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

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

Licence: Public Domain Mark

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

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    ON THE NATURE, MECHANISM, AND TREATMENT OF FACE PRESENTATIONS. Perhaps there is no point connected with practical midwifery where so much discrepancy of opinion exists as regarding face presentations. This is the more wonderful, seeing that from their frequency they form a large proportion of the deviations from the natural position, which every obstetric physician must meet with in practice. The proportionate frequency is seen from the following table: Number of Number of Face Deliveries. Presentations. Boivin .... 20,517 74 Lachapelle .... 22,243 103 Kilian . . . . 17,000 122 Boer ..... 6,555 58 Dubois . . . . 10,742 30 Clarke . . . .10,317 44 Collins .... 16,654 33 Guy s Hospital . . . 4,666 24 Total, . . . 108,694 488 This is about 1 in every 222 cases. In former days face cases were considered preternatural, and so difficult as generally to require the operation of turning, the same as transverse presentations, before delivery could be accom- plished. This was the opinion and practice of the accoucheurs of the last and preceding half of the seventeenth century. Smel- lie says, when the face presents, resting on the upper part of the pelvis, the head ought to be pushed up to the fundus uteri, the child turned and brought by the feet, according to the direc- tions that will be given when we come to treat of preternatural deliveries. {Treatise., vol. i. p. 238.) Burton states, The head may come with the face or chin towards the os uteri, having the back of the head lying back- warks. * * * Therefore when the head presents in any of the above directions, and that the os uteri is sufficiently dilated, he must introduce his hand into the womb along the child's breast, to bring it forth by the feet. {New System of Midwifery., p. 200.) The same opinion was held by La Motte. Cooper, Giffard, Fischet de Flechy, &;c.
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