(From gero, to carry). See AEora.

Gestatio. Gestation, or pregnancy, cuophoria. It is the progress of the foetus from the time of conception to that of parturition. See Foetus.

The time of a woman's pregnancy is nine solar months, or about two hundred and eighty days; but the child is sometimes born at seven months, and in a few instances at ten. See Medicina forensis.

From the moment in which the foetus is animated, a change takes place in the mother's constitution. Sometimes this is so striking as to be at once perceptible; sometimes it is so trifling that months pass on before any obvious change takes place. The change first perceptible is increased irritability. Fancies the most singular and extravagant possess the mind; objects most cherished lose their interest, and others seem to assume new attractions; the appetite is equally capricious; the sleep is broken and interrupted. The stomach partakes of this caprice; and food, the most alimentary, loses its relish, while the most unpleasing, and apparently disgusting, diet is sought after. At the moment of leaving the bed, sickness and faintness come on; the stomach strains with violence, and nothing, or a little bile only, is discharged. The greater number of these symptoms, however, occur in most instances only about the end of the month or six weeks, and they vary in their number and degree, seldom disappearing till about the middle period, or about two hundred clays. In this interval they are often truly distressing. Every kind of food is immediately rejected, faintness follows, and even the night is not free from distressing fancies. In such circumstances art is of little avail. Opiates will sometimes quiet the irregular exertions of the stomach, but it will sometimes fail. The columbo root, in powder or in tincture, is sometimes useful; and the aqua kali, or ammoniac purae, will occasionally relieve the vomiting, or the distressing heart burn. In general, something should be taken into the stomach before the expecting mother rises from bed, and a cup of peppermint or camomile tea is the most effectual means of lieving the usual urging.

The cause of these commotions we know not, but they are evidently neither unnatural nor morbid. They arise probably from the irritation of the uterus, communicated to the stomach, and are the effect of the new unaccustomed motions excited in this very irritable organ. That they are not morbid is sufficiently clear, from their scarcely in any instance producing abortion, and from the child being born healthy and active; though for at least three months, sometimes through the whole period, the mother has never retained a single meal, and is apparently worn to the lowest state of debilitv; a degree of debility under which some delicate women have sunk. The final cause seems to be the necessitv of securing a supply for the foetus. When a woman is first pregnant, all the evacuations are diminished, and a plethoric state occurs. Nature, at that time, requiring no recruit, rejects every addition: secure in what is provided, all adventitious aid is rejected. Were more accumulated, the embryo might be thrown off by the effort of vessels excited beyond their powers; and vomi:-ing, which, as we have shown, determines to the surface, prevents the uterine vessels from being too much distended. When the uterus rises above the pelvis, when the foetus has attained the power of motion, and is felt at first in irregular fluttering, and afterwards by more distinct actions, all the supply which the mother can convey is wanted. The scene is then changed: the appetite returns, the sleep is uninterrupted, digestion rapid and perfect, the spirits free and unruffled. So far from irritation suggesting fancied evils, real ones disappear; and, though she sometimes talks of the future delivery being fatal, she acts as if she looked forward to a numerous offspring, and even to their descendants. In short, if there is a period of greater health and activity than any other, it is from the two hundred and fortieth to the two hundred and eightieth day; interrupted only, at last, by the unwieldy size, and probably, through the whole, by a little constipation.

In other cases the practitioner feels greater difficulties. Pregnancy sometimes is not discovered by its appropriate symptoms, and these are occasionally concealed. In the early weeks, the abdomen is said to be flatter than usual: it is at least not fuller; and if obstruction takes place, with none of the appropriate symptoms of pregnancy, that is considered as a disease, and active emmenagogues are employed. Luckily, this discharge, as we shall find, is not much in our power. If a woman is married, not advanced in years, even though in a bad state of health, pregnancy should be always suspected. If she has been before regular, the suspicions are stronger; but, if not so, we must still suspect, and avoid any powerful evacuants, till the period when the state can be ascertained by unequivocal symptoms, or by the touch. If the woman is clandestinely pregnant, every artifice is employed to conceal the real symptoms, and the facts are only ascertained by the greatest address. The look of a chlorotic and a pregnant girl greatly differs. In the former the face is sunk; the skin muddy; the breasts flaccid; and the nostrils dry--in the latter, whatever are the symptoms of debility, the skin is clear, the features retain some animation, the breasts are full, and the nipple ruddy. These appearances cannot be disguised; but the state of menstruation is concealed, for by this means they hope to escape from their inconveniences, by the probability of what they style "forcing medicines" being ordered. In every circumstance, however, where the slightest doubt remains, the prudent practitioner will abstain from active measures, till the period arrives when the tumour, or the touch, will clear all his doubts. The tumour, in these clandestine pregnancies, is attributed to dropsy; and on this head we have already spoken. (See Ascites.) The touch is more decisive; and, by this means, real pregnancy may be ascertained, and distinguished from scirrhus, or polypus of the uterus. If the woman leans forward on a chair, the surgeon, from behind, introduces his fore or middle finger into the vagina, and moves it round till the point touches the os tincae. In the virgin state it is smooth and even; the uterus yields to the finger, and may be moved like a light ball with ease. In the first three months the difference is inconsiderable; but the tubercle at the mouth of the uterus is somewhat enlarged, and the womb itself sinks, seemingly, lower in the vagina. These marks are, however, equivocal; for even in the unimpregnated state women differ in these respects. But at about the fifth month, the cervix uteri begins to be distended, and the Os tincae to offer a different sensation to the finger. The tubercle shortens, the orifice expands, the uterus itself is moved with difficulty. At last the os tincae no longer conveys' the idea of a fissure, but of an elliptical tube, and is sometimes at that period wholly beyond the reach of the finger. The tumour, at the same time, affords no unequivocal sign. It is not uniform over the whole abdomen. It does not yield, as if its contents were flatus; there is no fluctuation, as if there were water; no unequal hardness, as if any contained part were scirrhous. The swelling rises from above the pubes, generally leaning to one, very often the right, side: it is circumscribed above, hard, but not considerably or irregularly so; and from the state of the urinary secretion, cannot be confounded with a distended vesica. In the fifth month the uterus extends about half way between the pubes and navel, and the neck of the womb is sensibly shortened. In the seventh month the fundis uteri reaches to the umbilicus; in the eighth, midway between this and the pit of the stomach; in the ninth, to the scrobiculus cordis. After the fifth month, and more decidedly in the further stages, the breasts are full; the areola round the nipple extends, and from a ruddy assumes a brown or blackish hue. In reality, however, after the sixth month deception must be at an end: the facts are decisive.

Not to break the continuation of the subject, we omitted mentioning the distinction between pregnancy and scirrhus, or polypi of the uterus. In the first the weight of the womb is considerable, but the edges of the os tincae are hard and irregular: in the second we find also considerable weight in the uterus, but the other symptoms of pregnancy are wanting, and it is very generally the disease of advanced life.

During gestation the uterus enlarges not from distention or pressure, for distended organs become thinner, and compresed ones thicker than natural: the womb preserves its former thickness; and even increases to the usual bulk of the gravid state when the foetus is in the ovary, the Fallopian tubes, or the abdomen. Its substance, during gestation, becomes softer; its veins enlarge, so as to assume the appellation of minuses; its arteries run in a serpentine direction, and Freely anastomose, especially near the placenta, and open obliquely into this organ. Its fibres are circular, and arise from three distinct sources; the spot where the placenta is attached, and from the orifice of each tube. When the womb rises high, as is usual in a first pregnancy, the ligamenta rotunda are considerably stretched, and pains, striking from the belly downward, are very distressing.

A surgeon is often consulted about the reckoning. It is usual to commence from about the middle of the period between the last return and the suppression; but it is safer to reckon about a week earlier. If the menses return scantily in a woman usually regular, the reckoning should commence about a week before this inefficient recurrence. But the whole should be corrected by the quickening, the period when the child's motion is perceived. This is at first indistinct, resembling rather a flatulence in the bowels; but producing sometimes a deliquium. When thus unequivocally marked, somewhat more than the fourth month may be supposed complete, or from one hundred and thirty to one hundred and forty days. When not-thus marked, about a week may be reckoned back from the certain feeling of a motion, and that may be fixed on as the same period of pregnancy. When, from the irregularity of the menses, the weakness of the child's motion, and the mother's age, generally connected with the two former, we cannot determine from either circumstance, the state of the tumour must decide. See La Motte's Midwifery; Denman's Midwifery, vol. i.; and Dr. Hamilton's very excellent Outlines.