Page:The New International Encyclopædia 1st ed. v. 14.djvu/848

* OBSTETRICS. 720 O'CALLAGHAN. child is at riglit angles to that of the mother). Delivery being impossible in this position, artifi- cial correction of the presentation, usiiallj" by turning and bringing down the feet, must be resorted to. Labor is arbitrarily divided into three stages: The first stage begins with the earliest premonitory pains and ends with the complete dilatation of the uterine outlet; this stage may last .several liours or even days. Dur- ing the second stage the bag of water ruptures, the uterine contractions become stronger, and the child passes through the parturient canal and is born. This event completes the second stage. The third stage ends with the expulsion of the placenta and fa-tal membrane, and lasts usually about half an hour. The duration of laboi' in first confinements is on an average about twelve hours; in succeeding labors, six to eight hours; although nnich longer periods are not dangerous or inicommon. The pueri)eral or lying-in state begins at the completion of labor and lasts about six weeks. During this time lactation is inaugurated and the uterus gradually resumes its wonted size and sluipe (involution). The length of the lying-in period varies in dill'erent countries and races; among imcivilized people :ind in parts of the East the mother resumes her usual occupations immediately after jiarturition ; but in civilized countries the woman is conlined to her bed for a week or ten days. The P.tiioi,(h;v of Pkeonancy. While the pregnant woman is liable to disease equally with other individuals, there are certain disorders which are peculiarly apt to arise during gesta- tion, or are (lepeiulent on it. The teeth nu>y nndergo decay, owing to the fact that the mineral elements necessary for their nutrition are ap- jiropriated by the embryo. Constipation from both mechanical and sympathetic causes is a common disorder. The kidneys, owing to the increased functional activity demanded of them, not infrcqucully Ijccome diseased, as evidenced by the appearance of albumen in the urine. These organs failing in their function, poisonous prod- ucts of metabolism accumulate in the blood, pro- nounced nervous symptoms, such as headaches, vomiting, and impairment of sight and hearing, appear, and if not relieved, uriemic convulsions (the so-called eclampsia) arc induced, ending often in coma and death. Besides these and many other alVections incident to pregnancy, there are certain chronic diseases which, by reason of the increased strain upon the vitality at this time, are likely to prove fatal. The heart normally luulcrgoes a measure of hyper- trophy in pregnant women in order to meet the increa.sed denuinds of circulation. When, how- ever, there exists chronic disease either of the substance or the valves of this organ, it may prove unequal to the strain. The danger from this condition increases with each succeeding jiregnaney. When pulmonary phthisis exists in the mother, gestation in the majority of eases accelerates the progress of the disease. Pregnancy nuiy be terminated at any time before the normal period of 280 days. When this occurs during the first six months, it is called abortion or miscarriage; when it happens during the three succeeiling months, it is termed prenuiture delivery. A fa-tiis horn l>efore the fifth month does not ordinarily survive. Abor- tion is always u serious accident, either from loss of blood, or blood poisoning and peritonitis. This is particularly the ease in forcilde or criminal abortion, in which the mortality is very high. Kxtra-uterine (ectopic, tubal, or abdominal) pregnancy occurs when the impreg- nated ovum fails to reach the interior of the uterus and lodges in the Fallopian tube or drops into the abdominal cavity. The fietus develops in this sitnaliim, and unless the comli- ti<m is recognized early and operated upon, death is likely to occur during the third or fourth month from rupture of the tube, hemorrhage, and peritonitis. A similar condition of afl'airs takes place in what is termed 'missed labor' when the fcetus fails to be expelled at term. Ojiera- tion for tubal pregnancy was advocated by Tait, 'eit, JIunde, and others, and is now a common ]iroeedure. The ])rogiess of natural labor may be ob- structed by certain conditions of the mother and child. In the former, deformities of the bony pelvis, disease of the uterus resulting in rupture, and malpositicm of the placenta (placenta previa) are the most im])ortant. The child may be too large, or ill-formed, or present abnormally. These abnormal conditions render necessary various obstetric operations. Among these are; the in- duction of abortion or iiremalure labor, when the mother's life is in danger, or the size or shape of the bony pelvis is such as to ]ireclude delivery at full term; the extraction of the cliild with forceps; the Ca'sarian operation ((Udivering the child through an opening in the alxionien) ; version or turning when the foetus presents ab- normally or labor needs to be rapidly completed; and perforation of the head (craniotomy). The chief danger to which the woman is liable after delivery is ])uerperal or childlied fever, which is now known to be simjily septicanuia (q.v.) or blood poisoning, due to infection from unclean hands, instruments, or appliances. Since the discovery of antisepsis, child-lied fever has l)een constantly on the decline, and at the present day is a comparatively infrequent complication, both in hospitals and private practice. See Piileg- xr..si. ALn. Doij;xs. OB VERSION (from Lat. obrcrteie, to turn touani or against, from ob. l)efore, toward + rerlcn; to turn). In logic, the .process of trans- forming a judgment into one of opposite quality, i.e. affirmative into negative, and vice versa. The change may be effected provided due com- pensation is made l)y changing the quality of the predicate. E.g. "All men are mortal' becomes by obversion 'Xo man is immortal.' OCALA, o-kii'lA. A city and the county-seat of Marion County, Fla,, 101 miles south by west of .lacksonville; on the Plant System and the Florida Central and Peninsular railroads (Map: Florida, F 2). Emerson ,Mi>mi>rial Home :ind School, a Methodist F-pisco])al institution for colored girls, is located here, Oeala is sur- rounded l>y one of the most productive sections of the State — a region interested largely in the cultivation of oranges iiml v<'gefables. It is the centre of extensive phosphate interests. There is a public market; anil the electric light plant also is owned bv the niunicipalitv. Population, in ISOO. 2!I04: in l!l0. ;i:isn. O'CALLAGHAN, .^■k,-ll'a-llan, EnMixn lt,i- i.NV ( 1 7117 1,S80) . ^Vn American historical scholar