Volume 1

A treatise on the science and practice of midwifery / by W.S. Playfair.

  • William Smoult Playfair
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the science and practice of midwifery / by W.S. Playfair. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    182/432 (page 158)
    [Part 11, less, viz. 131 for males, and 138 for females. He predicted the sex correctly by this means in 45 out of 57 cases, while Frankenhauser was correct in the whole 50 cases which he specially examined with reference to the point. Dr. Hiit- ton, of New York,' was also correct in 7 cases he fixed on for trial. Devilliers found the difference in the sexes to be the same as Steinbach ; he attributes it, however, to the size and weight rather than to the sex of the child, and believes the pulsations to be least numerous in large and well-developed children. As male children are usually larger than female, he thus explains the relatively less frequent pulsations of their hearts. Dr. Gumming, of Edinburgh, also believes that the weight of the child has considerable influence on the fre- quency of its cardiac pulsations, so that a large female child may have a slower pulse than a small male.^ The point, however, is more curious than practical, and the rapidity of the pulsations certainly would not justify any positive prediction on the subject. Circumstances influencing the maternal circulation seem to have no influence on that of the foetus. Sitg The fcBtal heart-sounds are generally propagated best by which the' i]^q ^ack of the child, and are, therefore, most easily audible heard!'^ when this is in contact with the anterior wall of the uterus, as is the case in the large majority of pregnancies. When the child is placed in the dorso-posterior position, the sounds have to traverse a larger amount of the liquor amnii, and are further modifi.ed by the interposition of the foetal limbs. They are, therefore, less easily heard in such cases, but even in them they can almost always be made out. As the foetus most frequently Kes with the occiput over the brim of the pelvis, and the back of the child towards the left side of the mother, the heart-sounds are usually most distinctly audible at a point midway between the umbiUcus and the left anterior superior spine of the ilium. In the next most common position, in which the back of the child lies to the right lumbar region of the mother, they are generally heard at a corresponding point at the right side, but in this case they are frequently more readily made out in the right flank, being then transmitted through the thorax of the child, which is in contact with the side of the uterus. In breech > Kew Yor/c Med. Jotir. July 1872. - Edin. Med. Jour. 1875.