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

  • James Blundell
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.

    76/456 (page 68)
    sides of the pelvis respectively, so that the greatest lengths of the head and the aperture may correspond with each other; and then, bearing the head towards the symphysis pubis, yet drawing on the whole in the axis of the brim, on a line stretching from the navel to the point of the coccyx, you cause the head to come down. The head descending in this manner, when it reaches the outlet of the pelvis, put the face into the hollow of the sacrum, and the occiput on the symphysis pubis, and then drawing downward and forward, careful not to lacerate the perineum, you complete the delivery. Now all this, on account of its importance, I describe afresh. The feet presenting, you suffer the womb to act till the thighs are lying forth in the outlet of the pelvis; then gently grasping the legs, you sway the body a little from side to side, or from before backward, careful that the genital fissure sustain no injury. When the breech passes, draw forth a little the umbilical cord, so as to prevent its extension during the subsequent descent of the child. When the thorax approaches, cautiously, tenderly, yet effectually, pass the finger into the side of the pelvis, and if the arm on either side be descending, extend it, and lay it at length on the side of the trunk. When the axilla begin to enter the interior part of the pelvis, be very careful, as they come forward, to press the arms toward the promontory of the sacrum, preventing their impaction between the head and the pubes, and in this manner facilitating their subsequent descent. The axille reaching the outlet, throw the body into the position most conducive to the descent of the arm; placing three or four fingers about the bend of the elbow, and in succession swaying the arms downward with a sweep over the face. Afterwards, abstracting the head with due attention to its position, guarding the perineum, and indeed taking care that the whole operation be conducted with that degree of force only which may inflict no violence on the mother or her child. Vis constlii expers mole ruit sud. Con- tusion, lacerations, sloughings, decapitation, dislocation, frac- tures — these are the dreadful evils to which brute force may give rise. Under the crural presentation, the abdomen of the child is some- times situated anteriorly, the case being just the converse of the preceding. When the abdomen, as examination shows, is situated on the front of the pelvis, there are ¢wo modes in which the child may be extracted, though not with equal facility: first, we may draw down the feet as before, and the axille being brought to a level with the outlet, we may extricate the arms by throwing the body thoroughly out of the way, getting the fingers into the bend of the elbow, and sweeping the arm out of the pelvis, over the face of the child, behind the symphysis. Although, however, the child may be abstracted in this manner, you will find there is a difficulty in the abstraction of the arms especially. ‘This being the case, it is wise to throw the abdomen of the child to the back