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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    cihle attempt should he made to deliver hy its aid hef ore pass ing on to turning or perforation. 3. The Extraction.—Get the nurse to press upon tlie right hip and support the back. Grasp the handles with one hand, and apply the fingers of the other hand to the ring or shoulders at the lock. Draw at first backward in the axis of the brim during the pains, if any be present, and at intervals of a minute or so, if there be none. Concur- rently with traction, alternate slight leverage movements may be executed by swaying the handles gently from side to side, always taking care not to press the shanks against the pelvic walls. Each blade is the fulcrum to its fellow. The finger which is used in the ring from time to time gauges the advance of the head. The advance of the head is measured by the following standards : First, you feel if the occiput approaches the pubic arch, by passing a finger below and behind the pubic bones. Secondly, you sweep your finger round the circum- ference of the brim, and thus feel if the equator of the head- globe is pressing lower down through the brim. Thirdly, by feeling the direction of the sagittal suture. If you find that it is approaching parallelism with the conjugate diam- eter, you may be certain that the head is descending. Fur- ther evidence is found in the rotation of the forceps. As the head can hardly turn upon its cervico-vertical axis with- out at the same time descending in the pelvis, if the handles of the forceps are observed to rotate, this rotation, being imparted by the head, is evidence of advance. Again, as the head descends, of course more and more of the shanks and blades will become visible. This, indeed, is open to a fallacy. Allowance must be made for some degree of sli])- ping, which takes place with all the English instruments w^hose blades have only a moderate bow. And farther, when the head is fairly in the pelvic cavity, the blades lose something of that external support which, as explained in Chapter 11,, is the chief force in maintaining the grasp