.com
Copyright © 2008 by Wiley Publishing, Inc., Indianapolis, Indiana

Published simultaneously in Canada

ISBN: 978-0-470-18757-9
Manufactured in the United States of America

10 9 8 7 6 5 4 3 2 1

Library of Congress Cataloging-in-Publication Data is available from the publisher.

No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections
107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or
authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood
Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600. Requests to the Publisher for permission should be
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Limit of Liability/Disclaimer of Warranty: The publisher and the author make no representations or warranties
with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties,
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available in electronic books.
 Evjen fauth.tex V1 - 02/20/2008 1:50am Page v

About the Authors

Bill Evjen is an active proponent of .NET technologies and community-based learning initiatives for
.NET. He has been actively involved with .NET since the first bits were released in 2000. In the same year,
Bill founded the St. Louis .NET User Group (www.stlnet.org), one of the world’s first such groups. Bill
is also the founder and former executive director of the International .NET Association (www.ineta.org),
which represents more than 500,000 members worldwide.

Based in St. Louis, Missouri, USA, Bill is an acclaimed author and speaker on ASP.NET and XML
Web Services. He has authored or co-authored more than fifteen books including Professional C# 2008,
Professional VB 2008, ASP.NET Professional Secrets, XML Web Services for ASP.NET, and Web Services
Enhancements: Understanding the WSE for Enterprise Applications (all published by Wiley Publishing, Inc.).
In addition to writing, Bill is a speaker at numerous conferences, including DevConnections, VSLive, and
TechEd. Along with these items, Bill works closely with Microsoft as a Microsoft Regional Director and
an MVP.

Bill is the Technical Architect for Lipper (www.lipperweb.com), a wholly-owned subsidiary of Reuters, the
international news and financial services company. He graduated from Western Washington University
in Bellingham, Washington, with a Russian language degree. When he isn’t tinkering on the computer, he
can usually be found at his summer house in Toivakka, Finland. You can reach Bill at evjen@yahoo.com.

Scott Hanselman works for Microsoft as a Senior Program Manager in the Developer Division, aim-
ing to spread the good word about developing software, most often on the Microsoft stack. Before
this he worked in eFinance for 6+ years and before that he was a Principal Consultant at a Microsoft
Partner for nearly 7 years. He was also involved in a few things like the MVP and RD programs and
will speak about computers (and other passions) whenever someone will listen to him. He blogs at
http://www.hanselman.com and podcasts at http://www.hanselminutes.com and contributes to
http://www.asp.net, http://www.windowsclient.net, and http://www.silverlight.net.

Devin Rader is a Product Manager on the Infragistics Web Client team, responsible for leading the
creation of Infragistics ASP.NET and Silverlight products. Devin is also an active proponent and mem-
ber of the .NET developer community, being a co-founder of the St. Louis .NET User Group, an active
member of the New Jersey .NET User Group, a former board member of the International .NET Associ-
ation (INETA), and a regular speaker at user groups. He is also a contributing author on the Wrox title
Silverlight 1.0 and a technical editor for several other Wrox publications and has written columns for
ASP.NET Pro magazine, as well as .NET technology articles for MSDN Online. You can find more of
Devin’s musings at www.geekswithblogs.com/devin.
 Evjen fcredit.tex V1 - 01/28/2008 4:59pm Page vii

Credits
Acquisitions Director Editorial Manager
Jim Minatel Mary Beth Wakefield

Development Editors Production Manager

Adaobi Obi Tulton Tim Tate
Sydney Jones
Vice President and Executive Group Publisher
Technical Editors Richard Swadley
Eric Engler
Alexei Gorkov Vice President and Executive Publisher
Doug Holland Joseph B. Wikert
Darren Kindberg
Mark Strawmeyr Project Coordinator, Cover
Lynsey Stanford
Production Editor
Angela Smith Proofreader
Sossity Smith
Copy Editors
Nancy Rapoport Indexer
Sydney Jones J & J Indexing
 Evjen fack.tex V1 - 01/28/2008 4:59pm Page viii

Acknowledgments

I have said it before, and I will say it again: Writing a book may seem like the greatest of solo endeavors,
but it requires a large team of people working together to get technical books out the door-and this
book is no exception. First and foremost, I would like to thank Jim Minatel of Wrox for giving me the
opportunity to write the original ASP.NET book, which then led to this special edition. There is nothing
better than getting the opportunity to write about your favorite topic for the world’s best publisher!

Besides Jim, I worked with the book’s development editor, Adaobi Obi Tulton. Adaobi kept the book
moving along even with all the interruptions coming our way. Without Adaobi’s efforts, this book would
not have happened.

I worked closely with both Scott Hanselman and Devin Rader on this book, and these guys deserve a lot
of thanks. I appreciate your help and advice throughout the process. Thanks guys!

I would also like to thank the various editors who worked on this book: Alexei Gorkov, Mark Strawmeyr,
Darren Kindberg, Eric Engler, and Doug Holland. Big and ongoing thanks go to the Wrox/Wiley gang
including Joe Wikert (publisher), Katie Mohr (acquisitions editor), and David Mayhew (marketing).

Finally, thanks to my entire family. Book writing is a devil in disguise as it is something that I love to do
but at the same time, takes way too much time away from my family. Thanks to my family for putting
up with this and for helping me get these books out the door. I love you all.

— Bill Evjen
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page ix

Contents

Introduction xxxi

Chapter 1: Application and Page Frameworks 1

Application Location Options 1
Built-In Web Server 2
IIS 3
FTP 4
Web Site Requiring FrontPage Extensions 5
The ASP.NET Page Structure Options 6
Inline Coding 8
Code-Behind Model 10
ASP.NET 3.5 Page Directives 13
@Page 14
@Master 17
@Control 18
@Import 19
@Implements 21
@Register 21
@Assembly 22
@PreviousPageType 22
@MasterType 23
@OutputCache 23
@Reference 24
ASP.NET Page Events 24
Dealing with PostBacks 26
Cross-Page Posting 27
ASP.NET Application Folders 33
\App_Code Folder 33
\App_Data Folder 38
\App_Themes Folder 38
\App_GlobalResources Folder 39
\App_LocalResources 39
\App_WebReferences 39
\App_Browsers 39
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page x

Contents
Compilation 40
Build Providers 44
Using the Built-in Build Providers 45
Using Your Own Build Providers 46
Global.asax 51
Working with Classes Through VS2008 54
Summary 61

Chapter 2: ASP.NET Server Controls and Client-Side Scripts 63

ASP.NET Server Controls 63
Types of Server Controls 64
Building with Server Controls 65
Working with Server Control Events 67
Applying Styles to Server Controls 70
Examining the Controls’ Common Properties 70
Changing Styles Using Cascading Style Sheets 72
HTML Server Controls 76
Looking at the HtmlControl Base Class 79
Looking at the HtmlContainerControl Class 80
Looking at All the HTML Classes 80
Using the HtmlGenericControl Class 81
Manipulating Pages and Server Controls with JavaScript 83
Using Page.ClientScript.RegisterClientScriptBlock 84
Using Page.ClientScript.RegisterStartupScript 86
Using Page.ClientScript.RegisterClientScriptInclude 88
Client-Side Callback 89
Comparing a Typical Postback to a Callback 89
Using the Callback Feature — A Simple Approach 90
Using the Callback Feature with a Single Parameter 96
Using the Callback Feature — A More Complex Example 99
Summary 105

Chapter 3: ASP.NET Web Server Controls 107

An Overview of Web Server Controls 107
The Label Server Control 108
The Literal Server Control 110
The TextBox Server Control 111
Using the Focus() Method 112
Using AutoPostBack 113
Using AutoCompleteType 114

x
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xi

Contents
The Button Server Control 115
The CausesValidation Property 115
The CommandName Property 115
Buttons That Work with Client-Side JavaScript 117
The LinkButton Server Control 119
The ImageButton Server Control 119
The HyperLink Server Control 120
The DropDownList Server Control 121
Visually Removing Items from a Collection 124
The ListBox Server Control 125
Allowing Users to Select Multiple Items 126
An Example of Using the ListBox Control 126
Adding Items to a Collection 129
The CheckBox Server Control 129
How to Determine Whether Check Boxes Are Checked 131
Assigning a Value to a Check Box 131
Aligning Text Around the Check Box 131
The CheckBoxList Server Control 132
The RadioButton Server Control 134
The RadioButtonList Server Control 136
Image Server Control 138
Table Server Control 139
The Calendar Server Control 142
Making a Date Selection from the Calendar Control 142
Choosing a Date Format to Output from the Calendar 144
Making Day, Week, or Month Selections 144
Working with Date Ranges 144
Modifying the Style and Behavior of Your Calendar 147
AdRotator Server Control 151
The Xml Server Control 153
Panel Server Control 153
The PlaceHolder Server Control 156
BulletedList Server Control 157
HiddenField Server Control 162
FileUpload Server Control 164
Uploading Files Using the FileUpload Control 164
Giving ASP.NET Proper Permissions to Upload Files 167
Understanding File Size Limitations 167
Uploading Multiple Files from the Same Page 170
Placing the Uploaded File into a Stream Object 172
Moving File Contents from a Stream Object to a Byte Array 173

xi
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xii

Contents
MultiView and View Server Controls 174
Wizard Server Control 178
Customizing the Side Navigation 180
Examining the AllowReturn Attribute 180
Working with the StepType Attribute 180
Adding a Header to the Wizard Control 181
Working with the Wizard’s Navigation System 182
Utilizing Wizard Control Events 183
Using the Wizard Control to Show Form Elements 184
ImageMap Server Control 189
Summary 192

Chapter 4: Validation Server Controls 193

Understanding Validation 193
Client-Side versus Server-Side Validation 194
ASP.NET Validation Server Controls 195
Validation Causes 196
The RequiredFieldValidator Server Control 197
The CompareValidator Server Control 202
The RangeValidator Server Control 206
The RegularExpressionValidator Server Control 209
The CustomValidator Server Control 211
The ValidationSummary Server Control 216
Turning Off Client-Side Validation 220
Using Images and Sounds for Error Notifications 221
Working with Validation Groups 222
Summary 227

Chapter 5: Working with Master Pages 229

Why Do You Need Master Pages? 229
The Basics of Master Pages 231
Coding a Master Page 233
Coding a Content Page 235
Mixing Page Types and Languages 239
Specifying Which Master Page to Use 241
Working with the Page Title 242
Working with Controls and Properties from the Master Page 243
Specifying Default Content in the Master Page 250
Programmatically Assigning the Master Page 251
Nesting Master Pages 253
Container-Specific Master Pages 257

xii
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xiii

Contents
Event Ordering 258
Caching with Master Pages 259
ASP.NET AJAX and Master Pages 259
Summary 262

Chapter 6: Themes and Skins 263

Using ASP.NET Themes 263
Applying a Theme to a Single ASP.NET Page 263
Applying a Theme to an Entire Application 265
Removing Themes from Server Controls 266
Removing Themes from Web Pages 267
Understanding Themes When Using Master Pages 267
Understanding the StyleSheetTheme Attribute 268
Creating Your Own Themes 268
Creating the Proper Folder Structure 268
Creating a Skin 269
Including CSS Files in Your Themes 272
Having Your Themes Include Images 275
Defining Multiple Skin Options 278
Programmatically Working with Themes 280
Assigning the Page’s Theme Programmatically 280
Assigning a Control’s SkinID Programmatically 281
Themes, Skins, and Custom Controls 281
Summary 286

Chapter 7: Data Binding in ASP.NET 3.5 287

Data Source Controls 287
SqlDataSource Control 289
LINQ Data Source Control 302
AccessDataSource Control 307
XmlDataSource Control 307
ObjectDataSource Control 309
SiteMapDataSource Control 314
Configuring Data Source Control Caching 314
Storing Connection Information 315
Using Bound List Controls with Data Source Controls 317
GridView 318
Editing GridView Row Data 334
Deleting GridView Data 341
DetailsView 344
Inserting, Updating, and Deleting Data Using DetailsView 349

xiii
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xiv

Contents
ListView 350
FormView 360
Other Databound Controls 365
DropDownList, ListBox, RadioButtonList, and CheckBoxList 365
TreeView 366
Ad Rotator 366
Menu 367
Inline Data-Binding Syntax 367
Data-Binding Syntax Changes 368
XML Data Binding 369
Expressions and Expression Builders 369
Summary 375

Chapter 8: Data Management with ADO.NET 377

Basic ADO.NET Features 378
Common ADO.NET Tasks 378
Basic ADO.NET Namespaces and Classes 383
Using the Connection Object 384
Using the Command Object 386
Using the DataReader Object 387
Using Data Adapter 389
Using Parameters 392
Understanding DataSet and DataTable 395
Using Oracle as Your Database with ASP.NET 3.5 400
The DataList Server Control 403
Looking at the Available Templates 403
Working with ItemTemplate 404
Working with Other Layout Templates 407
Working with Multiple Columns 409
The ListView Server Control 410
Looking at the Available Templates 410
Using the Templates 411
Creating the Layout Template 412
Creating the ItemTemplate 414
Creating the EditItemTemplate 415
Creating the EmptyItemTemplate 415
Creating the InsertItemTemplate 416
The Results 416
Using Visual Studio for ADO.NET Tasks 419
Creating a Connection to the Data Source 419
Working with a Dataset Designer 422
Using the CustomerOrders DataSet 427

xiv
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xv

Contents
Asynchronous Command Execution 432
Asynchronous Connections 454
Summary 454

Chapter 9: Querying with LINQ 455

LINQ to Objects 455
Traditional Query Methods 455
Replacing Traditional Queries with LINQ 464
Data Grouping 472
Other LINQ Operators 473
LINQ Joins 473
Paging Using LINQ 475
LINQ to XML 476
Joining XML Data 479
LINQ to SQL 481
Insert, Update, and Delete Queries through LINQ 490
Extending LINQ 494
Summary 495

Chapter 10: Working with XML and LINQ to XML 497

The Basics of XML 498
The XML InfoSet 500
XSD–XML Schema Definition 501
Editing XML and XML Schema in Visual Studio 2008 503
XmlReader and XmlWriter 506
Using XDocument Rather Than XmlReader 508
Using Schema with XmlTextReader 509
Validating Against a Schema Using an XDocument 511
Including NameTable Optimization 513
Retrieving .NET CLR Types from XML 515
ReadSubtree and XmlSerialization 517
Creating CLR Objects from XML with LINQ to XML 518
Creating XML with XmlWriter 519
Creating XML with LINQ for XML 522
Improvements for XmlReader and XmlWriter in 2.0 524
XmlDocument and XPathDocument 525
Problems with the DOM 525
XPath, the XPathDocument, and XmlDocument 525
DataSets 530
Persisting DataSets to XML 530
XmlDataDocument 531

xv
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xvi

Contents
The XmlDataSource Control 533
XSLT 537
XslCompiledTransform 539
XSLT Debugging 543
Databases and XML 544
FOR XML AUTO 545
SQL Server 2005 and the XML Data Type 549
Summary 556

Chapter 11: IIS7 557

Modular Architecture of IIS7 557
IIS-WebServer 558
IIS-WebServerManagementTools 561
IIS-FTPPublishingService 562
Extensible Architecture of IIS7 562
IIS7 and ASP.NET Integrated Pipeline 562
Building a Customized Web Server 564
Update Dependencies 565
Installing IIS7 on Windows Vista 565
Installing IIS7 on Windows Server 2008 565
Command-Line Setup Options 567
Unattended Setup Option 568
Upgrade 569
Internet Information Services (IIS) Manager 569
Application Pools 570
Web Sites 575
Hierarchical Configuration 577
Delegation 581
Moving an Application from IIS6 to IIS7 584
Summary 586

Chapter 12: Introduction to the Provider Model 587

Understanding the Provider 588
The Provider Model in ASP.NET 3.5 589
Setting Up Your Provider to Work with Microsoft SQL Server 7.0, 2000, 2005, or 2008 591
Membership Providers 598
Role Providers 602
The Personalization Provider 606
The SiteMap Provider 608

xvi
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xvii

Contents
SessionState Providers 609
Web Event Providers 612
Configuration Providers 620
The WebParts Provider 623
Configuring Providers 625
Summary 626

Chapter 13: Extending the Provider Model 627

Providers Are One Tier in a Larger Architecture 627
Modifying Through Attribute-Based Programming 628
Simpler Password Structures Through the SqlMembershipProvider 629
Stronger Password Structures Through the SqlMembershipProvider 632
Examining ProviderBase 633
Building Your Own Providers 635
Creating the CustomProviders Application 635
Constructing the Class Skeleton Required 636
Creating the XML User Data Store 640
Defining the Provider Instance in the web.config File 641
Not Implementing Methods and Properties of the MembershipProvider Class 642
Implementing Methods and Properties of the MembershipProvider Class 643
Using the XmlMembershipProvider for User Login 651
Extending Pre-Existing Providers 652
Limiting Role Capabilities with a New LimitedSqlRoleProvider Provider 652
Using the New LimitedSqlRoleProvider Provider 656
Summary 660

Chapter 14: Site Navigation 661

XML-Based Site Maps 662
SiteMapPath Server Control 664
The PathSeparator Property 666
The PathDirection Property 668
The ParentLevelsDisplayed Property 669
The ShowToolTips Property 669
The SiteMapPath Control’s Child Elements 670
TreeView Server Control 670
Identifying the TreeView Control’s Built-In Styles 674
Examining the Parts of the TreeView Control 676
Binding the TreeView Control to an XML File 676
Selecting Multiple Options in a TreeView 679

xvii
 Evjen ftoc.tex V2 - 01/28/2008 5:00pm Page xviii

Contents
Specifying Custom Icons in the TreeView Control 683
Specifying Lines Used to Connect Nodes 685
Working with the TreeView Control Programmatically 687
Menu Server Control 693
Applying Different Styles to the Menu Control 694
Menu Events 700
Binding the Menu Control to an XML File 701
SiteMap Data Provider 703
ShowStartingNode 703
StartFromCurrentNode 704
StartingNodeOffset 705
StartingNodeUrl 706
SiteMap API 706
URL Mapping 709
Sitemap Localization 710
Structuring the Web.sitemap File for Localization 710
Making Modifications to the Web.config File 711
Creating Assembly Resource (.resx) Files 712
Testing the Results 712
Security Trimming 714
Setting Up Role Management for Administrators 715
Setting Up the Administrators’ Section 716
Enabling Security Trimming 718
Nesting SiteMap Files 720
Summary 722

Chapter 15: Personalization 723

The Personalization Model 723
Creating Personalization Properties 725
Adding a Simple Personalization Property 725
Using Personalization Properties 726
Adding a Group of Personalization Properties 730
Using Grouped Personalization Properties 731
Defining Types for Personalization Properties 731
Using Custom Types 732
Providing Default Values 735
Making Personalization Properties Read-Only 735
Anonymous Personalization 735
Enabling Anonymous Identification of the End User 736
Working with Anonymous Identification 739
Anonymous Options for Personalization Properties 739
Warnings about Anonymous User Profile Storage 740

xviii
Exploring the Variety of Random
Documents with Different Content
susceptible of all colours, is itself colourless; and in like manner are the
media or organs of each of the senses destitute of all the other qualities of
sensible things: the organs of smelling and hearing, and the air which
ministers to them, are without smell and sound; the saliva of the tongue and
mouth is also tasteless.
And it is upon this argument that they mainly rely who maintain the
possibility of an incorporeal intellect, viz. because it is susceptible of all
forms without matter; and as the hand is called the “instrument of
instruments,” so is the intellect called “the form of forms,” being itself
immaterial and wholly without form; it is, therefore, said to be possible or
potential, but not passible.
This fluid, or one analogous to it, appears also to be the ultimate aliment
from which Aristotle taught that the semen, or geniture, as he calls it, is
produced.[350] I say the ultimate aliment, called dew by the Arabians, with
which all the parts of the body are bathed and moistened. For in the same
way as this dew, by ulterior condensation and adhesion, becomes alible
gluten and cambium, whence the parts of the body are constituted, so,
mutatis mutandis, in the commencement of generation and nutrition, from
gluten liquefied and rendered thinner is formed the nutritious dew: from the
white of the egg is produced the colliquament under discussion, the radical
moisture and primigenial dew. The thing indeed is identical in either
instance, if any credit be accorded to our observations; and in fact neither
philosophers nor physicians deny that an animal is nourished by the same
matter out of which it is formed, and is increased by that from which it was
engendered. The nutritious dew, therefore, differs from the colliquament or
primigenial moisture only in the relation of prior and posterior; the one is
concocted and prepared by the parents, the other by the embryo itself, both
juices, however, being the proximate and immediate aliment of animals; not
indeed “first and second,” according to that dictum, “contraria ex
contrariis,” but ultimate, as I have said, and as Aristotle himself admonishes
us, according to that other dictum, “similia ex similibus augeri,” “like is
necessarily increased by its like.” There is in either fluid a proximate force,
in virtue of which, no obstacles intervening, it will pass spontaneously, or
by the law of nature, into every part of the animal body.
Such being the state of the question, it is obvious that all controversy
about the matter of animals and their nourishment may be settled without
difficulty. For as some believe that the semen or matter emitted in
intercourse is taken up from every part of the body, so do they derive from
this the resemblance of the offspring to the parents. Aristotle has these
words: “Against the opinion of the ancients, it may be said that as they
avow the semen to be a derivative from all parts else, we believe the semen
to be disposed of itself to form every part; and whilst they call it a
colliquament, we are rather inclined to regard it as an excrement” (he had,
however, said shortly before that he entitled excrement the remains of the
nourishment, and colliquament that which is secreted from the growth by a
preternatural resolution); “for that which arrives last, and is the excrement
of what is final, is in all probability of the same nature; in the same way as
painters have very commonly some remains of colours, which are identical
with those they have applied upon their canvass; but anything that is
consuming and melting away is corrupt and degenerate. Another argument
that the seminal fluid is not a colliquament, but an excrement, is this: that
animals of larger growth are less prolific, smaller creatures more fruitful.
Now there must be a larger quantity of colliquament in larger than in
smaller animals, but less excrement; for as there must be a large
consumption of nourishment in a large body, so must there be a small
production of excrement. Farther, there is no place provided by nature for
receiving and storing colliquament; it flows off by the way that is most
open to it; but there are receptacles for all the natural excrements—the
bowels for the dry excrements, the bladder for the moist; the stomach for
matters useful; the genital organs, the uterus, the mammæ for seminal
matter—in which several places they collect and run together.” After this he
goes on by a variety of arguments to prove that the seminal matter from
which the fœtus is formed is the same as that which is prepared for the
nutrition of the parts at large. As if, should one require some pigment from a
painter, he certainly would not go to scrape off what he had already laid on
his canvass, but would supply the demand from his store, or from what he
had over from his work, which was still of the same nature as that which he
might have taken away from his picture. So and in like manner the
excrement of the ultimate nutriment, or the remainder of the gluten and
dew, is carried to the genital organs and there deposited; and this view is
most accordant with the production of eggs by the hen.
The medical writers, too, who hold all the parts to be originally formed
from the spermatic fluid, and consequently speak of these under the name
of spermatic parts, say that the semen is formed from the ultimate
nourishment, which with Aristotle they believe to be the blood, being
produced by the virtue of the genital organs, and constituting the “matter”
of the fœtus. Now it is obvious enough that the egg is produced by the
mother and her ultimate nutriment, the nutritious dew, to wit. That clear part
of the egg, therefore, that primigenial, or rather antegenial colliquament, is
more truly to be reputed the semen of the cock, although it is not projected
in the act of intercourse, but is prepared before intercourse, or is gathered
together after this, as happens in many animals, and as will perhaps be
stated more at length by and by, because the geniture of the male, according
to Aristotle, coagulates.
When I see, therefore, all the parts formed and increasing from this one
moisture, as “matter,” and from a primitive root, and the reasons already
given combine in persuading us that this ought to be so, I can scarcely
refrain from taunting and pushing to extremity the followers of Empedocles
and Hippocrates, who believed all similar bodies to be engendered as
mixtures by association of the four contrary elements, and to become
corrupted by their disjunction; nor should I less spare Democritus and the
Epicurean school that succeeded him, who compose all things of
congregations of atoms of diverse figure. Because it was an error of theirs
in former times, as it is a vulgar error at the present day, to believe that all
similar bodies are engendered from diverse or heterogeneous matters. For
on this footing, nothing even to the lynx’s eye would be similar, one, the
same, and continuous; the unity would be apparent only, a kind of congeries
or heap—a congregation or collection of extremely small bodies; nor would
generation differ in any respect from a [mechanical] aggregation and
arrangement of particles.
But neither in the production of animals, nor in the generation of any
other “similar” body (whether it were of animal parts, or of plants, stones,
minerals, &c.), have I ever been able to observe any congregation of such a
kind, or any divers miscibles pre-existing for union in the work of
reproduction. For neither, in so far at least as I have had power to perceive,
or as reason will carry me, have I ever been able to trace any “similar”
parts, such as membranes, flesh, fibres, cartilage, bone, &c., produced in
such order, or as coexistent, that from these, as the elements of animal
bodies, conjoined organs or limbs, and finally, the entire animal, should be
compounded. But, as has been already said, the first rudiment of the body is
a mere homogeneous and pulpy jelly, not unlike a concrete mass of
spermatic fluid; and from this, under the law of generation, altered, and at
the same time split or multifariously divided, as by a divine fiat, from an
inorganic an organic mass results; this is made bone, this muscle or nerve,
this a receptacle for excrementitious matter, &c.; from a similar a dissimilar
is produced; out of one thing of the same nature several of diverse and
contrary natures; and all this by no transposition or local movement, as a
congregation of similar particles, or a separation of heterogeneous particles
is effected under the influence of heat, but rather by the segregation of
homogeneous than the union of heterogeneous particles.
And I believe that the same thing takes place in all generation, so that
similar bodies have no mixed elements prior to themselves, but rather exist
before their elements (these, according to Empedocles and Aristotle, being
fire, air, earth, and water; according to chemists, salt, sulphur, and mercury;
according to Democritus, certain atoms), as being naturally more perfect
than these. There are, I say, both mixed and compound bodies prior to any
of the so called elements, into which they are resolved, or in which they
end. They are resolved, namely, into these elements according to reason
rather than in fact. The so-called elements, therefore, are not prior to those
things that are engendered, or that originate, but are posterior rather—they
are relics or remainders rather than principles. Neither Aristotle himself nor
any one else has ever demonstrated the separate existence of the elements in
the nature of things, or that they were the principles of “similar” bodies.
The philosopher,[351] indeed, when he proceeds to prove that there are
elements, still seems uncertain whether the conclusion ought to be that they
exist in esse, or only in posse; he is of opinion that in natural things they are
present in power rather than in action; and therefore does he assert, from the
division, separation, and solution of things, that there are elements. It is,
however, an argument of no great cogency to say that natural bodies are
primarily produced, or composed of those things into which they are
ultimately resolved; for upon this principle some things would come out
composed, of glass, ashes, and smoke, into which we see them finally
reduced by fire; and as artificial distillation clearly shows that a great
variety of vapours and waters of different species can be drawn from so
many different bodies, the number of elements would have to be increased
to infinity. Nor has any one among the philosophers said that the bodies
which, dissolved by art, are held pure and indivisible in their species, are
elements of greater simplicity than the air, water, and earth, which we
perceive by our senses, which we are familiar with through our eyes.
Nor, to conclude, do we see aught in the shape of miscible matter
naturally engendered from fire; and it is perhaps impossible that it should
be so, since fire, like that which is alive, is in a perpetual state of fluxion,
and seeks for food by which it may be nourished and kept in being; in
conformity with the words of Aristotle,[352] that “Fire is only nourished,
and is especially remarkable in this.” But what is nourished cannot itself be
mingled with its nutriment. Whence it follows that it is impossible fire
should be miscible. For mixture, according to Aristotle, is the union of
altered miscibles, in which one thing is not transformed into another, but
two things, severally active and passive, into a third thing. Generation,
however, especially generation by metamorphosis, is the distribution of one
similar thing having undergone change into several others. Nor are mixed
similar bodies said to be generated from the elements, but to be constituted
by them in some certain way, solvent forces residing in them at the same
time.
These considerations, however, properly belong to the section of
Physiology, which treats of the elements and temperaments, where it will be
our business to speak of them more at large.
 ON PARTURITION.
On generation follows parturition, that process, viz. by which the fœtus
comes into the world and breathes the external air. I have, therefore, thought
it well worth while, and within the scope of my design, to treat briefly of
this subject. With Fabricius, then, I shall consider the causes, the manner,
and the seasons of this process, as well as the circumstances which both
precede and follow it. The circumstances which occur immediately previous
to birth, and which, in women especially, indicate that the act of parturition
is not far distant, are, on the one hand, such a preparation and arrangement
on the part of the mother as may enable her to get rid of her offspring; and
on the other, such a disposition of the fœtus as may best facilitate its
expulsion.
With respect to the latter, viz. the position of the fœtus, Fabricius says,
[353] “that it is disposed in a globular form and bent upon itself, in order that
its extremities and prominent points generally may not injure the uterus and
the containing membranes; another reason being that it may be packed in as
small a space as possible.” For my own part, I cannot think that these are
the reasons why the limbs of the fœtus are always kept in the same position.
Swimming and moving about, as it does, in water, it extends itself in every
direction, and so turns and twists itself that occasionally it becomes
entangled in a marvellous manner in its own navel-string. The truth is, that
all animals, whilst they are at rest or asleep, fold up their limbs in such a
way as to form an oval or globular figure: so in like manner embryos,
passing as they do the greater part of their time in sleep, dispose their limbs
in the position in which they are formed, as being most natural and best
adapted for their state of rest. So too the infant in utero is generally found
disposed after this manner: the knees are drawn up towards the abdomen,
the legs flexed, the feet crossed, and the hands directed to the head, one of
them usually resting on the temples or ears, the other on the chin, in which
situation white spots are discernible on the skin as the result of friction; the
spine, moreover, is curved into a circle, and the neck being bowed, the head
falls upon the knees. In such a position is the embryo usually found, as that
which we naturally take in sleep; the head being situated superiorly, and the
face usually turned towards the back of the mother. A short time, however,
before birth the head is bent downwards towards the orifice of the uterus,
and the fœtus, as it were, in search of an outlet, dives to the bottom. Thus
Aristotle:[354] “All animals naturally come forth with the head foremost;
but cross and foot presentations are unnatural.” This, however, does not
hold universally; but as the position in utero varies, so too does the mode of
exit; this may be observed in the case of dogs, swine, and other multiparous
animals. The human fœtus even has not always the same position; and this
is well known to pregnant women, who feel its movements in very different
parts of the uterus, sometimes in the upper part, sometimes in the lower, or
on either side.
In like manner the uterus, when the term of gestation is completed,
descends lower (in the pelvis), the whole organ becomes softer, and its
orifice patent. The “waters” also, as they are vulgarly called, “gather;” that
is, a portion of the chorion, in which the watery matter is contained, gets in
front of the fœtus, and falls from the uterus into the vagina; at the same time
the neighbouring parts become relaxed and dilatable; in addition to which
the cartilaginous attachments of the pelvic bones so lose their rigidity that
the bones themselves yield readily to the passage of the fœtus, and thus
greatly increase the area of the hypogastric region. When all these
circumstances concur, it is quite clear that delivery is not far distant. Nature,
in her provident care, contrives this dilatation of the parts in order that the
fœtus may come into the world like the ripe fruit of a tree; just as she fills
the breasts of the mother with milk that the being who is soon to enjoy an
independent existence may have whereon to subsist. These, then, are the
circumstances which immediately precede birth; and thus it happens that
the presence of milk has especially been regarded as a sign of approaching
delivery—milk, I mean, of a character suitable for the sustenance of the
offspring; and this, according to Aristotle,[355] is only visible at the period
of birth; it is therefore never observed before the seventh month of
pregnancy.
Fabricius[356] maintains that on the subject of parturition there were two
special heads of inquiry, viz. the time at which and the manner in which the
process took place. Under the first of these heads he considers the term of
utero-gestation; under the second, the way in which the fœtus comes into
the world.
 Aristotle[357] thought that the term of utero-gestation varied much.
“There is,” he says, “a certain definite term to each animal, determined in
the majority of cases by the animal’s duration of life; for it follows of
necessity that a longer period is required for the production of the longer-
lived animals.” He attributes, however, the chief cause to the size of the
animal; “for it is scarcely possible,” he continues, “that the vast frames of
animals or of aught else can be brought to perfection in a short period of
time. Hence it is that in the case of mares and animals of cognate species,
though their duration of life is small, their term of utero-gestation is
considerable; and thus the elephant carries its young for the space of two
years, the reason being its enormous size, for each animal has a definite
magnitude, beyond which it cannot pass.” I would add, that the material of
which each is formed has also its fixed limit in point of quantity. He says,
moreover, “There is good reason why animals should have the periods of
gestation, generation, and duration of life in certain cycles—I mean by
cycle, a day, night, month, and year, and the time which is described by
these; also the motions of the moon—for these are the common origin of
generation to all. For it is in accordance with reason that the cycles of
inferior things should follow those of the higher.” Nature, then, has decreed
that the birth and death of animals should have their period and limit after
this manner.
Just as the birth of animals depends on the course of the sun and moon,
so have they various seasons for copulation and different terms of utero-
gestation, these last being longer or shorter according to circumstances. “In
the human species alone,” says the philosopher in the same part of his
works, “is the period of utero-gestation subject to great irregularity. In other
animals there is one fixed time, but in man several; for the human fœtus is
expelled both in the seventh and tenth months, and at any period of
pregnancy between these; moreover, when the birth takes place in the
eighth month, it is possible for the infant to live.” In the majority of animals
there is a distinct season for bringing forth their young; this is generally
found to be in the spring, when the sun returns, but in many species it is in
the summer, and in some in the autumn, as is the case with the cartilaginous
fishes. Hence it is that animals, as the time of labour approaches, seek their
accustomed haunts, and provide a safe and comfortable shelter where they
may bring forth and rear their young. Hence, too, the title “bird-winds,”
applied to those gales which prevail toward the beginning of spring, the
word owing its origin to the fact of certain birds at that period of the year
availing themselves of these winds to accomplish their migrations. In like
manner stated seasons are observed by those fishes which congregate in
myriads in certain places for the purpose of rearing their young. Moreover,
in the spring, as soon as caterpillars fall under our notice (their ova, as may
be observed by the way, like to invisible atoms, being for the most part
carried by the winds, and not owing their origin, as commonly supposed, to
spontaneous generation, or to be looked upon as the result of putrefaction),
straightway the trees put forth their buds, soon to be devoured by these
creatures; and these in their turn fall victims to birds innumerable, and are
carried to the nest as food for the young brood. So constantly does this hold,
that whenever strange species of caterpillars fall under notice, at the same
time we are sure to see some rare and foreign birds, as if the latter had
chased the former from some remote corner of the earth. Now in both of
these classes of creatures the time for bringing forth their young is the
same. Physicians, too, when these phenomena occur, are enabled to predict
the approach of sundry strange diseases. Bees bring forth in the month of
May, when honey abounds; wasps in the summer, when the fruit is ripe; and
this is analogous to what takes place in viviparous animals, who produce
their young at the period when their milk is best adapted for their offspring.
But other animals of the non-migratory classes, in the same way, at stated
seasons seek a place to deposit their young as they do a store of food. And
thus it results that the countryman is able to decide what are the proper
seasons for ploughing, sowing, and getting in his harvest, forming his
opinion chiefly from the approach of flocks of birds, and especially of the
seminivora. There are, however, some animals in whom there is no fixed
time for production, and this is chiefly the case with those which are called
domestic, and live with the human species. These both copulate and
produce their young at uncertain seasons, and the reason probably is to be
sought for in the larger quantity of food they consume, and the consequent
inordinate salacity. But in these, as in the human species, the process of
parturition is often difficult and dangerous.
There are other animals also on whom the course of the moon has
influence, and which consequently copulate and bring forth their young at
certain periods of the year—rabbits, mice, and the human female may be
instanced. “For the moon,” observes Plutarch,[358] “when half full, is
represented as greatly efficacious in shortening the pains of labour, and this
she effects by moderating and relaxing the humours—hence, I think, those
surnames of Diana are derived, Locheia, i. e. the tutelar deity of childbirth,
and Eilytheia, otherwise Lucina; for Diana and the moon are synonymous.”
“In all other animals,” says Pliny,[359] “there are stated seasons and
periods for production and utero-gestation; in man alone are they
undetermined.” And this is, to a great extent, true; for in his case, although
nature has laid down for the most part certain boundaries, yet there is
sometimes a vast difference in individuals, and instances are recorded of
women bringing forth viable children, some in the seventh, and others in
the fourteenth month. Further, although Aristotle[360] asserts “that the
majority of eight months’ children in Greece die,” he still admits “that they
survive in Egypt and in some other countries, where the women have easy
labours;” and although he says “that children born before the seventh month
can under no circumstances survive, and that the seventh month is the first
in which anything like maturity exists, and that the feebleness of children
born even then is such as to make it necessary to wrap them in wool,” he
still allows “that these are viable.” Franciscus Valesius tells us of a girl in
his time, who, although a five months’ child, had arrived at the age of
twelve years. Adrianus Spigelius[361] also records the case of a certain
courier, “who proved to the satisfaction of all, on the public testimony of
the city of Middleburgh, that he was born at the commencement of the sixth
month, and that his frame was so slight and fragile that his mother found it
necessary to wrap him up in cotton until such times as he was able to bear
the ordinary dress of infants.” Avicenna[362] also states that a sixth months’
child is very capable of surviving. In like manner it is proved, both by
ancient and modern authorities, that children may live who are born after
the completion of the eleventh month. “We are told,” says Pliny,[363] “by
Massurius, that when his inheritance was claimed by the next heir, Lucius
Papyrius the prætor gave the decision against the claimant, although, by his
mother’s account, Massurius was a thirteen months’ child—the ground of
the judgment being that the term of utero-gestation had not been as yet
accurately determined. There was indeed, not so long since, a woman in our
own country who carried her child more than sixteen months, during ten of
which she distinctly felt the movements of the fœtus, as indeed did others,
and at last brought forth a living infant. These are rare contingencies, I will
allow; and therefore it is hardly fair of Spigelius to blame Ulpianus the
lawyer because he regarded as legitimate no child born after the completion
of the tenth month. Both laws and precepts of art, we must remember, have
reference to the general rules of vital processes. Besides, it is impossible to
deny that many women, either for purposes of gain or from fear of
punishment, have simulated pregnancy, and not hesitated to swear to the
truth of their assertion:—others again have frequently been deceived, and
fancied themselves pregnant, whilst the uterus has contained no product of
conception. On this point Aristotle’s[364] words may be quoted: “The exact
period at which conception takes place in the case of those born after the
eleventh month can scarcely be ascertained. Women themselves do not
know the time at which they conceive; for the uterus is often affected by
flatulent disorders, and if under these circumstances conception takes place,
women imagine this flatulency to mark the period of conception, because
they have recognized certain symptoms which accompany actual
conception.”
In the case of other women in whom the fœtus has died in the third or
fourth month, then putrefied, and come away in the form of fetid lochial
discharges, we have known superfœtation to take place; and yet these same
women have persisted that they have brought forth their children after the
completion of the fourteenth month. “It happens sometimes,” says Aristotle,
[365] “that an abortion takes place, and ten or twelve products of
superfœtation come away. But if the (second) conception takes place soon
after (the first), the woman goes to the full time with the second, and brings
forth both as twins. This was said to have been the case in the fable of
Iphicles and Hercules. And it is a subject which admits of proof; for it is
known of a woman that she brought forth one child resembling her
husband, and another like a man with whom she had had adulterous
intercourse. Another woman became pregnant of twins, and conceived
another by superfœtation. Her labour came on, and she brought forth the
twins well formed and at their proper time, whilst the third child was at the
fifth month, and so died immediately.”
A certain maid-servant being gotten with child by her master, to conceal
her disgrace, fled to London in the month of September; here she was
delivered, and returned home with her health restored. In December,
however, the birth of another child, conceived by superfœtation, proclaimed
to the world the fault she had committed. “It happened to another woman,”
adds the philosopher, “to be delivered of a seven months’ child, and
afterwards of twins at the full term, the single child dying, the twins
surviving. Other women also, having become pregnant of twins, have
miscarried of one, and borne the other to the full term.” It is very easy to
understand how, if the earlier or later product of superfœtation come away
after three or four months have elapsed, that mistakes may be made in
calculating the subsequent months, especially by credulous and ignorant
women. We have sometimes observed, both in women and other animals,
the product of conception perish, and come away gradually in the form of a
thin fluid, somewhat resembling fluor albus. Not long since a woman in
London, after an abortion of this kind, conceived anew, and brought forth a
child at the proper period. Subsequently, however, after a lapse of some
months, as she was engaged in her ordinary duties, without any pain or
uneasiness, there came away piecemeal some dark bones belonging to the
fœtus of which she had formerly miscarried. I was able to recognize in
some of the fragments portions of the spine, femur, and other bones.
I am acquainted with a young woman, the daughter of a physician with
whom I am very intimate, who experienced in her own person all the usual
symptoms of pregnancy; after the fourteenth week, being healthy and
sprightly, she felt the movements of the child within the uterus, calculated
the time at which she expected her delivery, and when she thought, from
further indications, that this was at hand, prepared the bed, cradle, and all
other matters ready for the event. But all was in vain. Lucina refused to
answer her prayers; the motions of the fœtus ceased; and by degrees,
without inconvenience, as the abdomen had increased so it diminished; she
remained, however, barren ever after. I am acquainted also with a noble
lady who had borne more than ten children, and in whom the catamenia
never disappeared except as the result of impregnation. Afterwards,
however, being married to a second husband, she considered herself
pregnant, forming her judgment not only from the symptoms on which she
usually relied, but also from the movements of the child, which were
frequently felt both by herself and her sister, who occupied the same bed
with her. No arguments of mine could divest her of this belief. The
symptoms depended on flatulence and fat. Hence the best ascertained signs
of pregnancy have sometimes deceived not only ignorant women, but
experienced midwives, and even skilful and accurate physicians—so that as
mistakes are liable to arise, not only from deception on the part of the
women themselves, but also from the erroneous tokens of pregnancy, I
should say that no rule is to be rashly laid down with respect to births taking
place before the seventh or after the fourteenth month.
Unquestionably the ordinary term of utero-gestation is that which we
believe was kept in the womb of his mother by our Saviour Christ, of men
the most perfect; counting, viz. from the festival of the Annunciation, in the
month of March, to the day of the blessed Nativity, which we celebrate in
December. Prudent matrons, calculating after this rule, as long as they note
the day of the month in which the catamenia usually appear, are rarely out
of their reckoning; but after ten lunar months have elapsed, fall in labour,
and reap the fruit of their womb the very day on which the catamenia would
have appeared, had impregnation not taken place.
As regards the causes of labour, Fabricius, besides that of Galen[366]
(who held “that the fœtus was retained in utero until it was sufficiently
grown and nourished to take food by the mouth,” according to which theory
weakly children ought to remain in utero longer than others, which they do
not), gives another and a better reason, viz. “the necessity the fœtus feels
for more perfectly cooling itself by respiration, since the child breathes
immediately on birth, but does not take food by the mouth. This is not only
the case,” he continues, “in man and quadrupeds, but has been particularly
observed in birds: these, small as they are, and furnished as yet with but
tender bills, peck through the egg-shell at the point where they have need of
respiration; and they do this rather through want of breath than of food,
since the instant they quit the shell the function of respiration begins, whilst
they remain without eating for two days, or longer.” This point, however,
whether the object of respiration be really to “cool” the animal, shall be
discussed elsewhere at greater length.
In the mean time I would propose this question to the learned—How
does it happen that the fœtus continues in its mother’s womb after the
seventh month? seeing that when expelled after this epoch, not only does it
breathe, but without respiration cannot survive one little hour; whilst, as I
before stated, if it remain in utero, it lives in health and vigour more than
two months longer without the aid of respiration at all. To state my meaning
more plainly—how is it that if the fœtus is expelled with the membranes
unbroken, it can survive some hours without risk of suffocation; whilst the
same fœtus, removed from its membranes, if air has once entered the lungs,
cannot afterwards live a moment without it, but dies instantly? Surely this
cannot be from want of “cooling,” for in difficult labours it often happens
that the fœtus is retained in the passages many hours without the possibility
of breathing, yet is found to be alive; when, however, it is once born and
has breathed, if you deprive it of air it dies at once. In like manner children
have been removed alive from the uterus by the Cæsarean section many
hours after the death of the mother; buried as they are within the
membranes, they have no need of air; but as soon as they have once
breathed, although they be returned immediately within the membranes,
they perish if deprived of it. If any one will carefully attend to these
circumstances, and consider a little more closely the nature of air, he will, I
think, allow that air is given neither for the “cooling” nor the nutrition of
animals; for it is an established fact, that if the fœtus has once respired, it
may be more quickly suffocated than if it had been entirely excluded from
the air: it is as if heat were rather enkindled within the fœtus than repressed
by the influence of the air.
Thus much, by the way, on the subject of respiration; hereafter, perhaps,
I may treat of it at greater length. As the arguments on either side are very
equally balanced, it is a question of the greatest difficulty.
To return to parturition. Besides the reasons alluded to above, viz. “the
necessity for respiration and the want of nourishment,” Fabricius gives
another; he says, “that the weight of the fœtus becomes so great as to exert
considerable pressure, and the bulk such that the uterus is unable to retain it,
added to which the quantity of excrementitious matter is so much increased
that it cannot be contained by the membranes.”[367]
Now it has been shown above that the uterine humours are not
excrementitious. Nor do the weight and bulk of the fœtus help us to a more
probable explanation; for the fœtus suspended in water weighs but slightly
on the placenta or uterus; besides which some nine months’ children are
very small, much less in fact than many fœtuses of eight months,
nevertheless they do not abide longer in the womb. And as to weight, any
twins of eight months are far heavier than a single nine months’ child; yet
they are not expelled before nine months are completed. Nor do we find a
better reason in “want of nutriment;” twins, and even more children, are
abundantly supplied with support up to the full term; and the milk which
after delivery is sufficient for the nourishment of the child, could equally
well, if transferred to the uterus, nourish the fœtus there.
I should rather attribute the birth of the child to the following reason—
that the juices within the amnion, hitherto admirably adapted for nutriment,
at that particular period either fail or become contaminated by
excrementitious matter. I have touched on this subject before. The variation
in the term of utero-gestation, occurring as it does chiefly in the human
species, I believe to depend on the habits of life, feebleness of body, and on
the various affections of the mind. And thus in the case of domesticated
animals, owing to their indolence and overfeeding, the seasons both of
copulation and production are less fixed and certain than in the wilder
tribes. So women in robust health usually experience easy and rapid
labours; the contrary holding good in those whose constitutions are
shattered by disease. For the same thing befalls them that happens to plants,
the seeds and fruits of which come later and less frequently to perfection in
cold climates than in those where the soil is good and the sun powerful.
Thus oranges in this country usually remain on the tree two years before
they arrive at maturity; and figs, which in Italy ripen two or three times
annually, scarcely come to perfection in our climate:—the same thing
happens to the fruit of the womb; it depends on the abundance or deficiency
of nutriment, on the strength or weakness of body, and on the right or
wrong ordering of life with reference to what physicians call the “non-
naturals,” whether the child arrives sooner or later at maturity, i. e. is born.
Fabricius describes the manner of parturition as follows: “The uterus
having been so enlarged by the bulk of the fœtus that it will admit of no
further distension without risk, and thus excited to expulsion, is drawn into
itself by the action of the transverse fibres, and diminishes its cavity. Thus
whilst previously neither the excrementitious matters from their quantity,
nor the fœtus from its bulk, could be contained within it, the uterus,
contracted and compressed as it is now, becomes still less able to retain
them. Wherefore, first of all, the membranes, as being the weaker parts, and
suffering most pressure, are ruptured, and give exit to the waters, which are
of a very fluid consistence, for the purpose of lubricating the passages. Then
follows the fœtus, which tends towards, and, as it were, assaults the uterine
aperture, not only by the force of its own gravity as no longer floating in
water, but compressed and propelled by the action of the uterus: the
abdominal muscles and the diaphragm also assist mightily in the entire
process.”
Now in these words Fabricius rather describes the process of defæcation
or an abortion than a genuine and natural birth. For although in women, as a
general rule, the membranes are ruptured before the escape of the fœtus, it
is not universally so; nor does it hold in the case of other animals which
bring forth their young enveloped in their membranes. This can be observed
in the bitch, ewe, mare, and others, and more particularly in the viper,
which conceives an ovum of an uniform colour and soft shell (resembling
in fact the product of conception in the woman); this is retained until the
fœtus is completely formed; it is then expelled entire, and, according to
Aristotle,[368] is broken through by the young animal on the third day. It
sometimes happens, however, that kittens, whilst yet in utero, gnaw through
the membranes, and so come into the world uninvolved.
And so also, according to the observation of experienced midwives,
women have occasionally expelled the child with the membranes unbroken.
And this kind of birth, in which the fœtus is born enveloped in its
coverings, appears to me by far the most natural; it is like the ripe fruit
which drops from the tree without scattering its seed before the appointed
time. But where it is otherwise, and the placenta, subsequently to birth,
adheres to the uterus, there is great difficulty in detaching it, grave
symptoms arise, fetid discharges, and sometimes gangrene occur, and the
mother is brought into imminent peril.
Since then the process of parturition, as described by Fabricius, does not
apply to all animals, but to women alone, and this not universally, but only
where the labour is premature, and, as it were, forced, we must regard it not
so much as a description of a natural as of a preternatural and hurried
delivery, in fact, of an abortion.
In natural and genuine labour two things are required, which mutually
bear upon and assist each other: these are, the mother which produces, and
the child to be produced; and unless both are ready to play their part, the
labour will hardly terminate favorably, requiring as it does the proper
maturity of both. For if, on the one hand, the fœtus, from restlessness and
over-desire to make its way out, does violence to the uterus, and thus
anticipates the mother; or if, on the contrary, the mother, owing to
feebleness of the uterus, or any other circumstance necessitating expulsion,
is beforehand with the fœtus, this is to be looked upon rather as the result of
disease than as a natural and critical birth. The same may be said of those
cases where parts only of the product of conception escape, whilst others
remain; for instance, if the fœtus itself is disposed to come away when the
placenta is not yet separated from the uterus, or, on the other hand, if the
placenta is separated when the fœtus is not rightly placed, or the uterus is
not sufficiently relaxed to allow of its passage. Hence it is that midwives are
so much to blame, especially the younger and more meddlesome ones, who
make a marvellous pother when they hear the woman cry out with her pains
and implore assistance, daubing their hands with oil, and distending the
passages, so as not to appear ignorant in their art—giving besides medicines
to excite the expulsive powers, and when they would hurry the labour,
retarding it and making it unnatural, by leaving behind portions of the
membranes, or even of the placenta itself, besides exposing the wretched
woman to the air, wearying her out on the labour-stool, and making her, in
fact, run great risks of her life. In truth, it is far better with the poor, and
those who become pregnant by mischance, and are secretly delivered
without the aid of a midwife; for the longer the birth is retarded the more
safely and easily is the process completed.
Of unnatural labours, therefore, there are chiefly two kinds: either the
fœtus is born before the proper time (and this constitutes an abortion), or
else subsequently to it, when a difficult or tedious labour is the result, either
from the due time and order not being preserved, or from the presence of
dangerous symptoms; these arise either from failure of the expelling powers
on the part of the mother, or from sluggishness on the part of the fœtus in
making its way out; it is when both perform their proper parts that a safe
and genuine labour results.
Fabricius ascribes the business of expelling the offspring to the uterus;
and he adds, “the abdominal muscles and the diaphragm assist in the
business.” It seems to me, however, on deep investigation, that the throes of
childbirth, just as sneezing, proceed from the motion and agitation of the
whole body. I am acquainted with a young woman who during labour fell
into so profound a state of coma that no remedies had power to rouse her,
nor was she in fact able to swallow. When called to her, finding that
injections and other ordinary remedies had been employed in vain, I dipped
a feather in a powerful sternutatory, and passed it up the nostrils. Although
the stupor was so profound that she could not sneeze, or be roused in any
way, the effect was to excite convulsions throughout the body, beginning at
the shoulders, and gradually descending to the lower extremities. As often
as I employed the stimulus the labour advanced, until at last a strong and
healthy child was born, without the consciousness of the mother, who still
remained in a state of coma.
We can observe the manner of labour-pains in other animals, as the
bitch, sheep, and larger cattle, and ascertain that they do not depend on the
action of the uterus and abdomen only, but on the efforts of the whole body.
The degree in which the offspring contributes to accelerate and facilitate
birth is made clear from observations on oviparous animals; in these it is
ascertained that the shell is broken through by the fœtus and not by the
mother. Hence it is probable that in viviparous animals also the greater part
of delivery is due to the fœtus—to its efforts, I mean, not to its gravity, as
Fabricius would have it. For what can gravity do in the case of quadrupeds
standing or sitting, or in the woman when lying down? Nor are the efforts
of the fœtus to get out, the result, as he believes, of its own bulk or of that
of the waters; the waters, it is true, when the fœtus is dead and decomposed,
by their putrid and acrimonious nature, stimulate the uterus to expel its
contents; but it is the fœtus itself which, with its head downwards, attacks
the portals of the womb, opens them by its own energies, and thus struggles
into day. Wherefore a birth of this kind is held the more speedy and
fortunate; “it is contrary to nature,” says Pliny,[369] “for a child to be born
with the feet foremost; hence those so born were called Agrippæ, i. e. born
with difficulty”—(ægre parti), for in such the labour is tedious and painful.
Notwithstanding this, in cases of abortion, or where the fœtus is dead, or, in
fact, when any difficulty arises in the delivery so as to require manual aid, it
is better that the feet should come first; they act as a wedge on the narrow
uterine passages. Hence, when we chiefly depend upon the fœtus, as being
lively and active, to accomplish delivery, we must do our best that the head
escape first; but if the business is to be done by the uterus, it is advisable
that the feet come foremost.
We are able to observe in how great a degree the fœtus contributes to
delivery, not only in birds, which, as I have said above, break through the
shell by their own powers, but also in many other animals. All kinds of flies
and butterflies pierce the little membrane in which they lie concealed as
“aureliæ;” the silkworm also, at its appointed time, softens by moistening,
and then eats through the silken bag which it had spun round itself for
protection, and makes its way out without any foreign aid. In the same
manner wasps, hornets, all insects in fact, and fishes of every kind, are born
by their own will and powers. This can be best seen in the skate, fork-fish,
lamprey, and the cartilaginous fishes generally. These conceive a perfect
two-coloured egg, made up, that is, of albumen and yelk, and contained in a
strong quadrangular shell; from this, still retained within the uterus, the
young fish is formed: it then breaks through the shell, and makes its way
out. In an exactly similar manner the young viper eats through the egg-
shell, sometimes whilst it remains in utero, sometimes when within the
passages, at others two or three days after birth. Hence arose the fable of the
young viper eating through the womb of its mother, and so avenging its
father’s death; it does, in fact, nothing but what the young of every animal
does, breaking though the membranes which envelope it, either in the
delivery itself, or a short time subsequently to that event.
We learn moreover from positive observations how much the fœtus
contributes to its own birth. A woman in my own neighbourhood, and I
speak as having knowledge of the circumstance, died one evening, and the
body was left by itself in a room; the next morning an infant was found
between the thighs of the mother, having evidently forced its way out by its
own efforts. Gregorius Nymmanus has collected several instances of a
similar kind from trustworthy authors.
I am further acquainted with a woman who had the whole length of the
vagina so torn and injured in a difficult labour, that subsequently, after she
had again become pregnant, not only did the parts in the neighbourhood of
the nymphæ, but the whole cavity of the vagina as far as the orifice of the
uterus, become adherent; this went to such an extent that coition became
impossible, nor could a probe be passed up, nor was there any passage left
for the ordinary discharges. When her labour came on her sufferings were
so dreadful that all hope of delivery was abandoned. She therefore gave up
the keys to her husband, arranged her affairs, and took leave of her friends
who were present. On a sudden, however, by the violent efforts of the fœtus
the whole space was burst through, and a vigorous infant born; thus was the
fœtus the salvation both of itself and its mother, besides opening the way
for subsequent children. By the exhibition of proper remedies the mother
recovered her former good state of health.
 The following instance is even more remarkable. A white mare of great
beauty had been presented to her Serene Highness the Queen, and in order
that its symmetry and usefulness might not be impaired by foal-bearing, the
grooms, as is the custom, had infibulated the animal with iron rings. This
mare (by what chance I know not, nor could the grooms inform me) was got
with foal; and at length, when no one suspected anything of the kind, she
foaled in the night, and a living foal was found the next morning by the
mother’s side. When I heard of the circumstance I went immediately to the
place, and found the sides of the vulva still fastened together by the rings,
but the whole pudendum on the left side so thrust and torn away from the
pelvis by the almost incredible efforts of the fœtus, that a gap sufficiently
wide was made to admit of its escape. Such is the force and vigour of a full-
grown and healthy fœtus.
But, on the contrary, if the fœtus is diseased or feeble, or is bom before
the full term, it must be considered more an abortion than a regular birth,
the fœtus being expelled rather than born; and thus for some days after birth
it neither properly takes the breast nor gets rid of its excretions.
And yet the following example will show that the uterus also contributes
towards delivery. A poor washerwoman had long suffered from procidentia
uteri to such an extent that a tumour hung between the thighs as large as the
fist. As no remedies had been applied, the prolapsed part became so rough
and wrinkled as to take on the appearance of the scrotum, and in this state
she suffered less than at the commencement of her illness. When consulted
on her case, I ordered her to keep her bed for several days, to employ
fomentations and ointments, and after the uterus was returned, to keep it in
its place by means of pessaries and bandages, until by the use of
strengthening applications it should be fixed firmly in its place. This plan
was followed by some success; but she soon suffered a relapse, when
compelled by her circumstances to follow her usual occupations, and
continue long in the erect position. She bore, however, her inconvenience
with patience, the uterus at times protruding, at others not doing so. At night
she could usually reduce it, and it remained for some time in its proper
place. After the lapse of a few days she returned, and complained that the
uterus was so swelled from the use, as she thought, of the remedies, and
especially of the fomentations, that it could not any longer be retained. By
using some applications she was enabled to accomplish the reduction; but
the cure was only temporary, for as soon as she stood up, and followed her
ordinary occupations, the uterus immediately gave her much inconvenience
by its weight, and at length entirely prolapsed. And now it hung down to the
middle of the thigh, like the scrotum of a bull, to such an extent that I
suspected not only the vagina but also the uterus to be inverted, or that there
was some kind of uterine hernia. At length the tumour exceeded in
magnitude a man’s head, acquired a resisting character, and hung down as
low as the knees; it also gave her much pain, and prevented her walking
except in the prone position; added to which it discharged a sanious fluid
from its inferior part, as if some portion had ulcerated. On ocular inspection
(for I did not employ the touch) I feared that cancer or carcinoma might
result, and so thought of the ligature or excision; in the mean time I advised
the employment of soothing fomentations to ease the pain. The following
night, however, a fœtus of a span long, perfectly formed, but dead, was
expelled from the tumour, and was brought to me the next day. I took out
the intestines, and kept it in cold water without decomposition for many
months, showing it to my friends as an extraordinary object of curiosity.
The proper skin in this fœtus was not yet formed, but in its place there was
a pellicle, which could be stripped off entire, like that on a baked apple;
underneath all the muscles of the body could be distinctly seen, the fœtus
being very lean. I shall describe at another opportunity what I discovered in
this fœtus on dissection. I have mentioned the case on this occasion to show
that it was the uterus alone which excited the abortion, and expelled the
fœtus by its own efforts.
Fabricius[370] suggests two circumstances as especially worthy of
admiration in and after birth: first, the dilatation of the uterus at the time of
birth; secondly, the way in which after birth it is restored to its usual small
size. He wonders how the uterus can be so distended as to allow the fœtus
to escape, and afterwards in so short a period return to its pristine state.
He says, “that with Galen[371] we can only wonder, but not understand,”
how the neck of the uterus, a part so thick, hard, and closely sealed, as not
to admit a probe, can suffer such distension at the time of deliver”. He
gives,[372] however, the following reason: “that the unimpregnated uterus is
of a thick and hard consistence, and so is its orifice, but when impregnated
is yielding and soft, and in proportion as the term of delivery approaches,
both the body of the uterus and its orifice become more and more yielding.”
He believes this to arise “from the distension which the uterus undergoes,
and that when this distension takes place, the compact and plaited, so to
speak, body of the uterus is expanded and unfolded; thus what was before
thick and hard becomes soft and yielding, and ready to admit of the passage
of the fœtus.” He adds subsequently, “Some one may ask—if all this is
correct, how is it that in pregnant animals the uterine aperture is so closed
that it will not admit a probe? I answer, that this is so because the uterus,
whilst it is being distended and undone, like a closely-folded piece of linen,
begins to undergo these changes at its superior part; the lower portions then
gradually widen, until the power of distension arrives at the aperture; this
generally takes place at the period of birth. With reason then is the uterine
orifice closely shut in the first months of pregnancy, whilst it is still hard
and thick, but inclined to dilate in the latter ones. Thus much may be said
about the unknown cause of Galen. Other circumstances may be mentioned
as conducing to the dilatation of the orifice; for instance, the excretions of
the fœtus, such as the sweat and urine; for although these are contained in
their proper receptacles and membranes, yet some degree of moisture may
be communicated to the uterine aperture, especially as it lies low, and
always in the immediate neighbourhood of these humours; added to which,
mucous and slimy matters are always found about the orifice.” But in my
opinion this great man is wrong; for the neck of the uterus is not hard from
being folded on itself, but in consequence of its own proper substance and
cartilaginous nature; and the accidental causes which he gives can have but
little weight towards furthering the dilatation. This, doubtless, like every
other contrivance in the human body, is owing to the divine providence of
Nature, which directs her workmanship to certain ends, actions, and uses.
The structure, then, of the uterus is such, that immediately on conception it
shuts up closely its cartilaginous aperture, for the purpose of retaining the
seed; this part subsequently, at birth, and that the fœtus may escape, like
fruit on the tree, comes to maturity and softens, and this not by any
unfolding of its tissue, but by a change in its natural character. For a
loosening and softening takes place even in the commissural attachments of
bones, as in those between the haunches and the sacrum, the pubes, and the
pieces of the coccyx. It is a truly wonderful thing that the little point of a
sprouting germ, say of the almond or another fruit, should break the shell
which a hammer can scarcely crush; or that the tender fibres of the ivy-root
should penetrate the narrow chinks of the stone, and at length cause rents in
mighty walls. But it does not appear so marvellous that the parts of the
woman, when distended by labour, should recover their natural firmness, if
we consider the state of the male organ in coition, and how soon it
subsequently becomes soft and flaccid. A greater matter for wonder is it,
and surpassing all these “foldings,” that the substance of the uterus, as the
fœtus increases, not only is day by day enlarged and distended or unfolded,
as it were, to take Fabricius’s notion, but that it should become more thick,
fleshy, and strong. We may even, with Fabricius, marvel still more at the
means by which the mass of the uterus, by the intervention of the ordinary
lochial discharges, returns to its original size in so few days; for this is not
the case with other tumours or abscesses; these require a longer period for
dispersion, being made up of unnatural matters, and such as require
digestion, a process opposed to the power of expulsion. Yet this is not more
worthy of admiration than the other works of nature, for “all things are full
of God,” and the Deity of nature is ever visibly present.
In the last place, it is object of great wonder to Fabricius how those
vessels of the fœtus (meaning the oval opening out of the vena cava into the
pulmonary vein, and the duct from the pulmonary artery into the aorta, on
which subjects I have entered fully in my Essay on the Circulation of the
Blood) immediately after birth begin to shrivel up and become obliterated.
He is driven to that reason given by Aristotle,[373] and already cited by me,
which is, that all parts are made for a certain function, and if the function
ceases to be required that they themselves disappear. The eye sees, the ear
hears, the brain perceives, the stomach digests, not because such characters
and structures (naturally) belong to these organs; but they are endowed with
such characters and structures to accomplish the functions appointed them
by nature.
On grounds like these it would appear that the uterus holds the first place
among the organs destined for generation; for the testicles are made to
produce semen, the semen is for the purposes of intercourse, and coition
itself, or the emission of the semen, is instituted by nature that the uterus
may be fecundated and generation result.
I have said before that an egg is, as it were, the fruit of an animal, and a
kind of external uterus. Now, on the other hand, we may regard the uterus
as an egg remaining within. For as trees are gay with leaves, flowers, and
fruit at stated periods, and oviparous animals at one time conceive and
produce eggs, at another become effete, so that neither the “place” or the
part that contained them can be found, so have viviparous animals their
spring and autumn allotted them. At the season of fecundation the genital
organs, especially in the female, undergo great changes, so much so that in
birds, the ovary, which at other times is scarcely visible, now becomes
turgid; and the belly of the fish, near about the time of spawning, far
exceeds in bulk the rest of the body, owing to the enormous number of ova
and the quantity of semen contained within it. In very many viviparous
animals the genital organs, that is, the uterus and spermatic vessels, are not
always found presenting the same mode and course of action and structure;
but as they are capable or not of conception, so changes take place, and to
such an extent that the organs can hardly be recognized as the same. In
nature, just as there is nothing lacking, so is there nothing superfluous; and
thus it happens that the organs of generation wither away and are lost when
there is no longer any use for them.
At the period of coitus in the hare and mole, the testicles of the male
become visible, and in the female the horns of the uterus appear. In truth, it
is most marvellous to see what an enormous quantity of semen is contained
in full-grown moles and mice at those times, whilst at others no semen can
be seen, and the testicles are shrunk and retracted. So also when the
reproductive faculty ceases in the female, the uterus is found with difficulty,
and it is scarcely possible to distinguish the sexes.
The uterus, especially in the woman, varies extraordinarily as it is
fecundated or not, both in constitution and in the results of that constitution
—I mean in position, size, form, colour, thickness, hardness, and density. In
the girl, before the age of puberty, the breasts are no larger than those of the
boy, and the uterus is a small, white, membranous organ, destitute of
vessels, and not larger than the top of the thumb, or a large bean. In like
manner in old women, as the breasts are collapsed, so is the uterus
shrunken, flaccid, withered, pale, and void of vessels and blood. I attribute
the suppression of the catamenia in elderly women to this cause; in them the
menstruous fluid either escapes as hemorrhoidal flux, or is prematurely
stopped, to the injury of the health. For when the uterus becomes cold and
almost lifeless, and all its vessels are obliterated, the superfluous blood
boils up, and either falls back and stagnates, or else is diverted into the
neighbouring veins. On the contrary, in those pale virgins who labour under
chronic maladies, and in whom the uterus is small and the catamenia
stagnate, “by coition,” says Aristotle,[374] “the excrementitious menstrual
fluid is drawn downwards, for the heated uterus attracts the humours, and
the passages are opened.” In this way their maladies are greatly lessened,
seeing that want of action on the part of the uterus exposes the body to
various ills. For the uterus is a most important organ, and brings the whole
body to sympathize with it. No one of the least experience can be ignorant
what grievous symptoms arise when the uterus either rises up or falls down,
or is in any way put out of place, or is seized with spasm—how dreadful,
then, are the mental aberrations, the delirium, the melancholy, the
paroxysms of frenzy, as if the affected person were under the dominion of
spells, and all arising from unnatural states of the uterus. How many
incurable diseases also are brought on by unhealthy menstrual discharges,
or from over-abstinence from sexual intercourse where the passions are
strong!
Nor are the changes which take place in the virgin less observable when
the uterus first begins to enlarge and receive warmth; the complexion is
improved, the breasts enlarge, the countenance glows with beauty, the eyes
lighten, the voice becomes harmonious; the gait, gestures, discourse, all are
graceful. Serious maladies, too, are cured either at this period or never.
I am acquainted with a noble lady who for more than ten years laboured
under furor uterinus and melancholy. After all remedies had been employed
without success, she became affected with prolapsus uteri. Contrary to the
opinion of others, I predicted that this last accident would prove salutary,
and I recommended her not to replace the uterus until its over-heat had been
moderated by the contact of the external air. Circumstances turned out as I
anticipated, and in a short time she became quite well; the uterus was
returned to its proper situation, and she lives in good health to the present
day.
I also saw another woman who suffered long with hysterical symptoms,
which would yield to no remedies. After many years her health was restored
on the uterus becoming prolapsed. In both cases, when the violence of the
symptoms was abated, I returned the uterus, and the event proved favorable.
For the uterus, when stimulated by any acrid matter, not only falls down,
but like the rectum irritated by a tenesmus, thrusts itself outwards.
Various, then, is the constitution of the uterus, and not only in its
diseased, but also in its natural state, that is, at the periods of fecundity and
barrenness. In young girls, as I said, and in women past childbearing, it is
without blood, and about the size of a bean. In the marriageable virgin it has
the magnitude and form of a pear. In women who have borne children, and
are still fruitful, it equals in bulk a small gourd or a goose’s egg; at the same
time, together with the breasts, it swells and softens, becomes more fleshy,
and its heat is increased; whilst, to use Virgil’s expression with reference to
the fields,
 “Superat tener omnibus humor,
Et genitalia semina poscunt.”

Wherefore women are most prone to conceive either just before or just
subsequent to the menstrual flux, for at these periods there is a greater
degree of heat and moisture, two conditions necessary to generation. In the
same manner when other animals are in heat, the genital organs are moist
and turgid.
Such is the state of the uterus as I have found it before birth. In pregnant
women, as I have before stated, the uterus increases in proportion to the
fœtus, and attains a great size. Immediately after birth, I have seen it as
large as a man’s head, more than a thumb’s breadth in thickness, and loaded
with vessels full of blood. It is, indeed, most wonderful, and, as Fabricius
remarks, quite beyond human reason, how such a mass can diminish to so
vast an extent in the space of fifteen or twenty days. It happens as follows:
immediately on the expulsion of the fœtus and its membranes, the uterus
gradually contracts, narrows its neck, and shrinks inwardly into itself; partly
by a process of diaphoresis, partly by means of the lochia, its bulk
insensibly lessens; and the neighbouring parts, bones, abdomen, and all the
hypogastric region, at the same time diminish and recover their firmness.
The lochial discharge at first resembles pure blood; it then becomes of a
sanious character, like the washings of flesh, and is otherwise pale and
serous. At this last stage, when no longer tinged with blood, the women call
it “the coming of the milk,” for the reason probably that at that time the
breasts are loaded with milk, and the lochia sensibly diminish; as if the
nutritive matter was then transferred to the breasts from the uterus.
In other animals the process is shorter and simpler; in them the parts
concerned recover their ordinary bulk and consistence in one or two days.
In fact, some, as the hare and rabbit, admit the buck, and again become
fecundated, an hour after kindling. In like manner, I have stated that the hen
admits the cock immediately on laying. Women, as they alone have a
menstruous, so have they alone a lochial discharge; added to which they are
exposed to disorders and perils immediately after birth, either from the
uterus, through feebleness, contracting too soon, or from the lochia
becoming vitiated or suppressed. For it often happens, especially in delicate
women, that foul and putrid lochia set up fevers and other violent
symptoms. Because the uterus, torn and injured by the separation of the
placenta, especially if any violence has been used, resembles a vast internal
ulcer, and is cleansed and purified by the free discharge of the lochia.
Therefore do we conclude as to the favorable or unfavorable state of the
puerperal woman from the character of these excretions. For if any part of
the placenta adhere to the uterus, the lochial discharges become fetid, green,
and putrid; and sometimes the powers of the uterus are so reduced that
gangrene is the result, and the woman is destroyed.
If clots of blood, or any other foreign matter, remain in the uterine cavity
after delivery, the uterus does not retract nor close its orifice; but the cervix
is found soft and open. This I ascertained in a woman, who, when laboring
under a malignant fever, with great prostration of strength, miscarried of a
fœtus exhibiting no marks of decomposition, and who afterwards lay in an
apparently dying state, with a pulse scarcely to be counted, and cold sweats.
Finding the uterine orifice soft and open, and the lochia very offensive, I
suspected that something was undergoing decomposition within;
whereupon I introduced the fingers and brought away a “mole” of the size
of a goose’s egg, of a hard, fleshy, and almost cartilaginous consistence, and
pierced with holes, which discharged a thick and fetid matter. The woman
was immediately freed from her symptoms, and in a short time recovered.
When the neck of the uterus contracts in a moderate degree after birth,
and certain pains, called by the midwives “after pains,” ensue, in
consequence of the difficulty with which the clots are expelled, the case is
considered a favorable one, and is so in fact; for it indicates vigour on the
part of the uterus, and that it is inclined readily to contract to its usual bulk;
the result of which is that the lochia are duly expelled, and health restored
to the woman.
But I have observed in some women the uterine orifice so closed
immediately after parturition, that the blood has been retained in the uterus,
and then, becoming putrid, has induced the most dangerous symptoms; and
when art did not avail to promote its exit, the woman has presently died.
A noble lady in childbed being attacked with fever for want of the
ordinary lochial discharge, had the pudenda swollen and hot; finding the
uterine orifice hard and firmly closed, I forcibly dilated the part by means
of an iron instrument sufficiently to admit of my introducing a syringe and
throwing up an injection; the effect of which was that grumous and fetid
blood, to the amount of several pounds, flowed away, with present relief of
the symptoms.
The wife of a doctor of divinity was brought to me; a lady of a very
tolerable constitution, but who was barren, and having an extreme desire for
progeny, had tried all kinds of prescriptions in vain. In her the catamenia
appeared at their proper period; but at times, especially after horse exercise,
a bloody and purulent discharge came from the uterus, and then, in a short
time, ceased suddenly. Some considered the case as one of leucorrhœa;
others, led chiefly by the fact that the discharge was not continually present,
and in small quantities, but appeared by intervals and in abundance,
suspected a fistulous ulcer; whereupon they examined the whole vagina by
means of a speculum uteri, and applied various remedies, but in vain; when
I was at length called to her. I opened the uterine orifice, and immediately
two spoonfuls of pus came away of a sanious character and tinged with
streaks of blood. On seeing this I said that there was a hidden ulcer in the
uterine cavity, and by applying suitable remedies I restored her to her
former state of health. But during the time when I was engaged in her cure,
when the ordinary remedies did not appear to be doing much good, I
applied stronger ones, suspecting as I did that the ulcer was of long
standing, and perhaps covered by exuberant granulations. I therefore added
a little Roman vitriol to the injection employed previously, the effect of
which was to make the uterus contract suddenly and become as hard as a
stone; at the same time various hysterical symptoms showed themselves,
such, I mean, as are generally supposed by physicians to arise from
constriction of the uterus, and the rising of “foul vapours” therefrom. The
symptoms continued some time, until by the application of soothing and
anodyne remedies the uterus relaxed its orifice; upon which the acrid
injection, together with a putrid sanies, was expelled, and in a short time the
patient recovered.
I have introduced this account from my “medical observations” for the
purpose of showing how acutely sensible the uterus is, and how readily it
closes on the approach of danger, especially when urgent symptoms
accompany the puerperal state. Women are peculiarly subject to these
accidents, especially those among them who lead a luxurious life, or whose
health is naturally weak, and who easily fall into disorders. Country
women, and those accustomed to a life of labour, do not become
dangerously ill on such small grounds. Some of them may be found
pregnant a month after delivery; whilst two months frequently elapse before
others are able to set about the ordinary occupations of life.
It is laid down by Hippocrates,[375] that as many days are required for
the “after-purgings” as there are for the formation of the fœtus; therefore
there are more for a female than a male child. “But this,” says Scaliger,[376]
“is false; for in none of our women do “the cleansings” last more than a
month; in very many they cease on the fifteenth day; in some even on the
seventh day; and I have seen a case where they lasted only until the third
day, although the woman had borne twins.” Galen has many observations
on this subject in his work περὶ κυουμένων, (On the Formation of the
Fœtus.) In the New World, it is said that the woman keeps apart the day
only on which she is delivered, and then returns to her ordinary
occupations.
I will add, in conclusion, an extraordinary instance told me by the noble
Lord George Carew, Earl of Totness, and long Lord-Lieutenant of Munster
in Ireland—he who wrote the history of these times. A woman, great with
child, was following her husband, who served as a soldier, and it happened
that the army, when on the march, was compelled to halt for the space of an
hour near a small river which impeded their passage; whereupon the
woman, who felt her labour at hand, retired to a neighbouring thicket, and
there, without the aid of a midwife or any other preparation, gave birth to
twins; after she had washed both herself and them in the running stream,
she wrapped the infants in a coarse covering, tied them on her back, and the
same day marched barefoot twelve miles with the army, without the
slightest harm ensuing. The following day the Viceroy, Earl Mountjoy, who
at that time was leading an army against Kinsale, then occupied by the
Spaniards, and the Earl of Totness, were so affected by the strange incident,
that they appeared at the font, and had the infants called by their own
names.
 ON

THE UTERINE MEMBRANES AND HUMOURS.

OF THE
UTERINE MEMBRANES AND HUMOURS.
“Four kinds of bodies” are enumerated by Hieronymus Fabricius[377]
“as existing externally to the fœtus; these are the umbilical vessels, the
membranes, the humours, and a fleshy substance.” On these subjects,
guided by my observations, I shall briefly state wherein I differ from him;
first, however, giving his statement in his own words.
“There are,” he says, “three membranes, two of which envelope the
whole fœtus, but the third does not do so. Of those which envelope the
whole fœtus, the innermost, immediately investing one, is called ἃμνιον, i.
e. the mantle. That which follows next is entitled by the Greeks χόριον; the
Latins, however, have not given it a name, although some interpreters have
thought proper erroneously to call it “secundæ” or “secundina,” the
secundines; this also envelopes the entire fœtus. The third is called
ἀλλαντοειδὴς, i. e. gut-like, from its resemblance to a stuffed intestine; it
does not entirely encompass the fœtus, but is applied upon the thorax and
part of the abdomen, and extends to either horn of the uterus.” He allows
that this last membrane is only found in the fœtus of the sheep and cow; he
asserts also that it is continuous with the urachus, and by means of this
receives the urine from the bladder. Hence, he goes on, “horned animals, in
whom this allantois is found, have the urachus so wide and straight, that it
resembles a small intestine; it gradually decreases in size until it reaches the
fundus of the bladder; whence it would appear to owe its origin rather to the
intestine than to the bladder itself. But in man and other animals furnished
with incisors in both jaws, and in whom the allantois is wanting, the size of
the urachus is so diminished, that although it rises from the fundus of the
bladder as a single tube, it afterwards splits into innumerable fibres, which
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