The Philadelphia practice of midwifery / By Charles D. Meigs.

  • Charles Delucena Meigs
Date:
1838
Catalogue details

Licence: Public Domain Mark

Credit: The Philadelphia practice of midwifery / By Charles D. Meigs. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

    43/436 (page 17)
    ])clvis be possessed of an excessive amplitude, the womb does not rise up as it ought to do ; the female continues to experience, throughout the uterogestation, the symp- toms of a prolapsus of tliat organ, the lower end of the womb sinking down towards the perineal strait, and in- commoding both the rectum and bladder by its pressure, and ])roducing that uneasy sense of dragging weight, and pain about the loins, which are chracteristic marks of prolapsus uteri. When labour comes on in a woman with a very ample pelvis, her throes have the effect of urging the whole body of the uterus down towards the perineal outlet, and hence, before the mouth of the womb is fully dilated, the head of the child, still partially en- veloped in the undilated womb, may be pushed through the vulva. On the other hand, if the orifice of the womb should yield readily, the head, finding little resistance from the capacious bones of the pelvis, is liable to be very suddenly expelled, and the womb, surprised, as it were, by the sudden evacuation of its cavity, falls into a state of atony, the consequence of which might be either he- morrhage, or inversion of the organ. These are the in- conveniences resulting from deformity from excessive amplitude. The reader will see that most of them may be readily obviated by a careful practitioner, and that they possess a greater apparent, than real importance or magnitude. Not so with deformity from want of am- plitude. Inasmuch as tlie bony frame of one individual may differ from that of another, in respect to size and form, some being very large and others very small, as the head of one woman is smaller than that of another, it is evi- dent that the pelvis may be smaller in one than in an- other. A woman shall have a pelvis, which, to all ap- pearance, is perfectly well formed, all its parts bearing a due proportion to each other, whereas, when it comes to be measured, it is found to be of an under size. Such a female would experience far greater difficulty in giving birth to her child than she w^ould if her pelvis had been of a full size, and the difficulty would be just in propor- tion to the departure from the average or standard size.