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Authentic records of 5 and 6 at a birth are extremely rare and infinitesimal in proportion. The reputed births in excess of 6 must be looked on with suspicion, and, in fact, in the great majority of reports are apochryphal.

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The examples of multiple births of a single pregnancy will be taken up under their respective numbers, several examples of each being given, together with the authorities. Many twin and triplet brothers have figured prominently in history, and, in fact, they seem especially favored. The instance of the Horatii and the Curatii, and their famous battle, on which hung the fate of Rome and Alba, is familiar to every one, their strength and wisdom being legendary with the Romans.

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Twins and triplets, being quite common, will not be considered here, although there are 2 cases of interest of the latter that deserve citation. Sperling reports 2 instances of triplets; in the first there was 1 placenta and chorion, 2 amnions, and the sex was the same; in the second case, in which the sexes were different, there were 3 placentas, 3 chorions, and 3 amnions. What significance this may have is only a matter of conjecture. Petty describes a case of triplets in which one child was born alive, the other 2 having lost their vitality three months before. Mirabeau has recently found that triple births are most common (1 to 6500) in multiparous women between thirty and thirty-four years of age. Heredity seems to be a factor, and duplex uteruses predispose to multiple births. Ross reports an instance of double uterus with triple pregnancy.

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Quadruplets are supposed to occur once in about every 400,000 births. There are 72 instances recorded in the Index Catalogue of the Surgeon General's Library, U. S. A., up to the time of compilation, not including the subsequent cases in the Index Medicus. At the Hotel-Dieu, in Paris, in 108,000 births, covering a period of sixty years, mostly in the last century, there was only one case of quadruplets. The following extract of an account of the birth of quadruplets is given by Dr. De Leon of Ingersoll, Texas:--

"I was called to see Mrs. E. T. Page, January 10, 1890, about 4 o'clock A.M.; found her in labor and at full time, although she assured me that her 'time' was six weeks ahead. At 8 o'clock A.M. I delivered her of a girl baby; I found there were triplets, and so informed her. At 11 A.M. I delivered her of the second girl, after having rectified presentation, which was singular, face, hands, and feet all presented; I placed in proper position and practised 'version.' This child was 'still-born,' and after considerable effort by artificial respiration it breathed and came around 'all right.' The third girl was born at 11.40 A.M. This was the smallest one of the four. In attempting to take away the placenta, to my astonishment I found the feet of another child. At 1 P.M. this one was born; the head of this child got firmly impacted at the lower strait, and it was with a great deal of difficulty and much patient effort that it was finally disengaged; it was blocked by a mass of placenta and cords. The first child had its own placenta; the second and third had their placenta; the fourth had also a placenta. They weighed at birth in the aggregate 19 1/2 pounds without clothing; the first weighed 6 pounds; the second 5 pounds; the third 4 1/2 pounds; the fourth 4 pounds. Mrs. Page is a blonde, about thirty-six years old, and has given birth to 14 children, twins three times before this, one pair by her first husband. She has been married to Page three years, and has had 8 children in that time. I have waited on her each time. Page is an Englishman, small, with dark hair, age about twenty-six, and weighs about 115 pounds. They are in St. Joseph, Mo., now, having contracted with Mr. Uffner of New York to travel and exhibit themselves in Denver, St. Joseph, Omaha, and Nebraska City, then on to Boston, Mass., where they will spend the summer."

There is a report from Canada of the birth of 4 living children at one time. The mother, a woman of thirty-eight, of small stature, weighing 100 pounds, had 4 living children of the ages of twelve, ten, eight, and seven years, respectively. She had aborted at the second month, and at full term was delivered of 2 males, weighing, respectively, 4 pounds 9 1/4 ounces and 4 pounds 3 ounces; and of 2 females, weighing 4 pounds 3 ounces and 3 pounds 13 3/4 ounces, respectively. There was but one placenta, and no more exhaustion or hemorrhage than at a single birth. The father weighed 169 pounds, was forty-one years old, and was 5 feet 5 inches tall, healthy and robust. The Journal of St. Petersburg, a newspaper of the highest standard, stated that at the end of July, 1871, a Jewish woman residing in Courland gave birth to 4 girls, and again, in May, 1872, bore 2 boys and a girl; the mother and the 7 children, born within a period of ten months, were doing well at the time of the report. In the village of Iwokina, on May 26, 1854, the wife of a peasant bore 4 children at a birth, all surviving. Bousquet speaks of a primiparous mother, aged twenty-four, giving birth to 4 living infants, 3 by the breech and 1 by the vertex, apparently all in one bag of membranes. They were nourished by the help of 3 wet-nurses. Bedford speaks of 4 children at a birth, averaging 5 pounds each, and all nursing the mother.

Quintuplets are quite rare, and the Index Catalogue of the Surgeon General's Library, U. S. A., gives only 19 cases, reports of a few of which will be given here, together with others not given in the Catalogue, and from less scientific though reliable sources. In the year 1731 there was one case of quintuplets in Upper Saxony and another near Prague, Bohemia. In both of these cases the children were all christened and had all lived to maturity. Garthshore speaks of a healthy woman, Margaret Waddington, giving birth to 5 girls, 2 of which lived; the 2 that lived weighed at birth 8 pounds 12 ounces and 9 pounds, respectively. He discusses the idea that woman was meant to bear more than one child at a birth, using as his argument the existence of the double nipple and mamma, to which might be added the not infrequent occurrence of polymazia.

In March, 1736, in a dairy cellar in the Strand, London, a poor woman gave birth to 3 boys and 9 girls. In the same journal was reported the birth at Wells, Somersetshire, in 1739, of 4 boys and a girl, all of whom were christened and were healthy. Pare in 1549 gives several instances of 5 children at a birth, and Pliny reports that in the peninsula of Greece there was a woman who gave birth to quintuplets on four different occasions. Petritus, a Greek physician, speaks of the birth of quintuplets at the seventh month. Two males and one female were born dead, being attached to the same placenta; the others were united to a common placenta and lived three days. Chambon mentions an instance of 5 at a birth. Not far from Berne, Switzerland, the wife of John Gelinger, a preacher in the Lordship of Berne, brought forth twins, and within a year after she brought forth quintuplets, 3 sons and 2 daughters. There is a similar instance reported in 1827 of a woman of twenty-seven who, having been delivered of twins two years before, was brought to bed with 5 children, 3 boys and 2 girls. Their length was from 15 1/2 to 16 1/2 inches. Although regularly formed, they did not seem to have reached maturity. The mother was much exhausted, but recovered. The children appeared old-looking, had tremulous voices, and slept continually; during sleep their temperatures seemed very low.

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