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M D w
per pan o; rhe T"gin:\, in fuch a manner as hinders the
fcw rernlining waters fropl, being difcharged at once ;
though in el'ery pair), a fm all quantity di(lils on each fide
of rhe head, for lu:'nClting (he pans, fa .\5 that lhe cllIld
may lJip along Ihe more eJfily.
The merus oon~ raéls, th t: paios bccome qu:cker and
fironger. the ero'!"o of (he head is pulht d down to (he
lo\\'e r pan of lhe pelvis, agaieH one of rhe ¡fcbia. al its
Jowa extremity i the for€head, heing al the upper pan
o f lhe oppo(!.te lfchium, is ioreed into rhe hoUow of rhe
uilder pan of the racrum, while (he vertcx and hindhcad
is p,c!f:d, bclow the os pubis, (C« Plate, eXI. 6g. 7.)
from whence ir rifes in a qua l ter turo, gradually opening
the os externuOl : the fr:enl3m labioru~u , or fourcheue,
perir.zum, fundilment, and the' pans lhat interven,e be·
t wixt that and tlle extremity orthe f3crum, are allltretch·
cd out\vards in form o f a Jarge tumour. The perinzum,
which is eornmonly b:Jt one ¡neh from the os eXlernuOl to
the anus, is no\V Hretched to (hree, the anus tO t\\"o, aDd
,he pans betweeo t¡"'t aod the eoeeyx are f1refched froOl
t\Vo lnehes loabout th ree or more, The broad faerofciatic
li.: 1mcntS rea. hiOg from each fide of the tower pan of the
f ..crúm, . 1O the under part of eaeh ¡r,biúm, are alCo out–
wardly.extcnde.d, ~nd lhe cocey=< is foreed ;
while lhe erown of lhe head, where lhe lambdaidal crolfes
the end of lhe ragíttal future, cantinueS' tO be pufhed along,
and dilates lhe os eXlernuOl more and more. See
CXlI. fig. l . whieh is ioteodcd prioeipally tO Chew
in what manner the periDreum and external pans are
Il:rerehcd by the head of 'the {retus, in a ¡¡rll:, pr<g–
Di\ncy, towards the ead of Jabour.
A, T he abdomeo_
B, The labia
e, The cl itorís and in prreputium.
D , The hairy fealp of the fretu. Cwdled at tbe venex,
in a Jaborious ca(ej and prot rudedte lhe os externum .
EF. Tlfe perir.:Eum aod anus puChed OUt by the
head of the fcetus in form of a large tumour. 1
G G. The parto that eO"ff tbe tuberofitics ol' bte otra
j(chium.
H. 'r he pan that cOl'ers lhe os coccyp,is.
W'heo the head is fo far .dv.1oeed, that ,he bael< part
of the oeck is come belo'JJ lhe unde.r pan of the os Fubis,.
lhe foreheau forces lhecoccyx, fu ndaOlcntl aod perin=eunl,
bflckwards and downwards; t!lcn the hi ndhead rif"s a·
bout IWO or tbree inches h om under rhe pubes. m..kíng
a half Tou nd tu ro in its arcent, by whieh the forehead is
equally rai:ed. from the p:!.rtS upon which il prcíí.:d, anJ
the 'perinreum e(c;¡pes WilhoUI bcing fpll[ or torn; ilt rhe
fame time, the 'lhoulders ad\'ance ¡mo the (idts of the
peh'is at its brim , whele ir is \\ iden , .:md, wít h lhe bo ,
dy, are foreed aluog aod de),vereJ: lOcao whi le, by the
cunr raétioQ of the merus, lhe ,placC"ntii a'nJ chorion are
loofed from t"Cinn~r· furface tO \1,hlch they adhered , i'
foreed lh rough th,e n tr,,:na j 0\11 al ~he es ex:trnum . .
' ,Vhen the he?d rc.:ils at I~dc above the t;l inl" of lhe
pelvis, and is not far ?qn\nced . the ;'o:uanelie may be
plainly fdl wirh the fio gcr, commonly ta w:trds the í:dc
of the pelvis: lhis is the pldCt where :.h:! C)fon ! ero..rfes
tb.e faginal Cuture, 2nd the Loo:, are a l.,de [~rlrahl
F E R y, 21$
from eaeh other, yieldiog a [oftoeCs to the rouch, by
which may be difiingui!hed four futures, or r athcr one
eroffing ano{he~. TheCe m;t y be 'plaj.oly peJlcclved, (ven
befare rhe membranes are oroke; yel ,he cxaminalioB
rnull 001 be made dUl ing a paio, when lhe m<mbrane~
are nrt=tched down and tiJlecl wich·watcrs i bUl only when
lhe paio b~gios to remit,' aod the membralles te be re.–
la"ed; otherwife tbey may be brok< too fooo, before th~
os interoum be fulfi ciently dilatcd, and the head proper1y
ack.oeed.
V/hen the vcrtex is come lower do\Vo, the ragittaL,
future only is te be (el t ; beeaufe, as the hiodbc"d de .
fcends in lhe pelvis, thCil fontaoelJe is 1urned (llore back..
wards, tO the tide... or towards the concavity of lhe fa~
crum: bUI, after it has arrived below the unoer part of
the otra pubis, the lambdoidal may b. fdt eroOiog the eod
of lhe fagilul fUlure, lhe occiput mak ing iíl more oblufe
angle tha" tha! of thé parietal bones, "the place 'where
th~ three are jsined logether. BUl all lhefe eircum~
Il:anees are mor~ eaGly diilioguilhed after ,he membranes
are broke, or when lhe bead is fa compre{fed thu tbe
bones ride over one another, pro\'ideo the hairy fcalp be
oOt exeellively flVelled. SeeP¡'te ex!. 6g. 7.--S"
alCo
eXI!. 6g . 2. w! _h Chews io IVhat maooer tbe
head of the f"'tus is Ioelped aJong with the forceps,
as artificial hands.. wheo il ís far the fafety
o{ either motber or ehild .
AABC; The ,·ertebr., Of the Joins, os faerum, aod
eoecyx .
D, The os pubis of tho left fideo
E . T he rem.ioing pan of the bladder.
FF. The intell:ioum reélum.
GGG, The uterus.
H, The mons veneris.
1, The clnorís, Wilh the Jeft l'Iympha.
H, The corpus cavtrnofu m clituridls.
V, The meatus urina rius .
K. T he Icrt I.bium pudcodi.
L , The anus.
N, T he perin2!um.
Ql.'. T he left bip and thigh.
R, TI:e O,io aoc muleul.. parts of the loios.
H &'W nndwh~n l o breaK. lhe M CtotB RASf S.
1f lhe child be (u rroun¿ed Wilh a large quaotity of
,traters , the uterus eannot come in eont.é't with the body
fo as lO prer~ Jown (be hcad . uncil [he membranc:s are
PUfilCd ~ confiJ cr.lble way before ir into the \"aginn; nor
e:ven rhen, Ilntil they are broke, Olnd lhe Huid d iminifhed
in fuch a 1,11anner as w;1I 8110 w lhe wOOlb to contraét, and,
\',il h [he .\J1iClance of the pains, force along lhe child.
' Vh....:n rhe membranes thc: rcrore are Orong or unl dvanced:
3:ld con1Í l'lue fo long unb.l'oke r!laClhe dclivery is rttard~
.d, pro• .(led t he os iote,nuln be ~ ¡¡¡eiemly dilated, they
oug:H 10 be nrokc without funhc:r dclay ; efpeeially jr lhe
woman híllh be:eo mueh fatÍgucd or cxhau ned Wilh la.
bour, 01' is feized Wll h a viol(:n1 tlooding : in which care,
lhe rupture of the membran es haHens delivn y, aod 1he
ha:Olorrhage is 'diminiOled by the eootraélion of the mcrus,
wl.ieh