. The science and art of midwifery. f the cervix had welladvanced. The bag of waters, in the form of a cylindrical sac twoinches in diameter, protruded into the vagina. Both the cervicalorifices were distinctly defined ; the cervix was equally expandedthroughout its entire extent; and the head rested above the os inter-num. The cervix clearly formed no part of the uterine cavity, but * Sur les differents etats du col dc luterus, mais principalement sur les changementsque la gestation et laccouchement lui font eprouver, Strasbourg, 1826. f On the Cervix Uteri in Pregnancy, Edinburgh Med. Jour.,
. The science and art of midwifery. f the cervix had welladvanced. The bag of waters, in the form of a cylindrical sac twoinches in diameter, protruded into the vagina. Both the cervicalorifices were distinctly defined ; the cervix was equally expandedthroughout its entire extent; and the head rested above the os inter-num. The cervix clearly formed no part of the uterine cavity, but * Sur les differents etats du col dc luterus, mais principalement sur les changementsque la gestation et laccouchement lui font eprouver, Strasbourg, 1826. f On the Cervix Uteri in Pregnancy, Edinburgh Med. Jour., vol. iv, 1859, p. Vide Edinburgh Med. Jour., September, 1863. * Taylor, On the Cervix Uteri, Am. Med. Times, June 21, 1862. I Vide likewise case of Angus McDonald, in Edinburgh Med. Jour., April, 1877. 90 PHYSIOLOGY OF PREGNANCY. served merely as a communicating passage between the uterus andvagina. Dr. Taylor has made some very interesting observations uponthe action of the cervix during labor, using for the purpose a large. Fig, 70.—Appearance of vaginal portion in primipara; end of ninth month. (Taylor.) (three to three and a half inch) cylindrical speculum, by means ofwhich the entire process can be freely witnessed. In multiparous womenhe has seen the head descend during a pain so as to produce completeobliteration of the cervix, and then recede, leaving the latter with thesame appearances as existed previous to labor.* While the non-shortening of the cervix has been fairly demon-strated, it is not so clear that the os internum remains closed in allcases up to the beginning of labor. Certainly there are rare excep-tions to the rule. Litzmann f reported a case in which the mem-branes were found, at the time of labor, attached to the cervical wallaround the periphery of the os externum. In a few instances I havehad an opportunity, during the last period of pregnancy, to deter-mine by touch the dilatation of the os internum. The cervix, how-ever, did not expand in su
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
