3. _Pulsation of the Fœtal Heart._--The sounds of the fœtal heart were first noticed by Mayar in 1818, and those of the placenta, or _placental souffle_, by Kergaradec in 1822. The sound of the fœtal heart is composed of a rapid succession of short, regular double pulsations, differing from that of the adult heart in rhythm and frequency. It can be heard more or less over the whole of the abdomen about the middle of the fourth month, and is not unlike the muffled ticking of a watch. In frequency it varies from 100 to 140. The auscultator should be careful not to hang his head down, or he may be apt to mistake the throbbing of his own arteries for sounds communicated from the patient. 4. _Intermittent Contraction of the Uterus._--From the fourth to the tenth month of pregnancy, the uterus may be felt by the palpating hand to alternately contract and relax; the period of contraction and relaxation varies. It is present in pregnancy whether the fœtus be alive or dead. Pregnancy may be simulated by ascites, by fibrous tumours of the uterus, by ovarian dropsy, and by enlargement of the uterus from retention of the catamenia due to an imperforate hymen, &c. The breasts may also become affected by uterine tumours. Diagnosis of Pregnancy 1. _Pseudo-Pregnancy._--In the examination of cases of alleged pregnancy, the medical jurist should bear in mind the possibility of enlargement of the uterus and abdomen from the presence of tumours. The probable occurrence of _pseudo-pregnancy_ should also be considered. Tumours and pseudo-pregnancy may occur in the married and unmarried; and as the latter is not infrequently accompanied with many of the signs and symptoms of pregnancy, an early diagnosis is of the utmost importance. The diagnosis will consist in-- (_a_) A careful examination of all the symptoms present, when, in most cases, a break in their order of sequence may be observed, or certain signs may be added which do not occur in true pregnancy. (_b_) Presence or absence of the hymen. (_c_) If the patient be placed well under the influence of chloroform, the tumour, if the result of pseudo-pregnancy, will subside, gradually returning as the effects of the anæsthetic pass off. Whilst the patient is under the influence of the anæsthetic, the hand may be pressed on the abdomen at each expiration, and there retained, the pressure being continued during the inspirations. 2. _Dropsy._--Use of the stethoscope; examination of the breasts for milk, and the urine for albumen. 3. _Fibrous Tumours._--Absence of fœtal movements and other signs of pregnancy. 4. _Ovarian Dropsy._--Tumour on one side of the abdomen; breasts unaffected, and auscultation giving negative results. 5. _Retention of the Catamenia._--On examination, the hymen found perfect and bulging. This condition cured by a crucial incision. DELIVERY