The principles and practice of midwifery : with some of the diseases of women.

  • Milne, Alexander
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of midwifery : with some of the diseases of women. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    the free end of the first finger precisely behind the symphysis pubis, and the point of the second finger against the promontory of the sacrum. It is seldom but what one can extend the fingers sufficiently for this, even in normal cases. The fingers are then to be care- fully withdrawn, and their position maintained until the space betwixt the two extremities is ascertained by compasses or a measure. This plan can be carried out even when the head has descended somewhat into the pelvis, for the fingers may be pushed up between it and the pehdc wall. Another ))lan I have adopted in some cases of contracted lirim is this. I have introduced the whole hand into the pelvis, and pushed it u]) between the symphysis pubis and the sacral promontory. As one knows, or may readily know, the breadth of one’s liand, the antero-posterior diameter may be made out by the number of fingers admitted. If your hand just fits in, it does not look very promising, but if, say only two fingers are admitted, it is serious indeed. In a normal case the hand readily passes up witliout imping- mg either in front or beliind. More than once I liave thus been able early, and before a patient has been too much exhausted, to find out the necessity and unavoid- ableness of craniotomy. Chloroform facilitates gi’eatly the internal measurement of the pelvis. 25. Pelvic Deformities and Abnormalities.—A knowledge of the deviations of the jiclvis from its normal size, or shape, is of the utmost imjiortance, because these deviations always affect parturition moi'o or less, and sometimes render it a dangerous and even fatal process. In some few very extreme cases it is even made impossible by reason of them. The abnor- mal deviations have been divided into the general and special, the foiuner embracing those eases where there is cither increased or diminished cajiacity. Those where there is an excess of room—i]\G pelvis ccquahiliter jiisto major—are not uncommon; while those where there is an equal diminution of space—pelvis cequahiliter