Observations on the directions given by various writers on the practice of midwifery, for turning the child : with an account of an improved method of performing that operation / by John Breen.

  • Breen, John
Date:
[1818]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the directions given by various writers on the practice of midwifery, for turning the child : with an account of an improved method of performing that operation / by John Breen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    to avoid tlie imputation of inventing a position favourable to the illustration of the method now recommended. Were this plate exhibited to an intelligent person, whose mind had not been biassed by such expressions as “ tirer par les pieds,” “ search for the teet and turn,” and an inquiry made from such an indi- vidual, what would be the best method of changing the situation of the child, so that the head should be removecl towards the fun- dus uteri, little doubt can exist, that he would direct one or two fingers to be hooked in the flexure of the knee, and the other hand to be applied to the presenting part, which should be pushetl gently upwards, while the hand engaged in the ute- rus should be drawn downwards and forwards, towards the centre of the longest diameter of the brim of the pelvis. By thus proceeding, the child would be made revolve on the lesser axis of the trunk, and the foot would be brought into the vagina within the reach of a noose. By adopting a different procedure, and endeavouring to lay hold of a foot, according to the usual directions, it is obvious, that the hand of the operator must traverse a greater space of the uterus, a matter of very consider- able difliculty, cither when the action of that viscus is strong, or when it is closely contracted on the body of the child. This dif- ficulty being surmounted, when the foot is laid hold on, it is very apt to slip and recede from the grasp, as well from the violence of uterine action, as from the hand being cramped, and nearly powerless, by reason of the previous exertion. Those of my readers engaged in the practice of midwifery will be well aware, that these difficulties are not imaginary, but such as frequently occur, and cause extreme embarrassment to the practitioner, and much additional pain to the patient. By adhering to the direc- tion of liooking the knee, the hand of the operator is in a great measure protected during the pains, and he is enabled delibe- rately to proportion the force requisite to change the position to the resistance he encounters. Besides, as the knees must have been nearly in contact with the superior part of the abdomen from the earliest developement of the extremities of the embryo, should, what may be called accidental circumstances have re- moved them from this natural and usual position, but little force will be requisite to restore them to it. I am satisfied it some- times happens in a position such as is represented in the plate, that when tlie proper measures are not taken in time, that, by the strong and violent action of the uterus, an interior extremi- ty may be removed from the natural situation, and a foot brought nearer than the knee to the vagina. In such case it will of course be proper to take hold of the foot in preference to searching for the knee. This occurrence I consider more likely to have frequently taken place when the practice of midwifery
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