SIGNS OF PREGNANCY 295 without being pregnant may miss their menstrual periods for some time after illicit intercourse simply from, fear and nervousness. In married women an, intens^-desjre for pregnancy jtnay stop menstruation for some time. Pregnancy may occur in a^oman^who has never menstruated. It has already been mentioned that pregnancy has occurred in some cases even after the climacteric period. It may also occur in a woman during the amenorhhcea of lactation. When a woman suckles her child she does not usually menstruate for the first isixmonths afterfjdeliyery, but it is quite possible for her to be impregnatSctlffij^ relates the case of a woman who was delivered of a healthy full-term female child on February 2, 1929. The child was breast-fed and the mother never men- struated. She was again delivered of another fully developed female child on December 1, 1929. In rare cases menstruation may occur for the first two or three periods after conception until the decidua vera and decidua reflexa are separate. They generally adhere to one another about the twelfth week of pregnancy. Lastly, a woman may practise deception on the medical jurist by denying the stoppage of the monthly course, and imitating the catarnenia by blood, if she wants to conceal pregnancy. Similarly, she may conceal menstruation if she feigns pregnancy. 2. Morning Sickness.—Nausea or vomiting, usually as a sign of preg- nancy, most frequently occurs soon after the woman rises from bed in the morning. It commences about the beginning of the second month, and lasts generally till the end of the fourth month. It may, however, commence soon after conception. It is not a reliable sign, as it may occur in gastric troubles or chronic alcoholism, irrespective of pregnancy. 3. Sympathetic Disturbances.—Salivation, perverted appetite in the form of longings or cravings for very strange and even disgusting articles of food, and irritable temper are a few of the conditions which are caused reflexly by pregnancy. 4. Quickening.—The first perception of the foetal movement felt by the mother is known as " quickening ". It is attributed to the uterus coming into contact with the abdominal wall, and occurs at any time between fourteen and eighteen weeks. When quickening is felt, the woman is said to be " quick with child ". The sensation of quickening may be simulated by flatulence and peristaltic movements of the intestines, especially in a nervous or hysterical woman, who is anxious to have children, although she is not pregnant. None of the above signs are reliable, and the medical jurist should never venture an opinion on these signs alone. OBJECTIVE SIGNS These are— 1. Mammary changes. 7. Intermittent uterine 2. Pigmentation of the skin. contractions. 3. Changes in the vagina, «• Fcetal movements. 4. Changes in the cervix uteri. -J Ff^f so™ , - o, Pj_ . T ., .,,, r 10- -bsetal heart sounds. 5. Softening and compressibility of n Ballottement. the lower segment of the uterus. 12. X-Ray examination, 6. Enlargement of the abdomen. 13. Biological Test. 1. Mammary Changes.—From the very commencement of the breasts become full and tender, and by the second month _ _ ••..._ - - •._•.. 4. Brit. Med. Jour., April 11, 2981, p. 652.