On the duration of labour as a cause of mortality and danger to the mother and infant; &c : in reply to a letter of Dr. Collins / by J.Y. Simpson.
- James Young Simpson
- Date:
- 1848
Licence: Public Domain Mark
Credit: On the duration of labour as a cause of mortality and danger to the mother and infant; &c : in reply to a letter of Dr. Collins / by J.Y. Simpson. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![est-sized long forceps used in Britain, even wlien com- pletely closed, measure from S| inches to 3^, it is clear that where the bones of the pelvis were denuded of their soft parts, there would not be space to admit of their applica- tion/' Now, here, you commit two most extraordinary errors in relation to the mechanism and application of the long forceps. They are not applied antero-posteriorly,— that is, in the most narrow and most occupied diameter of the pelvis. The contracted pelvic brim is cordate or ellip- tico-cordate; and, (in this part of the world at least,) chil- dren's heads are 7iot of that shape, but round or oval. Con- sequently, in entering the pelvic brim, they leave and must leave, laterally or diagonally, a free space on either side. It is in these free spaces that the blades of the long for- ceps are passed up by all who use them. Surely the rejection altogether of the benefits of the long forceps from the practice of the Dublin Hospital, when under your care, was based on grounds more valid than the two very strange and very grave errors which you have here expressed on an important yet simple point in obstetric anatomy and obstetric surgery. 8. In relation to the operation of craniotomy, you try to show that the whole mortality from it was small. Fif- teen only, you say, out of 79 died. That was 1 death in every 5 operations. Was that a small mortality? When the same operation was performed after labours of 48 hours' duration, my observations in regard to its mortality are, you state, frightful indeed; but, notwithstanding, you aver that the resulting mortality was marvellously small, for you argue the deaths were only 11 out of the ] 6,414 deliveries, (here reasoning again according to your old and erroneous mode of calculation.) There were 11 maternal deaths out of 27 craniotomy operations; or of the 27 women delivered by the crotchet at that late period of the labour, 1 in every 2i died. Whether is this mortality](https://iiif.wellcomecollection.org/image/b21474886_0022.jp2/full/800%2C/0/default.jpg)
