A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman.

Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    34/880 (page 6)
    CHAP. generally admitted to be true. The belief in these doctrines being thus sapped by the logic of facts, the whole rotten superstructure began to crumble away, and from this epoch modern midwifery may be said to have had its origin. It required a mind of no ordinary power and energy to be the pioneer in this new path ; but it requires no critical analysis of the work of Pare to show that the great surgeon was a great master, and that scientific Midwifery as well as Surgery had at last found a fitting modern exponent. Par6 advises turning by the feet in difficult cranial presentations ; but if this cannot be done, he recom- mends craniotomy, or delivering by the crotchet,—which instrument he directs us to fix, by the method of AEtius, in the orbit or mouth, or below the chin. He frankly confesses, that although he has carefully studied the position of the fcetus in utero, he has been unable to come to a satisfactory conclusion as to what is to be considered the normal posi- tion ] while, as regards the causes of difficult labour, he dilates at some length, and on the whole with considerable accuracy. After pointing out with great clearness the serious nature of the impediment caused by cicatrices, the result of former midwifery accidents, he enumerates the various positions of the foetus which interfere with or prevent delivery, and concludes by noting the bad effects of a premature escape of the waters, and of uterine inertia. At this period, the Parisian school was undoubtedly the first in the world; and as all the leading surgeons there practised midwifery, the practice as well as the theory of obstetrics became rapidly developed. Guillemeau, surgeon to the French king, and a pupil of Ambroise Par6, further developed the theories of his master; but the book which seems to have exercised the greatest influence was the remarkable one of Mauriceau, “Sur les Maladies des Femmes grosses, et de ceux qui sont accouclffies.” This author gives by far the best account which, up to his day, had appeared of the phenomena of labour as observed by the accoucheur. He criticises with some asperity the views of Columbus, which, however, we find to be, at least as regards the position of the chi hi in the womb, infinitely more correct than his own. The following are his conclusions on this point:—Up to the seventh or eighth month, the child is situated in the centre of the womb, the head being towards the fundus and the face looking, directly forwards. About this period an important change takes place in its position, which, if it happens sooner, is attended with danger. The weight of the head and upper part of the infant having now become relatively greater, it causes the child to turn forwards (faire la culbute cn devant), so that the face is now turned directly backwards to the promontory of the sacrum. This doctrine is simply an amplification of the views of Hippocrates on this