Dr. Conquest's outlines of midwifery : intended as a text-book for students, and a book of reference for junior practitioners.

Conquest, Dr.

Date:: 1854

Credit: Dr. Conquest's outlines of midwifery : intended as a text-book for students, and a book of reference for junior practitioners. Source: Wellcome Collection.

187/370 (page 173)

$tion, therefore, of the symptom before labour, where the patient has the sensation of a weight rolling from side to side of the abdomen as she moves about, and of the flaccid state of the cord if it happen to be prolapsed during labour, no one of these alleged proofs of the death of the child should be admitted; and, without the concurrence of several of them, an opinion cannot be satisfactorily formed. {^Auscultation. — When the sounds of the foetal heart can be heard, they necessarily afford an infal- lible sign of the child's vitality. They are, however, not invariably audible. An instance lately came under my notice, during a protracted case of partu- rition, in which they could not be heard, although the labour terminated with the birth of a living child. —J. M. W.] Should it have been determined on to perform the operation of cephalatomia, the general rules laid down for the application of instruments must be regarded, before proceeding to diminish the bulk of the head. The uterus and its contents should be kept in situ, by steady pressure made on the abdomen by an as- sistant, whilst the operator passes two fingers of his left hand per vaginam to the head of the child. Having fixed on a suture or fontanelle, the point of the perforator is to be carefully carried along the groove made by the approximation of the fingers to the part to be perforated, through which, by a semi- rotary or drilling motion, it is to be forced into the skull, until its progress is arrested by the shoulders of the instrument. The handles must now be opened,$