The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Francis H. Ramsbotham ; with notes and additions by William V. Keating.

  • Francis Henry Ramsbotham
Date:
1857
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Licence: Public Domain Mark

Credit: The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Francis H. Ramsbotham ; with notes and additions by William V. Keating. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    Fostal Circulation, view on left d 1c — v. a. Spine and rib?, b. Pelvi*. c. TT^art. p. Liver, t. Bladder, f, f. Placenta with arteries and reins: it is represented under size. G. o, G. Unil ilical cord.—1. Right ventricle. J. Left ventricle. 3. Left auricle. 4, 4. 4. Aorta and branches. 6. Pulmonary artery at its root. u-riosns from pulmonarv arterv to aorta. 7. Descending vena cava at junction of venae Innominate?-. v. s Aseen cava. 'J. Bifurcation of aorta into primitive i iiaca 10. External Mac artery, left side. 11. External i i ic vein, left side. 12. Internal iliac artery, left side. 13. Umbilical artery, the continuation thereof, 14. Umbilical artery of ri^ht side dotted off to show its progress. 15. Kxternal iliac artery of right side dotted off. 16 External iliac vein of right side dotted off. 17. 17. 17, 17. The ombiliea] vein. It is entwined spirally by the two umbilical The arteries carry the blood to the placenta, F. F. while the unil ideal vein returns it to the I tuonary —;. a. a. Sinus venre porta? or portarum. b. Vena porta1, comparatively small at this peri! of lift. Hepatic branches of vena portae. d. Ductus venosus. e. Poiut of discharge of ductus venosus into the ascending cava. THE FCETUS. The different constituents of the ovum, -which have been already described, are formed solely for the protection, preservation, and growth of the FCBTU8 : —to its necessities all the other parts are contributory and subservient. At the end of gestation the foetus ordinarily measures about twenty inches from the crown of the head to the heel, and weighs nearly seven pounds; but there is an amazing difference in both respects, particularly the latter; and the size is influenced by circumstances not very easily explained. Generally speaking, males weigh considerably more than females, and are longer by about half an inch.1 Some children at full time have been known to weigh even less than five pounds ; while many cases are on record where the weight exceeded double the average. Thus Baudelocque mentions that he had seen one child at birth which weighed twelve pounds, and another thirteen.2 The late Dr. Merriman delivered a woman of a foetus that weighed more than fourteen pounds.3 Sir Richard Croft saw one born alive of fifteen pounds.4 Spence gives a case in which the child and placenta together weighed sixteen pounds Dutch weight, after the brain had been evacuated.5 My father once delivered a woman of a foetus that weighed sixteen pounds and a half avoir- dupois.6 Dr. Moore, of New York, states that in 1821 a child was born in that city that also weighed sixteen pounds and a half.7 And Mr. Bloxam delivered a child by the forceps, which weighed seventeen pounds twelve ounces; and whose length was twenty-four inches.8 This, and that men- tioned in the note, as far as I know, are the heaviest well-authenticated 1 Prof. Simpson, in his essay in the Edinb. Med. and Surg. Journal, quoted at page 47 of this work, which will richly repay a careful perusal, says, that the average weight of -30 boys born in the Maternity Hospital at Edinburgh was 7 lbs. 9 oz. 1 dr. each; and the average weight of 50 girls was only 6 lbs. 12 oz. The average length of the males was 20 inches 5 lines; the average length of the females. 19 inches 10 lines. Dr. Jos. Clarke, in his letter to Dr. Price (Philosoph. Trans. 1786, p. 358) states that he found the average weight of birth, to be 7 lbs. 5 oz. 7 dr.: and that of girls, 6 lbs 11 oz. 6 dr. From this statement, we should expect to find, what really proves to be the case, that the birth of male children is attended, cceteris paribus, with more delay and difficulty than that of females, as well as that more boys are still-born than girls. But Dr. Simpson has further shown that many of those perilous casualties which complicate and embarrass parturition, occur more frequently to women giving birth to'boys than to girls; and also that more boys perish in the first few weeks of extra-uterine life than girls. And he attributes, with apparent justice, this series of mis- chances mainly, if not entirely, to the larger size which the male fcetus at birth possesses over the female. 1 L'Art des Accouchemens, parag. 432. 3 Communicated to me by Dr. Samuel Merriman. 4 Communicated by the same gentleman. See also Hutchinson on Infanticide, page 15. 5 System of Midwifery, case xxv. 6 Practical Observations in Midwifery, case liii., first edition, lv. of the second. 1 New York Med. and Phys. Journal, vol. ii. p. 20. • Lancet, vol. i. 1838-39, p. 477. The case is reported by Mr. J. D. Owen?. In tl Chirurg. Review, October, 1841, p. 427, there is the mention of a fcetus that weighed nearly eighteen pounds at birth.