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At 6 A.M., July 3d, I was called to see Mrs. D. R. Barnett. I found her greatly enlarged, with extreme œdema of the feet and legs. Labor had commenced four hours previously. Pains were frequent and regular, the os dilatable and a vertex presenting; the waters had not passed. After rupturing the sac labor progressed more rapidly, and about 8 o'clock a female child was born. The pains continuing, I examined again, and discovered a breech presenting, also in an unbroken sac. Shortly after rupturing this a male babe was delivered. Much to my surprise the pains continued, and after caring for the second child I examined again, and found another vertex engaged and also in its own sac. This I could not rupture in the usual manner with my finger, but had to use a pair of blunt scissors. In fifteen or twenty minutes a second
Arthur M. QUADRUPLE PREGNANCY. JAMA. 1885;V(6):167. doi:10.1001/jama.1885.02391050027010
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