Cranial presentations and cranial positions : suggestions, practical and critical / by R.U. West.

  • West, Robert Uvedale, 1810-1870.
Date:
1857
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Licence: Public Domain Mark

Credit: Cranial presentations and cranial positions : suggestions, practical and critical / by R.U. West. Source: Wellcome Collection.

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    u 11. The second kind of customary head-birth—the second posUwn of the Ivead “Which occurs much less frequently than the first, and which, indeed, seldom appears as a primary position, because, as a rule, it merely follows, or proceeds from, the Here the left parietal hone presents; the sagittal suture runs along the second or left oblique diameter of the brim of the pelvis; the lesser fontanelle lies towards the right, and somewhat forw'ard; the face and belly towards the left, and baekwards. “ 111. The third kind of head-birth—the third position of the head. After the first position, this is the most frequent, but, under favourable cireumstances, does not terminate as sueh, but rather, in the course of the labour, goes over into the second. It can only be reckoned amon^ conditionally regular births, for it cannot be terminated by the ordinary powers of nature, except under other- wise favourable circumstances. The left parietal Iwne presents here foremost; the sagittal suture runs nearly in the direction of the first or right oblique dia- meter of the pelvis; the great fontanelle lies towards the left, and somewhat forward; the lesser fontanelle towards the right, and somewhat backward; the face and belly of the child are towards the left, and forwards; the occiput and back of the child towards the right, and backwards.” It is unnecessary here, for the object of this paper, that I should give at length Busch and Illoser’s description of their fourth position. It is described as the least frequent of all, and as being precisely the converse of their third position, terminating usually in the first position, in like manner as their third does in their second. But let me remark that, while Busch and ]\Ioser so far give in to the opinions of Nagele, as to make the “ so-called thit^ posi- tion” the second most frequent cranial position, almost always terminating as a converse of the first—in short, making both their third and fourth positions terminate normally, like cases of their second and first positions respectively—they do not admit, with him, that these presentations do not require exceptionally favour- able circumstances to render possible this conversion. They are influenced by Niigele’s theory, but they are only partially con- vinced. And we find Dr. Rarasbotham still more hesitating on this point, in the foot-note which he devotes to the subject, in the last edition of his very elegant work on Obstetric Medicine,* and which gives a very clear resume of the question at issue:— “ I have thought it better not materially to alter the text, as written by me in the year 1839, although, of late, a change has come over the minds of many members of the profession—in which, to a certain extent, 1 participate—regard- ing the comparative frequency of the different kinds of vertex presentation; and this chiefly in consequence of the publication by Nagele of his views on the subject. An essay on the mech.anism of parturition—composed by that distin- guished Professor for one of the German periodicals, afterwards republished in a separate form in 1822, and translated into English by Dr. Rigby in 1829— attracted very considerable attention, as well here as on the Continent, and has served, in a great measure, to shake the previously-conceived notions on this interesting question. “ It used to be the prevailing, indeed almost universal idea, and, consequently, * The Principles and Practice of Obstetric Jlcdiciiic and Surgerj’. By F. II. Bams- botham, M.D. 4th edition. Foot-note at pp. 19+—197.