The German school of midwifery has laid down an important rule as a consequence of this observation, and I have never known an exception to occur in my experience. The rule is that when the uterus does not descend into the pelvis toward the close of the first pregnancy, it is because there is a disproportion between the child’s head and the maternal pelvis, or in other words that either the child’s head is too large for a natural or unaided delivery to take place, or that the pelvis of the mother is too small for a natural delivery to take place, and this is true, and knowing this to be true at the outset or commencement of a confinement it would be only torture and a valuable loss of time to wait at the bedside of a woman suffering with the pangs of childbirth in the vain hope that she might deliver herself—when in truth and as a fact that cannot be done without the aid of scientific assistance. The vagina and external organs are more or less modified in pregnancy. The vagina becomes wider and shorter and as there is an increase of spongy tissue, it presents a swollen appearance. The mucous glands become larger and secrete a greater abundance of mucus. The internal surface of the vagina becomes discolored in consequence of pregnancy and I believe that it is one of the most reliable presumptive signs; the mucous membrane presents a sort of bluish tint, a French authority calls it a violet hue, not unlike the lees of wine. Quickening is a term that is employed to designate the particular length of time that pregnancy has existed, and at the same time to furnish evidence to the mother through the movements of the fetus that she carries within her womb a living being. In a former chapter I have already detailed the theory of the ancients upon this subject, which was as absurd as it was fanciful. The late Professor Bedford defines “quickening as nothing more than the ordinary result of progressive increase when the physical organization of the fetus has reached a state of development which imbues it with the power of movement—a movement dependent upon muscular contraction.” The period of quickening is usually about the fourth and a half month or the middle term of pregnancy.