. The science and art of midwifery. r midnight. The pains then became slowand feeble. At about three oclock in the morning sudden collapseoccurred. On my arrival, thirty minutes later, I foundthe pulsescarcely perceptible, the breathing hurried, and the extremities the head was well down in the pelvis, I applied forceps, and ex-tracted without effort a dead child weighing ten and a half to the collapse the patient had felt comfortable. At themoment of its occurrence a distinct snapping sound was heard by thehospital physician, Dr. J. I). Griffith, who sat several yards
. The science and art of midwifery. r midnight. The pains then became slowand feeble. At about three oclock in the morning sudden collapseoccurred. On my arrival, thirty minutes later, I foundthe pulsescarcely perceptible, the breathing hurried, and the extremities the head was well down in the pelvis, I applied forceps, and ex-tracted without effort a dead child weighing ten and a half to the collapse the patient had felt comfortable. At themoment of its occurrence a distinct snapping sound was heard by thehospital physician, Dr. J. I). Griffith, who sat several yards distantfrom the bedside. The patient stated that she felt a sensation asthough a warm fluid was pouring into the abdominal cavity. As thepelvis was ample and the presentation normal, and as there was noirregularity of the labor-pains, the rupture could only be accounted 606 THE PATHOLOGY OF LABOR. for by assuming a vulnerability of the uterine tissues, and probably aclamping of the anterior lip between the head and the pelvic Fig. 244.—Case of ruptured uterus (anterior surface), a, body of uterus ; b, ring of Bandlc, thrombus, shining through the peritonaeum. On the other hand, so great is the distensibility of the tissues incertain cases that the foetus may pass entire from the uterus into thecavity of the obstetrical cervix without laceration ensuing. Bandl found that of 546 cases of rupture but sixty-four were inprimipara?. Their preponderance in multiparas is for the most partthe result of the laxity of the round and lateral ligaments of theuterus, which offer accordingly but slight resistance to the recessionof the contraction ring; of the stretched condition of the abdominalparietes, which permits obliquities and anteflexion to take place ; and RUPTURES OF THE GENITAL CANAL. 607 of the separation of the recti muscles, which interferes with the useof the abdominal compress. Of course, the loss of vitality over limited areas, resulting from thecompression to which
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