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"The first indication of formation that is possible to discover, even by the help of the microscope, consists of an oblong figure, obtuse at one extremity, swollen in the middle, blunt-pointed at the other extremity.
The rudimentary embryo is slightly curved forward, is of a grayish-white color, of a gelatinous consistence, from two to four lines long, and weighs one or two grains. A slight depression, representing the neck, enables us to distinguish the head; the body is marked by a swollen centre, but there are as yet no traces of the extremities. So much can be observed about the end of the third week after conception.
"At about the _fifth week_ the embryo presents more distinctions. The head is very large in proportion to the rest of the body, the eyes are represented by two black spots, and the upper extremities by small protuberances on the sides of the trunk. The embryo at this stage is nearly two-thirds of an inch in length and weighs about fifteen grains.
The lower extremities now begin to appear in the shape of two minute rounded tubercles. Till about this time a straight artery has been observed to beat with the regularity of the pulse; but now it appears doubled somewhat into the shape of an adult heart, although as yet it has but one auricle and one ventricle. As time advances we find the perfect heart, with its two ventricles and two auricles, all developed from the original straight artery. At this period the lungs appear to exist in five or six different lobes, and we can barely distinguish the bronchial tubes; about the same time the ears and face are distinctly outlined, and after awhile the nose is also faintly and imperfectly perceived.
"At about the _seventh week_, little bony deposit is found in the lower jaw. The kidneys now begin to be formed, and a little later the genital organs. The embryo averages one inch in length.
"At _two months_ the rudiments of the extremities become more prominent.
The forearm and hand can be distinguished, but not the arm above the elbow; the hand is larger than the forearm, but is not supplied with fingers. The s.e.x cannot yet be determined. The length of the embryo is from one inch and a half to two inches, and it weighs from three to five drachms. The eyes are discernible, but still uncovered by the rudimentary lids. The nose forms an obtuse eminence, the nostrils are rounded and separated, the mouth is gaping, and the epidermis can be distinguished from the true skin.
"At _ten weeks_ the embryo is from one and a half to two and a half inches long, and its weight is from one ounce to an ounce and a half; the eyelids are more developed, and descend in front of the eyes; the mouth begins to be closed by the development of the lips. The walls of the chest are more completely formed, so that it is no longer possible to see the movements of the heart. The fingers become distinct, and the toes appear as small projections webbed together like a frog's foot. At about this period the s.e.xual organs show their development, as follows: On each side of the urinary locality an oblong fold becomes distinguishable; in course of progress, if these folds remain separate, a little tubercle forms in the anterior commissure which becomes the c.l.i.toris; the nymphae develop, the urethra forms between them, and the female s.e.x is determined. If, on the other hand, these folds unite into a rounded projection, the s.c.r.o.t.u.m is formed, the little tubercle above becomes the p.e.n.i.s, and hence the male s.e.x. The t.e.s.t.i.c.l.es forming within the body descend later into the s.c.r.o.t.u.m, and organs similar to them, their counterparts, form in the females and are called ovaries. These ovaries are found attached to an organ called the womb, and this, again, is united with the v.a.g.i.n.a, which leads downwards and outwards between the l.a.b.i.a majora (or larger lips).
"At the end of the _third month_ the weight of the embryo is from three to four ounces and its length from four to five inches; the eyeb.a.l.l.s are seen through the lids, the pupils of the eyes are discernible, the forehead, nose and lips can be clearly distinguished. The finger-nails resemble thin membranous plates, the skin shows more firmness, but is still rosy-hued, thin and transparent. The s.e.x can now be fully determined.
"At the end of the _fourth month_ the product of conception is no longer called an embryo, but a fetus. The body is from six to eight inches in length, and weighs six or seven ounces. A few little white hairs are seen scattered over the scalp. The development of the face is still imperfect. The eyes are now closed by their lids, the nostrils are well-formed, the mouth is shut in by the lips, and the s.e.x is still more sharply defined. The tongue may be observed far back in the mouth, and the lower part of the face is rounded off by what a little later will be a well-formed chin. The movements of the fetus are by this time plainly felt by the mother, and if born at this time it may live several months.
"At the end of the _fifth month_ the body of the fetus is from seven to nine inches long, and weighs from eight to eleven ounces. The skin has a fairer appearance and more consistence; the eyes can no longer be distinguished through the lids, owing to the increased thickness of the latter. The head, heart and kidneys are large and well-developed.
"At the end of the _sixth month_ the fetus is from eleven to twelve and a half inches in length, and weighs about sixteen ounces, more or less.
The hair upon the scalp is thicker and longer, the eyes remain closed, and very delicate hairs may be seen upon the margins of the eyelids and upon the eyebrows. The nails are solid, the s.c.r.o.t.u.m small and empty, the surface of the skin appears wrinkled, but the dermis may be distinguished from the epidermis. The liver is large and red, and the gall-bladder contains fluid.
"At the end of the _seventh month_ the length of the fetus is from twelve and a half to fourteen inches; its weight is about fifty-five ounces, and it is both well-defined and well-proportioned in all its parts. The bones of the cranium, hitherto quite flat, now appear a little arched, and, as the process of ossification goes on, the arching increases until the vault is quite complete. The brain presents greater firmness, and the eyelids are opened. The skin is much firmer, and red.
The gall-bladder contains bile.
"At the end of the _eighth month_ the fetus seems to thicken up rather than to increase in length, since it is only from sixteen to eighteen inches long, while its weight increases from four to five pounds. The skin is red, and characterized at this period by a fine downy covering, over which is spread a quant.i.ty of thick viscous matter, called the sebaceous coat, which has been forming since the latter part of the fifth month. The lower jaw has now become as long as the upper one, and in the male the left t.e.s.t.i.c.l.e may be found in the s.c.r.o.t.u.m. Convolutions appear in the brain structure.
"At _nine months_ the anxious time of parturition (or birth) has arrived. The fetus is from nineteen to twenty-three inches in length, and weighs on an average from six to eight pounds. Children at birth sometimes weigh as much as fourteen pounds; but such extremes are very rare. At this period the white and gray matter of the brain are distinct, and the convolutions are well marked; the nails a.s.sume a h.o.r.n.y consistence, hair upon the head is more or less abundant, the testes are in the s.c.r.o.t.u.m, and the entire external genital organs of both male and female are well formed.
"How wonderfully and how instructively are all organs in the animal body disposed and arranged! In the highest place we find the brain to govern and rule over all below. It is the first organ formed, and in an orderly life should control all the others. Next in order and importance are the heart and lungs, which put into motion all other parts and enable the animal frame to continue in motion. So each and every organ is developed in its proper order, all to obey the commands of the first and most important--the brain, the seat of the reason and the will. Happy are they of either s.e.x who will govern themselves by a pure, enlightened reason and a pure, affectionate will."
While we may note the various stages of change and progress, yet to the thoughtful student there lies back of all these outer manifestations a hidden life, a divine unfolding of the human body which is mysterious and awe-inspiring. While we know something of what takes place, yet the declaration of the Book of Ecclesiastes is impressively true: "Thou knowest not what is the way of the Spirit, nor how the bones do grow in the womb of her that is with child." All who study it thoughtfully and reverently can exclaim with David: "I am fearfully and wonderfully made: marvelous are Thy works; and that my soul knoweth right well. My substance was not hid from Thee, when I was made in secret, and curiously wrought in the lowest parts of the earth. Thine eyes did see my substance, yet being imperfect; and in Thy book all my members were written, which in continuance were fas.h.i.+oned, when as yet there was none of them."
Let us turn now to the mother who has nourished and who is about to bring into the world the body of an immortal being. Some of the changes most easily noted in the body of the mother occur as she reaches the period when approaching maturity has prepared the body of the child for an early entrance into the outer world. Marvelous as are the less noticeable changes which have earlier taken place, the time has now come when others which are more marked are soon to manifest themselves.
Several days prior to the event there is a dropping or subsidence of the womb. This is preparatory to the distention and enlargement of the v.a.g.i.n.a through which the exit is to be made. The stomach and lungs are relieved of pressure, the mother feels more easy, is more inclined to move about, breathes more freely, and the sense of oppression which formerly caused her to desire inaction pa.s.ses away, and Providence thus fits her to make such necessary preparations as are important in view of the event which is soon to take place. As the days approach, the external parts give indication of the distention and enlargement which has taken place in the v.a.g.i.n.a and the preparations which nature is making for the more easy exit of the life which has developed within.
The entire physical nature of the mother is in a state of preparation for the great event. A large quant.i.ty of blood is being sent to the b.r.e.a.s.t.s, the lacteals are developing, and the preparation is being completed for the secretion of milk, so that there may be no lack when the little stranger arrives.
One of the earliest indications that the event is about to take place is the discharge of the small plug of mucus which has served to hermetically seal the neck of the womb against the entrance of any foreign substance; but its office or work is now completed. The cervix, or neck of the womb, enlarges, and this little plug, popularly known as "the show," pa.s.ses away with some streaks of blood. While the neck of the womb, the v.a.g.i.n.al pa.s.sage and the external parts have greatly enlarged, the womb itself is beginning to contract preparatory to the expulsion of that which it has fostered and nourished for a period of about nine months.
The earliest premonition that these contractions are taking place is found in the grinding pains, which come at irregular intervals, sometimes a couple of hours apart, or only separated by a half hour, or even a shorter period. These contractions of the abdominal muscles are soon followed by the true labor-pains, which come at more regular intervals. These grinding pains are felt in the back and loins. The contractions rise to a certain pitch of intensity, and then as gradually abate. Usually, as the regular labor-pains begin, the fluid contained in the amniotic sac, and within which the child has floated during its period of growth, is now liberated by the breaking of the sac, flows through the v.a.g.i.n.al pa.s.sage, lubricating the parts and preparing all for an easy exit of the body of the infant into the outer world. When the presentation is normal the head comes first, and usually in a period varying from a few minutes to a few hours the child is born. In exceptional cases the labor may be extended over a day or more, but such cases are relatively rare.
The apprehensions of dangers which a.s.sociate themselves in the minds of many with childbirth are not often realized. If the parts are not diseased, and the mother is in good health, and the laws of the unfolding life have been carefully observed, there is little peril, although, generally, considerable pain. There are many physicians who have attended hundreds of women in confinement who have never lost but an exceptional case or two. The extreme pain endured by many women is largely due to the lack of that knowledge which would have enabled the mother to approach this period with but little apprehension, and to have pa.s.sed through the period of parturition or childbirth with but slight inconvenience and pain.
While the perils may be greatly reduced and the pains greatly diminished, it is nevertheless a period of wonderful revolution throughout the entire physical nature of the mother. The blood which flowed from her heart to nourish and foster the growing body of her child is now turned in other directions, and the fountains at which the child is to receive its food and its strength begin to flow with their richness of life-giving currents.
After the placenta and the sacs which enclosed the fetus, which together const.i.tute what is known as "the afterbirth," have pa.s.sed away, the recuperating and renewing powers with which G.o.d has so wonderfully endowed the body of the mother beyond that of the father become active.
The muscular tissues of the womb, v.a.g.i.n.a and the external parts at once begin to contract, and the entire nature of the mother begins to adjust itself to the new relations of her child to her own body and the necessities of nouris.h.i.+ng and guarding it upon the external portion of her body, rather than within that mysterious chamber which G.o.d prepared for its beginning and the earliest unfoldings of its infant life.
When the child is born into the world its body also undergoes a wonderful revolution. Then, for the first time, its heart takes up its own independent action; air for the first time enters the cells of the lungs, and with the early shock, if it might so be called, of taking its first breath, the child usually utters its first cries. During the period of its fetal life the lungs have received only so much blood as was necessary for their own growth and development, but with the first breath they expand and receive the inflowing of the blood from the right side of the heart. This involves the opening of some pa.s.sages and the closing of others. These are but the first of a series of transformations which are early to take place. The various veins, arteries and ducts which have hitherto received the supplies of blood from the placenta and returned the worn and wasted material to that same centre, or distribute the supplies for special service throughout different portions of the body, by the cutting of the umbilical or navel cord, and the separation of the child from the placenta and body of the mother, now a.s.sume a new relation to the independent body of the newborn child. Some of these ducts and arteries soon entirely close, and in some instances degenerate into impervious cords with new and important offices; some are transformed into true ligaments, while others remain pervious. Now that the primitive purposes of some of these parts have been fulfilled, the parts themselves disappear, while still other parts take upon themselves new offices and duties which are imposed by the changes incident to birth--the separation from the body of the mother and the entrance upon its own independent life in the outer world.
Truly, "we are fearfully and wonderfully made." The infinite Author of all things has left the stamp of His wisdom upon everything that He has created. Whether we take the microscope and study the earliest beginnings and mysterious unfoldings of this spark of human life; whether we study the blade of gra.s.s beneath our feet, or the stars that s.h.i.+ne over our heads; everywhere we find the wonderful wisdom of our Creator. "Day unto day uttereth speech, and night unto night showeth knowledge." It matters not whether we listen to the lessons of a flower, the history of an atom, or the song of the spheres, "there is no speech nor language where their voice is not heard; their line is gone out through all the earth, and their words to the end of the world."
CHAPTER XVI.
WHEN THE BABY IS BORN.
At the end of about 280 days after the conception, or what under ordinary conditions would have been the tenth menstrual period, the days are completed and the expectant mother is usually delivered of her child. The day when the indications are that the child is to be born is always one of great anxiety, but need not be one of apprehension or fear. Where the laws of health have been observed there is no cause for apprehension. With the birth of the first child the labor is oftentimes somewhat more prolonged and attended with more pain, but the after-pains are usually not considerable. Generally the pains which precede the birth diminish with each succeeding confinement, but the after-pains increase in a similar manner.
Where the mother has made intelligent preparation for this great event, the child may be, and generally is, born without the actual a.s.sistance of the doctor. An intelligent nurse would be in position to render every needed a.s.sistance, but the presence of a well-equipped physician always brings such added ease to the mind of the mother, by removing all unnecessary risks, that it is always desirable that the physician should have been apprised in advance, notified promptly, and be on hand as soon as possible after the labor-pains commence. This is especially important when it is the first child.
If the labor should be short and the birth take place before the arrival of the physician, the nurse or attendant should be careful to see that the cord is not wound about the neck of the child, but placed free, and the child with its head in position so that it can breathe naturally, and with its body warmly covered.
When the pulsing in the cord has ceased and the child has cried vigorously, any nurse who has been present at previous confinements, who is intelligent and capable, would be able to sever the cord after having made the necessary bindings upon it. Indeed, some authorities contend that when the pulsing has _ceased_ the cord may be severed without any tying of the ends at all.
Dr. Alice B. Stockham, in "Tokology," makes the following sensible suggestions: "Usually, as the child is ushered into the world, it sets up a l.u.s.ty cry, indicating that respiration is established. Crying is not essential, as some authors claim, and the prompt covering usually causes it to desist. If it does not breathe at once, a little brisk patting on the breast and thigh may establish respiration. If this is not effectual, dash cold water in the face and on the chest. Still failing, artificial respiration must be established. To do this, close the nostrils with two fingers, blow into the mouth, and then expel the air from the lungs by a gentle pressure upon the chest. Continue this as long as any hope of life remains.
"_Sever the cord when pulsation has entirely ceased._ Use a dull pair of scissors, cutting about two inches from the child's navel. Following these directions, no tying is essential."
Tying is done in order to prevent excessive bleeding; but whether to tie the ends of the severed placentic cord, or not, is a matter which should be left wholly to the attendant doctor. It is well for the young husband to be intelligent and well-read along these and kindred lines, but if he employs a physician he should accept the physician's judgment and have his instructions followed. If he is not satisfied with the doctor whom he has employed, but sees fit to change for one whose opinions harmonize more closely with his own, that is a matter for the husband's own judgment, but the physician who is employed should always be supreme and left without interference or dictation. The doctor in charge must have absolute control in a lying-in room. He should direct, and not be dictated to.
If the husband is intelligent, enters into the sympathies of his wife, and has her confidence, if the physician consents, as he doubtless will, it seems quite natural that he should desire to be present with his wife in this trying experience of her life. If he understands the nature of the experience through which she is called upon to pa.s.s, his sympathy will be helpful to his wife, and if nature has endowed him with any of the qualifications of a good nurse, he can be of a.s.sistance to the doctor. Where the husband is without intelligence, is nervous, and exerts a depressing influence upon his wife, his absence may be more helpful than his presence. If the husband is intelligent and sympathetic, it seems to us that he could not but desire to be with his wife; but where he is wholly disqualified, his physician should not hesitate to express his judgment and preference in this matter.
The presence of a physician is always to be preferred, in order to determine the presentation, sever the cord, and look carefully after the afterbirth. The normal presentation is of the head foremost.
Where the inexperienced young husband is in an extremity, and finds himself alone at the hour of delivery, he should expect, as is most likely, that everything will move along normally, and he needs to be especially guarded only upon three points. When the head is born, see that the navel cord is not twisted around the child's neck. If this should be the case, it can easily be slightly loosened and then slipped over the child's head; otherwise the pressure of this tightened ligature would prevent its breathing and would result in strangulation. In an _extreme_ case the cord could easily be tied in two places, a couple of inches apart, and cut between them. This should be done by an experienced person only, and as a last resort. After the child is born, the next and last important thing is the coming away of the placenta, or afterbirth. This often occurs at the end of twenty minutes or a half hour, or may be longer delayed. In the meantime the mother should be warmly covered, and any drink given her should not be either extremely hot or extremely cold. The afterbirth should be kept in a vessel prepared for it until the doctor has inspected it, so that he may know whether all the parts have come away or not. If any part remains, it might cause serious trouble.
These things successfully accomplished, the bathing of the child and care of the mother are next in order. How soon these should be undertaken would have to be determined by conditions. With the mother, a period of rest is sometimes very desirable. When bathing her body, or changing her bed, the greatest care should be exercised to protect her from the danger of contracting cold. During these hours her physical nature undergoes a great revolution, and exposure at this time might entail permanent results of a serious character. Fevers, bealed b.r.e.a.s.t.s, the aches, pains and perils which so often accompany and follow confinement, are almost wholly due to lack of proper care at this period.
If the young husband is intelligent and desires the comfort and well-being of his wife he will see that for a sufficient period she is protected against callers, and even the visits of friends. She is weak and needs absolute rest. She needs at least several days or more before she should be visited. If callers are allowed in her room, they are liable to remain too long. If you lack the nerve to decline callers the privilege they may expect, then ask your physician to order that no one see her at present.
The comfort, safety and well-being of the wife renders the selection of a good nurse a matter of as great importance as the choice of a good physician. In this matter the doctor is oftentimes the best counselor.
He is constantly coming in contact with those who are in charge, where he is in attendance, and his suggestions ought to be most valuable. It is of the utmost importance that she should be a woman of pure blood; and for this a good moral character is the best guarantee. It is not wise to suppose that, since she is to remain but for a few weeks, the question of character is of no moment, for, without any outward evidences to arouse suspicion, she might bring with her, and by kissing and in other ways communicate to the child the results of venereal and other diseases which might entail, from this unsuspected source, consequences from which years could not bring subsequent relief.
Medical authorities a.s.sert that at least six weeks are required after childbirth before the womb a.s.sumes its natural size and position. An eminent physician, writing in the New York _Medical Journal_, says: "I have watched this very carefully in a number of women, and have seen in the perfectly clean womb of a non-nursing mother involution delayed as late as the third month."
It is perfectly safe to say that parents will make no mistake by observing the requirement of the Levitical teaching upon this subject.
After confinement or miscarriage, marital relations should be wholly omitted for a period. Upon this point the sanitary regulations of the Mosaic economy were very explicit. In the twelfth chapter of Leviticus instruction is given that after the birth of a male child at least forty days should elapse, and after the birth of a female, or maid child, at least eighty days should be permitted to elapse. Just why there should be this difference in time, six weeks after the birth of a male child and three months after the birth of a female child, seems not to be clearly understood either by theologians or medical authorities. When we know that this is intended and enjoined, we can rest a.s.sured that there are good and sufficient reasons, whether they be physical, social, sanitary or political.
No thoughtful or considerate husband would desire to impose upon his wife such exactions as would result in her certain discomfort, and possibly in such permanent physical injuries as are quite sure to follow.
One of the medical journals recently contained an incident narrated by a physician who had attended a woman in five different confinements. In each instance the physician noticed that about the seventh or eighth day the temperature of the patient indicated some unusual physical disturbance or irregularity. In the last confinement, when the physician called to mind similar conditions during previous periods of convalescence, he decided to discover the cause, and, by questioning the patient very critically, learned that the guilty husband was the occasion of his wife's trouble. While such occurrences are shameful in the highest degree, yet it is possible that such gross conduct is the occasion of many relapses upon the part of convalescing mothers, and to this it is probable that many deaths may easily be attributable.
That some husbands are brutal in this respect, we need but simply to name that an eminent physician of Philadelphia has stated that a legal friend had told him that he had procured a divorce within two years from her marriage for a wife whose charges of cruelty were sustained by the evidence that three days after her confinement her husband had driven the nurse out of his wife's room in order that he might make this cruel exaction of her.