this case you cannot, before labour, actually measure it — you cannot measure it as in the two former cases, by jamming the fingers into it. In all cases that can be done just after the child is born, and should be done. In the great deformities, such as those of the two women I have previously described, it can be done before labour, but in a case like this it cannot be done. Therefore I have here a judgment as to the measure of the true conjugate ; we do not actually measure it.
I have still another case of equal interest, but I shall not read it to you. I shall merely mention it. It is like the last, but still slighter in its dangerous character. It is the case of a woman who had had eleven children, and of these children she bore only two spontaneously — the first two. Of these two the second alone was born alive, and survives. Now I mention these few particulars of this case to point out to you an observation of great interest — the contrast between successive labours in a slightly de- formed pelvis and in a healthy pelvis. Everybody knows that, in an ordinary practice, tedious and difficult cases are expected among the primiparae : and it is quite true. The observation is correct. In the cases of primiparse you are not astonished at having a long, expectant sederunt. Subse- quent labours are undoubtedly more and more easy, mechani- cally speaking, till at last they very frequently become far too easy for the woman's safety. But in the case of the first degree of deformity of the pelvis you have, as this case illustrates, the opposite course. It is the first labours that are easiest. In the first labour the woman's power, and especially the labour including the uterine power, is the greatest, and in a woman's first labour she may succeed in forcing the child at the full time into the world, while in subsequent labours she utterly fails from weakness or inadequacy of the powers of labour. In a woman with a slightly deformed pelvis you expect subsequent labours to be the more difficult, apart
