Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / by Thomas Radford.

Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / by Thomas Radford. 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.

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    doubtless, the object of every obstetrician ; for, unless this were bis inteution, it would be better at once to have recoiirse to craniotoiiiy. The head of the child cannot bear more than a certain degree of pressure compatible with its life ; and, although it is wisely ordained that it can safely bear a greater degree of pressure before than after birth, yet there is a limit even here, beyond which it cannot be car- ried without the destruction of the infant's life. The head can also bear a greater degree of pressure when the force is applied in one direction, than it can in another. ]\Iuch greater compressing force can be more safely used when exercised in the bi-parietal, than Avhen applied in the occipito-frontal diameter. As the long forceps are usually placed on the head of the Infant so as to embrace it in its long diameter, we ought therefore to consider whether our Instru- ment is so constructed as to j)ermit such an undue degree of pressure as may prove unfavourable to the life of the Infant. The head of the infant, when it is situated at the brmi of the pelvis, usually lies with its fronto-occipital diameter corresponding to one of the oblique diameters of the pelvis; the Vertex or face being placed towards the right or tpwards the left acetabulum. But when the antero-posterior diameter of the pelvis is shortened by the sacrum projecting more forwards, the head assumes a more directly transverse position. Now, in this position of the head, it is most desirable to place the two blades of the forceps on the sides of the pelvis, so that one blade hes over the face, and the other over the occiput of the infant. In this case, the Instrument embraces the head in the most unfavourable direction for its safety, if forcible compression be made. But the lateral pelvic position of the blades of this Instrument is much safer for the maternal pelvic organs than if, as recommended by some practitioners, they were placed in the coujugate diameter. To add the bulk of the Instrument to the ah-eady diminished capacity of this part of the pelvis would be unwise. In all our artificial apphances, we ought to endeavour to produce similar changes on the head of the infant, which nature accompKshes, if left unaided. The head is lengthened, and its rounded shape changed; whilst its bi-parietal diameter is lessened. The former change we ought to obtain by having the Instrument so formed as to allow the head to elongate when traction is used, and by the pressure it receives from the anterior and posterior parts of the pelvis. Notwithstanding the high opinions expressed of the great advantages of compression, I am convinced it is mischievous. This
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