The attitude and positions, natural and preternatural, of the fœtus in utero, acts of the reflex or excito-motory system / by J. Y. Simpson.

  • James Young Simpson
Date:
1849
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Licence: Public Domain Mark

Credit: The attitude and positions, natural and preternatural, of the fœtus in utero, acts of the reflex or excito-motory system / 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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    lows The trunk and spine are usually slightly curved, and the head is bent forwards, with the cliin approaching toward the sternum. The thighs are drawn upwards and flexed upon the abdomen; and tlie legs are flexed and laid along the posterior surfaces of the thighs. The feet, which are sometimes crossed, are thus placed near the nates, and in front of them. In the interspace between the knees and face the upper extremities are situated, the arms being laid across the sides of the thorax, and the forearms flexed and crossed in front of the cliest.^ The whole foetus is thus flexed and rolled up into an ovoid mass, of such a form as to occupy the least pos- sible space. One end of the ovoid is formed by the head, the other by the breech of the cliild.^ This ovoid is, in obstetric practice, found to be placed over, or to present at, the os uteri at the time of labour, in three different modes. 1. In a large majoiity of cases, the head or ce])halic end of this ovoid mass is placed lowest in the uteras, and consequently presents at the time of birth. 2. Sometimes, however, the nates or pelvic ex- tremity of the foetal ovoid is the lowest and presentmg part. • 3. Still more rarely the foetus is placed with its long axis lying transversely to the long axis of the uterus, and the presenting pai*t is-the side of the ovoid mass of the foetus ; or, more strictly speaking, one of the shoulders or arms. The following table shows the proportion in which these three leading genera of positions or presentations of the foetus at the full time of pregnancy, occurred in fom* large reports of cases furnished by Lachapelle, Boivin, Clarke, and Collins. 1 Through the kindness of Professor Goodsir, I am enabled to give, in Plate I., a sketch of the attitude of the foetus in a subject brought into the dissect- ing rooms during the present winter. She had died of cholera, near the full time of utero-gestation. The placenta is seen situated on tlie right side of the uterus, opposite the right foot of the infant. In injecting the vessels, some wax escaped in the interspace between the two feet, and probably slightly altered their position. 2 The most common situation of the extremities is not to be determined, as they are found to be a little different in different dissections ; and in the living body they vary almost every moment: thence the hands are seen indis- criminately on the head or face, or across one another, or around the knees or legs, or the legs are sometimes extended, and the feet are placed by the face, or one in that position, and the other contracted and the foot downwards.— Dr William Hunter''s Anatomical Description of the Gravid Uterus. P. 62. 3 The foetus in utero, says Hunter, is naturally contracted into an oval form, adapted to the figure and circumstances of its habitation. The vertex of the head makes one end of the oval, and the nates the other. One side or edge of the oval is formed by the occiput, the back part of the neck, and the incurvated trunk ; the other is made by the forehead, and the mass of con- tracted and conglomerated limbs. The chin is close to the breast, the trunk is bent forwards, the knees are close to the fore parts of the hypochondria, the legs di-awn to tlie back parts of the thighs ; tlie feet, or lower parts of the legs, decussating each other; and the upper extremities contracted into the vacant space betwixt tlie forehead and knees.—An Anatomical Description of the Human Gravid Uterus. I79i. P. Cti.
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