A compendious system of midwifery : chiefly designed to facilitate the inquiries of those who may be pursuing this branch of study ... / by William P. Dewees.

William Potts Dewees

Date:: 1839

Credit: A compendious system of midwifery : chiefly designed to facilitate the inquiries of those who may be pursuing this branch of study ... / by William P. Dewees. 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.

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$pelvis where the opening of the superior strait in its small dia- meter will give three inches, these instruments have been suc- cessfiiliy employed; of which Baudelocque* gives us an example which not only proves the useful powers of these instruments, but shows the little certainty with which the death of the child is marked, even by the combination of many of the most formi- dable sign^. This case is full of in>truction, and should be care- fully read. 1547. But when the small diameter of the superior strait l-.as less than three inches,-f these instruments cannot be em.ploycd ;;t the full period of utero-gcstation with any chance of success. To be useful even then, requires that the head of the child shall be of moderate size, and yielding; well situated, and that n skilful hand should apply them :i: As, however, they offer a better chance, if properly conducted upon the head, than turning, thev should he employed always in preference to this operation, when even a force not to be called great, would be required to make the head pass the superior strait; for the child will suffer less from a com- pression of the head, than from the severe extension of its neck; which it must necessarily undergo, when detained in a pelvis in which the opening is less than f )ur inches. 1548. It must, however, not be concealed, that these instru- ments are not safe, under the circumstances we are now consi- dering, but in the hands of a few; and are only rendered so to them, by their superior profes-iional attainments, and the long habii of using them. To the inexperienced practitioner, tiiey should be entirely forbidden; not only because they may destroy the child, but also because the mother may be severely, or irre- parably injured by their use. Should, however, the defect of size be in the lower strait, and that not excessive, the forcej'S will every now and then answer a valuable end, as the following case will prove: • System, p-.n: 1898. f Tliis is the limit fived upon by Buiidclocque and oilier Fi-eneh writers: it m'.;st, llierefbre, be borne in mind, tiiat tbe Fi'cncb incli is one Hue or one-twelflli ofanincli l.irger tlian the Eng-lisU inch: con-iequently, the three inclies l-'iencl\ will be equal to 3 Aths of the English, or tliree inches and a quarter. ^ Bvit, inasmucli as we Iiave not discovered tbe means of appl}'ing- such pres- sure to and for liie benefit of the cliild, witliouf, in the mean time, compromlsin,:, the more im])ortant interests of tbe motlier, it slioukl be held as tiie bousitlen duty of our art, in the treatment of such cases, (cases of narrow ])elvis) to refrain from all inordinate forcible attempts to deliver with tbe forceps.—Dr. Bavin's Elein. Opcr. Mid. p. 140. 47*$