Obstetric operations : including the treatment of hmorrhage / by Robert Barnes ; with additions, by Benjamin F. Dawson.

  • Robert Barnes
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Obstetric operations : including the treatment of hmorrhage / by Robert Barnes ; with additions, by Benjamin F. Dawson. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    and to tear tlie uterus. The conditions of efficiency are these : The perforating blades must be strong and straight. The curve sometimes given is of no use whatever, as it throws the force out of the perpendicular. The shanks must be long, eight inches at least, so as to reach the pelvic brim without interfering with the working of the handles. There should be a broad rest for the hand, to give a powerful and steady hold. Almost all the instruments in use fail in this point. The best of all those I have tried and seen is the modification of Holmes's and Kaegele's by Dr. Oldham; it fulfils every indication. On the Continent, especially in Germany, the trepan, first introduced by Assalini, at times variously modified, is chiefly used. To use a trepan, the crown of which can hardly be less than an inch in diameter, you must have at least an equal amount of surface of the cranium accessible, and the crown must be applied quite perpendicularly to the cranium. ]^ow, these conditions are not always present. I have been much pleased in some cases with the trej^an of Professor Ed. Martin, of Berlin. But in others, where the pelvic defoi:mity was great, and especially where it was necessary to perforate after the body was born, there was no room for the passage or appli- cation of the instrument. I found no difficulty with Dr. Oldham's perforator ; it will run up through the merest fis- sure wherever the finger will go to guide it, and will readily penetrate any part of the skull. This, then, is the perfora- tor to be preferred.^ The Crotchet.—The design of the crotchet was to seize and extract, by taking a hold inside the cranium, after per- foration. For this purpose the best crotchet is the one used in the Dublin Lying-in Hospital. It has a curve in the shank, which is set in a transverse bar of wood for a handle. This gives an excellent hold for traction, that does not fatigue or cramp the operator. The crotchet, however, as an extracting instrument, has been greatly displaced by the ^ It is figured in the Obstetrical Society's Catalogue of Instruments, p. 16Y.