Lectures on the principles and practice of midwifery / [James Blundell] ; edited by Charles Severn.

  • Blundell, Dr., 1790-1878
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the principles and practice of midwifery / [James Blundell] ; edited by Charles Severn. Source: Wellcome Collection.

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    ment is twofold: you may, where the soft parts are relaxed in a high degree, use it internally, or you may apply it externally. When you apply it internally, placing one upright upon the sym- physis pubis, and the other against the promontory of the sacrum, you may read off by the scale of the distance between the two. If the parts are too rigid to admit of your using it internally, then you must lay one upright against the projection of the promontory, and the other to the pubes; and seven or eight lines must be deducted as an allowance for the thickness of the soft and harder parts in front, — the difference will give you the clear space between the front and the back. By accoucheurs of some repute, there is another instrument much applauded, and this instrument isnothing more than a pair of bow compasses, more useful perhaps than the other, because of very easy application. The method of using them is this: you place the one point on the symphysis pubis, the other on the spinous process of the last lumbar vertebra; then deducting three inches, in that manner you obtain the clear space, interposed between the sacrum and the symphysis pubis. This is an instrument I do not use myself, for I measure the pelvis in another way, as I shall now explain to you; but I deem it an useful one. Besides these methods, you may also measure the pelvis very sufficiently by means of the fingers. If you want to know the distance between the front and the back, let the fore-finger be placed_on the promontory of the sacrum, and the root of the finger at the arch of the pubes. To measure the brim from side to side you may spread out the fingers, —dintroducing all the fingers closely together, and then spreading them from one side to the other. But a better method of measurement consists in the appli- cation of all the fingers to the back part of the symphysis pubis. If there be a want of room behind the pubis, you will then feel something of an angle there. Ifthe brim be of full measure from side to side, when all the fingers are introduced and placed behind the symphysis, they will lie all in the same place. If you wish to measure the outlet of the pelvis, the most convenient time to ac- complish this is when the child’s head is there, and certainly then the inquiry becomes most important. You may easily pass your fingers round between the bones and the head, and so ascertain whether there is a sufficiency of space. If you think it worth while, however, before the head descends, you may measure the outlet of the pelvis from front to back, first by putting the fingers so that the root of the index lies against the arch of the pubes, ‘and the tip of it upon the coccyx, thus ascertaining the measure between the front and the back; secondly, by laying all the four fingers into the arch of the pubes, when you ascertain the distance between the tuberosities of the ischia —in other words, the mea- sure from side to side. However, all these I pass over, because in general practice you will find them but of little importance. When the pelvis is contracted in a slight degree only, and you 3