1000000031

Ihey are loeked logelher, care muO: ·be taken tha! they

are exal1ly oppofi,e 'o e.leh OIhe r, and bo,h Cuffi;iently

4ntroduceJ ..

)n (his

clfe,

lhe opl!r:Hor finds the up–

per pare of [he

(acTum

jetting,

in,

fo much [har [he point

of the

fOl'ceps cannOl

pafs

it.

1(;'[ him (ry wit h his hand

to turo the forcheaq a liltlc: b:\ckwM..:iS, fo

lhat

on: ear

will be to wards the groio , and

lhe

other

tO \~arJ9

lhe IjJe

of that pro:ninence;

conrequcntly,

[here will be

niare

room from lhe

blaJes

p'afs

along

lhe ears : but

lhe

forehead Ihould remai!'} immo\'eable, or thoup.h ' movcj

lol!turn to

fOrn1'::T

place.

Jet one

blade be

inHoduccd

~ehind

one car, and

i[S

fell ow

b~fore

the other, in

which

cafe

the' introduélion is

rometim~,

more ea(i(y performcJ.

whc:n the woman lies

her hack, than wh¡:(1 Ihe is laiJ

on ooelide. See Plate

e X l!.

lig o ,.

When /he

FAC E

¡re/en/I.

H E N

the face preCents, reO:ing on ,he upp;r

p.rt

the pelvis, Ihe he.d ough, tO be pu(hed up 'o. ,he fundus

u . the ehild turned .od brough t by the feet, bee.ufe

the hind head is turned back on the (houlders, and, unlefs

Yery

Cm.II,

canno, be pulled .Iong wi!h ,he foreep. ; but

fhould i, advanee pretty f. o: jn ,he pelvi.,

will he fome·

times delivered al¡ve, without any re(j(bnce. BU f,

d~rcends

Oowly.

Of,

aCter ir is low 'dowc, flicks for

a con·

fider.ble time, Ihe long pre(fure on ,he br¡in frequen!ly

de(!roys ,he ehilJ, if no' relieved in time, by lurning or

extraéti ng,

with

(he forceps.

'Vhen the head is dCI.ined oery high up . and no fign,

of i" defeending 'ppear, and th. opera,or havi ng O:meh·

ed-tbe

pUl'

with a view

turo, d¡fcQvers that the

pe! .

Ti, is narrow, and .the 'head large, he muO nOl proceed

'With

turning,

becaufe arter this Hath 'beco performed,

· perha~.

wi,h gre.. diflieulty, the head eannot be delj

v'O/"ed wi,hou, Ihe afliO:ance of the ero,ehel. No doubl

would be a great advantage in all c.-Jes where the face

()r forehead preCents, if we eould raife ,he head

as to

alter the bad poCidon. aod move

Co.

with

OUT

hand , as

to bring the crown of the h.ead

t O

prerent:

and iodeed

this fhould al\Vay. be tried, and more eCpeeially, when

t:he pelvis is

toO

nurow. or the head too large ; and whc:n

'\!le

are dubio", of Caving ,he .child by ,urning : bUI freo

<juently Ihis i, impoflible to be done, when ,he \Vaten

are evacuated, the uterus llrongly contr:d.8ed on rhe

cI~i ld,

,,"1 the upper part of the head fo Oippery as

elúJe our

hold ; infomuch that, -even when rhe preITllre is norgreat,

we Celdom Cuceced , unleCs Ihe head is

Cm.II

, and , heo we

can Cave Ihe child by ,u rDing. If you fucceed, and ,he

woman is Chong.

as in naturall.bollr; but, ir this

fails, then it

wilJ

mor~

advireable to wait \Vith patience

·for the deCeen, of ,he head, fo·•• ,hal

¡.,

Olay be deliver·

"d wi,h Ihe foreeps; and

eonre~ucntly

the chih:l may be

faved; bUf,

ir lli ll reOlains in ¡ts high fitUalion, and

the woman is weak and exhaufled, the forcep9 may be

Iried ; and, fhould they fail , recou rfe mu(! be had " . Ihe

crolchet ; becaure the mOlher's life is alw.\ys lO be more

regarded than !he

r.re<

y or Ihe child.

When the face or lhe ehild is

eom~

down, and Clicks

at the os externum, the greatdl p:\rt of lhe head is lhen

fqueezed down in,o the pelvi., and if no' Cpeeedily

.•

Ij'·<reJ, tbe cbild i, frc'l"oody

hll

by ,he v¡olent eom.·

'l.

prefiion of the

~;'"ain :

bcfid.:s, when

ís fo low clown,

J ~tJu11l

can be returncd, on account of

lhe

great contrae–

lion

lhe uteru,. lo lhis cafe, \V hen lhe ehin is lurned

to WMJ,

th~

os pubis, al lhe lowcr p'Ht of thJl bone,

lhe woman muH

I.ud

on her back. lhe forccps ¡ntro–

duced , as forl1lcrly di rc..::l ed in lhe liiti cafe , ancl when (he

chin is brougilt OUt from under lhe os pu'bls, the; hcad

mu(! be pulled half round upwuds; by whit h means ,he

fore and hind head

will

ralf~d

[rom the perinxum, and

the uoder pJrt

lhe

,ex.teroum pre·,temed from

being

tare.

,he chin points tO either fide of ,he pelvis, ,he wo.

~,n

muil be bid on her (ide, ,he bl. des of ,he foreep..

Introduced along

lh~

ears. one at rhe

pubis,' and (he

other at [he facru:ll; aod lhe chín, wheo brCiught Jower

do·"'n', turned to the pubis, and delivcred: for the pel–

vis being only two inches in depth al this place, the chin

i. eafil y

bro~ght

from und<r i" and ,hen ,he head is

Jibeny to be turned half round upwards

be'caure the

ehio being difen¡:. ged from ,llI' Dooe, ean be pulled up

over

ex{crnalty.;

which

mean~.

two inchesof roo:n,

at lean. ",dI be gained, for the more

e.Cy

dclivery of the

{ore ,and hind head, which are now prelfed againfl: the

p.!rincr:um. When ... (h.e ch¡n,ís to\vilrds the facrum, the

hind head pw(fed baek betwix , ,he fhoulders, fo ,ha, ,he

face i. kept froOl rifing up bdow ,h os pubis, Ihe head

muO: be pufhed up with ,he hand,

the upper pHt of

<he pelvIS, and the forceps introduced and 6xed on Ihe

ears;

t1~e

h¡ndhe.? m.ufl be turoed

one fide of ,he pel.

VIS,

whtle the chln

moved tO the other). Cide, and,

poflible,

' 10

the ·Iower pa" of the iCchium; ,hen ,he

hind head muO: be brough, into ,he

holl~w

of ,he f.erum,

with lhechin bclow th.e os pubis, and, delivered as

above

direéled.

this cannot be dóne, lel the opera,or try,

with tl,e forceps, 'o pull down Ihe hind·head below the

o, pubis, and at the

time, wirh the fingers of the

o,her hand , pufh ,he face and forehead b.ckwards aod

upwards iOto lhe holJow of lhe (acrum .

For

wlH:n

lhe chio

pOi~lS

to [he back pan of the pel...

vis, the foreht'ad is fquet.zed againfl lhe os pubis. while

th. hind· he"d is prc(fed upon ,h" back, betwix, the fhou l.

ders; fo that the head cannOl be

deliv~red

unlefs, lhe

occiput can be broughe

Out

from below lhe os pubis, as

forllle rly Jercribed. Se. PIate

eX!l.

fig. 4, and 5.

Flo. 4 . !he\vs, in , the lateral view the (ace of the

c" ild preCenting and foreed down iolO ,he lower

pan of the pelvis, lhe ehin being below Ihe pubes,

and {he venex in \he coocavity of the os fa.crum:

¡ 'he

water being likew'ife

difcharg(d, the uterus

appears c10fely joined 'o ,he body of the ch,ld.

FIG . 5. Chew5, in a lateraJview, the hcad ofthe ch¡ld

in lhe fdme po(jt ion

;¡',

in lhe forme r figure.

A B. Tbe verlebrre of the loíos. os fd.cruru, :md coccyx.

The os pubis of Ihe

Id ,

fiJe.

D .

Thc infe rior pan ofothe

r.au

E, The perim:cum .

l",

The leh I"bium pudendi.

CG G ,

·The uterus.

The C ..m of . 11 ,hal ha. beeo ("id on Ihis head, may

comprehtnued in lhe following general maxiOls.

Youn

pr.tétidoners are often at a

luli

know and

judgc