On the nature, mechanism, and treatment of face presentations / [James Marr].

  • Marr, James, -1866.
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: On the nature, mechanism, and treatment of face presentations / [James Marr]. Source: Wellcome Collection.

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    could be detected resting on the brim, but as the process advanc¬ ed the face came down. Rigby mentions having seen cases, 44 where the presentation was midway between one of the cranium and the face,” in which the face ultimately presented. Merriman, on the other hand, observes, 44 that he has twice known the pre¬ sentation of the face, converted by the pains alone, into a natural presentation.” (Synopsis, p. 48.) Mr Ziegler some time ago, at the Obstetrical Society, mention¬ ed an ingenious way of accounting for face presentations, on the supposition, that the hands of the foetus, being forced down from the breast against the chin by the action of the uterus, pushed it from the sternum, and occupying the space between them, forced the chin down, and of necessity caused the face to descend. Mr Ziegler stated at the same time, that it was from observing the hands come down immediately after the head in face cases, that he had been led to form this opinion. Varieties of Face Presentations.—These, like those of the cra¬ nium, have been most perplexingly and unnecessarily multiplied. In both it has been too much the custom to describe the varie¬ ties which authors could make, instead of carefully examining those which really exist in nature; thus forgetting one of the first rules of the illustrious Bacon—44 neque fingendum aut excogi- tandum sed inveniendum quid natura faciat aut feratfi Syste¬ matic authors, Baudelocque, Burns, Campbell, &c., enumerate six varieties, viz. with the chin to either acetabulum, either sacro¬ iliac symphysis, pubes, or sacrum. Some contrive to make even more. Naegele, and Mine. La-Chapelle, two greater names than whom, either for extent of experience, or carefulness of obser¬ vation, scarcely can be found, limit these varieties to two. This division has the advantage both of simplicity, and of comprising all the real varieties to be met with in practice. If, as we have just stated, face cases are transpositions, inversions, as it were, of the vertex, surely we ought not to have more varie¬ ties of the face than of the head itself. True it is, that, strictly speaking, we have four different positions of the cranium; but as Rigby has very ably shown in his late publication, these may all be included under two. The simplicity of this arrangement is peculiarly advantageous in face presentations, because it does away with the perplexity and confusion which the multiplicity of varieties under the old method always occasioned. The first position of the face is where the forehead is to the left acetabulum, and the chin is to the right sacro-iliac symphysis,-— is where the chin is to the right ileum; this corresponds to the first and fourth positions of the vertex ; the right cheek forms the presenting part, and as in cranial presentations the. caput suc- csdaneum is situated on the right parietal bone, so here it is on the right cheek.
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