Compendious system of midwifery : chiefly designed to facilitate the inquiries.

  • William Potts Dewees
Date:
1824
Catalogue details

Licence: Public Domain Mark

Credit: Compendious system of midwifery : chiefly designed to facilitate the inquiries. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    passed into their cavity, as a conductor for the bistoury, with which the uterus must be opened, cutting from within outwards, as was done with the teguments of the abdomen. 1494. This incision in the uterus must be extended at least as high as the superior angle of the external wound, and terminating it below, an inch and a half, or thereabouts, above the inferior an- gle of it. The extent of this incision must be determined in some measure by the size of the child, which is supposed in general to be such, as will in its small circumference measure ten, or ten and a half inches. An opening then of five or six inches, is generally sufficient ; but it is better to make it larger, than smaller, to avoid tearing the angles of the wound, when the child passes it. 1495. Should the centre of the placenta present itself under the knife, it must be cut; but if the edge is found in the neighbour- hood of the wound, it is better to detach it in order to open the membranes. 1496. When the uterus is properly opened, the hand must be passed into it, and the feet searched for and brought out—pro- ceeding as if a child were to be delivered footling. This rule must be observed, except where the head presents naturally to the wound of the uterus ; if it be not expelled speedily by the natu- ral contractions of the uterus, its exit may be favoured, by a slight pressure upon the sides of the belly of the woman, and at some distance from the incision, or by insinuating the forefinger of each hand, under the angles of the lower jaw. 1497. The placenta is soon expelled by the natural powers of the uterus forcing it towards the wound ; this may be favoured by gently acting upon the cord, or by taking hold of the edge of the placenta with the fingers, so soon as it may present itself. Care should be taken to remove any coagula that may have form- ed within the uterus, and a finger passed through its neck, to force any that may have formed in it into the vagina. If the uterus re-^ main soft and inactive after the removal of the placenta, it must be gently stimulated externally by the fingers, to oblige it to con- tract. 1498. But little blood is lost when the uterus is cut in the cen- tre of its anterior face, unless the placenta be attached there, and even then the discharge is of but short continuance, if this organ contract forcibly. A bleeding may supervene some hours after [73]