An Account of the Praeternatural Delivery of a Foetus at the Anus; Communicated by Mr. Nourse, One of the Assistant Surgeons to St. Bartholomew's-Hospital; Demonstrator of Anatomy at Surgeons-Hall, and F. R. S.

I. An Account of the præternatural Delivery of a Fœtus at the Anus; communicated by Mr. Nourse, one of the Assistant Surgeons to St. Bartholomew's-Hospital; Demonstrator of Anatomy at Surgeons-Hall, and F.R.S. The kind Invitation I had from Mr. Giffard the Surgeon, to assist at the Opening of a Patient of his, gives me an Opportunity to lay before this Society, a Case as extraordinary, and I believe very like what Mons. Littre has given us in the Memoirs of the Royal Academy of Sciences at Paris, Ann. 1702; (viz.) where a Fœtus had no other Nidus than the Ovary; and was brought forth through the Rectum. The Symptoms previous to this præternatural Birth, the forementioned Gentleman has very faithfully drawn up; be pleased therefore to take them in his own Words. 'I was sent for about the middle of August last, to a Woman who then judged herself to be between three and four Months gone with Child; she had all the Symptoms preceding a Miscarriage, and upon touching, I found the Os Tineæ somewhat dilated and spread, from whence I concluded a Miscarriage would ensue, and therefore ordered what I thought proper to promote it; but I was sometime after informed by her Husband, that although she before believed that she had miscarried, yet that she now thought herself Quick; as feeling somewhat to move within her Belly, agreeable to what she had perceived after former Quickenings. Thus it passed on for about six or seven Weeks; Weeks; in which Time she grew much bigger, and the Motion more perceptible; so that there remained no Doubt of her being with Child. About the third of October she was seized with violent Pains in her Belly and Back; which daily increasing, her Sister, by her Desire, came to me on the sixth, when I went to her, and found her labouring under very great Pains, and other Complaints like those preceding a Miscarriage or Delivery: But to be better satisfied, and to strengthen my Opinion, I passed up two Fin- gers into the Vagina, to examine by the Touch, whe- ther the Os Tinea began to open and spread. I there felt a large and unusual Fulness and Tension, which I then judged to be the Body of the Uterus sunk low into the Vagina, and much distending it, and extend- ing backwards, and pressing against the Rectum, so that the Excrements could not readily pass, neither could she, from its Pressure upon the Neck of the Bladder, freely make Water. I could not find the Os Tinea, although I very carefully examined all a- bout with the Ends of my Fingers; wherefore I then judged that the Fundus Uteri must have receded from its natural Position, and be bent backwards to- wards the Rectum: In which Opinion I was the more strengthened from the Fulness I before observed, stretching backwards; and therefore concluded that the Os Tinea must be very forward: Wherefore I en- deavoured to pass my Fingers between the Os Pu- bis and the Fulness which pressed against the upper Edge of the said Bone. This with some Difficulty I effected, and at length about two or three Inches a- bove the said Bone, I felt the Os Tinea with the Ends of my Fingers. The Cause of this Situation will more clearly appear in the Pursuit of this Account, I ordered her anodyne and quieting Medicines to re- lieve her Pain, which she was obliged to repeat at least every twelve Hours, with proper Cordials to sup- port Nature; and sometimes Clysters. Thus matters continued to the twentieth of the said Month, only that for some Days before, a Water tinged with Blood came away, as she imagined, through the Anus, and which she believed proceeded from the Piles, with which she was sometimes troubled. On the twentieth, her Husband came to me about six of the Clock in the Morning, telling me that the Midwife had brought away a Fœtus, but could not compleat her Business; whereupon I immediately went to the Midwife, who upon my coming told me that a Fœtus was protruded through the Anus; and to confirm it, desired me to examine, which I did im- mediately, and found the Funis Umbilicalis hanging out about two or three Inches beyond the Anus, and passing up through the same: I therefore passed my two fore Fingers by the String into the Anus; when I found about three Inches up, an Opening, as I then judged, into the Uterus, wide enough to admit the Ends of three or four Fingers, and the Funis Um- bilicalis passing into it; from hence I was assured that the Fœtus came out that Way. I endeavoured, with my Fingers passed into the Opening, to bring away the Placenta; but as it was very rotten, it tore a- way between my Fingers, so that I was forced to bring it in small Pieces, and was at last obliged to leave a large Part of it. The Septum or Partition between the Anus and Vagina was entirely whole, and no Perforation through it. From these Appear- ances ances I then concluded that a Mortification must have begun in the Uterus, and so from its Contiguity be communicated to the Rectum; so that Nature endeavouring to expel what was contained, and forcing it against this Part already mortified, and consequently ready to give way and separate upon any Pressure made against it, produced this Opening, and the Protrusion of the Fœtus through it into the Rectum, and so on through the Anus. There was a large Discharge of grumous Blood and other Substances through the Anus, which continued coming away until the twenty-sixth of the aforesaid Month, when the Woman died about three of the Clock in the Afternoon. I should have observed that there was a Fulness and Hardness very perceptible, to be felt outwardly in the fore-part of the Belly, some distance below the Navel, from the Time that the Fœtus came away to her Death; which upon opening the Body, I was well assured, was the Uterus forced upwards and forwards by a Sacculus, which being large and distended filled up the Pelvis; and by its Bulk pressed the Uterus forwards. The Fœtus was perfect in all its Parts; but much wasted and shrunk from its being some time dead; and consequently putrified. This we thought necessary to premise an Examination of the Parts (which I have here brought) whose Appearances upon Dissection, were as follow. The Vagina, Uterus, Ligamenta Rotunda, left Ovary, Fallopian Tube, and Ligamentum Latum on that side, together with the Hypogastrick, and Spermatick Vessels on the same Side, were in a natural State. The Fallopian Tube on the right Side, we traced traced from the *Fundus Uteri* almost to the *Morsus Diaboli*; where it was confusedly united with, and opened into the *Sacculus* hereafter to be described. The *Ovary* on this side with the *Ligamentum Latum*, was dilated into a large *Sacculus* of an irregular Form, extending itself behind the *Uterus* (to the posterior Paries of which it adhered) and passing on towards the left, was connected to that Part of the *Colon* that terminates in the *Rectum*, and the *Rectum*. In this *Sacculus* we found great part of the *Placenta*, and the Remains of lacerated Membranes, besides the Aperture of the *Fallopian Tube* mentioned before, and another about four Inches in Diameter into the Middle of the *Rectum*: That part of the *Ureter* on the right Side which lies between the Ovary and the Kidney was dilated, and so was that part of the *Rectum* between the Aperture into it, and the End of the *Colon*; both which were caused from the Contents of these Canals being obstructed in their Passage. **Fig. I.** Shews the *Uterus*, with the *Sacculus* behind it, part of the *Colon* and the *Rectum*; the *Fallopian Tubes*, *Ovary* on the left Side; *Ligamenta Rotunda*; and the *Vagina* laid open to the *Os Tincae*. *A* The *Uterus*. *B* The *Fallopian Tube* on the left Side. *C* The *Ovary* on the same Side. *D* The *Ligamenta Rotunda* *E* The *Vagina* laid open. *F* That part of the *Colon* that terminates in the *Rectum*. *G* The *Rectum* continued to the *Anus* under the *Vagina*. *H* The H The Fallopian Tube on the right Side, whose Extremity opens into the Sacculus formed from the Ovary. I The Sacculus extending itself behind the Uterus; wherein we found the Placenta and several lacerated Membranes; and from whence there was a large Opening into the Rectum. Fig. II. Shews the Inside of the Sacculus and its Aperture into the Rectum. A The Intestine. B The Sacculus adhering to it. C The Opening from the Sacculus into the Rectum. D The Membranes found within the Sacculus. E The Vagina turned to the Right. II. An Extract of a Letter from Mr. William Stevenson to Benj. Hoadly, M.D. F.R.S. Containing an Account of an Observation of an Eclipse of the Moon, on July 29, 1729, made in Barbados by Mr. Stevenson's Brother. He took care to regulate a very good Clock, and brought it to true Time about 14 Days before the Eclipse. On the Day it happened, he saw the Sun set, and found the Clock right, according to the mean Time, Refraction allowed. At the Beginning of the Eclipse, the Moon was clouded. At 7 H. 18 M. (in the Evening) apparent Time, he saw the Moon 2 Digits Eclipsed, about 30 Degr.