1000000031

j"dge by Ihe louel.l in lhe v. gino, when Ihe head is far

(n .. ugh cown in the bafcn for u(¡ ng the forceps. lf\\'e

we:re

takc our obrervations from ,\ hat \Ve recl of Ihe

h::2d al lhe

rubis, \Ve fhilulJ be frequendy clecai,'cd ;

b~Ca\lrc:

in that place thr! pelvis is only t\Vo ioches in deplh.

and

lhe

head will f.:em lower down th;:¡n

really is:

bUI

ir,

~x:tmlOing

b;:¡;ckwards, we find

linle

or no

pan

tow:arcls the

raefUm, Y.'e may

cenain

th;:¡t all

Ihe

head is above

lhe

brilll:

\lIe find

down as far as the

middle of the facfum, one third of

jt.

is advanced;

as far down as the lower part, one half; and

thi. cafe, Ihe I"gefl P"I is cqual \Vith Ihe briOl. When

is in this Catuation, we may be almuJl

ccuaio

of fue·

ceeding

Wilh

thlS forceps; and \\Ihen the hcad is fo

low as .to protrude the

cxternal pares, they neyer rail.

But thefe things will differ according

d.ffere.nt

circum ·

nances, that may occafióD a tedious delivery.

Let the

op~rator

acquire an accur"ate knowlcdge of

the figure, Chape. and

dim~nfions

of the pelvis. together

with the thape, fize, .od pofilioD of tbe child's head.

Le< Ihe breech of the \Voman be always brought for–

",ard., a liul. over Ihe bcd, and her tbigh. pul1cd up

to her beJly, whether Ibe li..

her fade or back, to give

room tO apply, and lo move the forceps

or down, or

from fide

fideo

L" the part.

opened and the fingen paf••he o.

internum ;

order tO which, ir it cannot

otherwire

aecompliOled , Iellhe head be raifed t\Vo or Ihree inche. , that

the 6ngers may have more room; ifthe head can be raifed

aboye lhe brim, your hand

nOl contlned

lhe bone:s ; ror,

as we have ,Iready obfcrYed; Ihe pelvis i• ..,ider from

fide to fide, al tht brim, lhañ al lhe lower

pan;

if lhe

fingers are Dot pan the os uHri. it

in danger of be.ing

includedbctwixt .he forcep••nd lhe child's head .

• TheJoreeps, ir

poffi~le,

thould

p.fs

along the ears,

becaufe,

that

c~Ce,

they feldom or never hun or mark

the head.

They ought to be pulhed up io an imagioary line,

t.,.,ards Ihe middle fpace belween lhe n.vel and Ccrobiculu.

cordis, otherwiCe lhe ends will run againn the (.crum.

The fOlell ead ought always to be lurned into the hol·

]ow of the facrum, when 'it is DOt alre.ady in that

fi~ua·

tion . When the face prefents, the

~hin

mua be turned

to below Ihe o. pubi., and the hiod·hoad iOlo the hol–

low of the f.crum .

When lhe thoulders ren "Ihe ·pubes. "here .lhey are

detained, the head

murl

be turned

large quaner tO the

oppofire fide, Co as lhar they may Jie towards .he fides of

the pelvis.

The head mu(l alway. be brought out wilh an half

round turn, over the oudide of the

pubis. for the pre ..

fervation of the perinzum, which mufl at the rame time

bo fupport rd wilh Ihe flat of the oth·er hand, . nd flide

1l0ndy backw.,ds ovor the he.d.

Wlien Ihe head is fo low as to protrude Ihe p. rts, in

form of a J,uge lun1our, and the vertex hath

. be~uD

dilate the os

e.Xlcrnum,

bUf. i,,(tf:od of.

~·dvancing,

long

deuined in

that

fituati on,

from

OIny

of the

Corcmentioned

t~lJCCS

(l(

)aborious rares. 2nd the operator

cannOI

cxaét ly

.diOingui/h ti", pofilion of lhe head, lel him intreduce a

~n¡;cr

belwcco lh, os

ru~i

••nd lhe h·o.d, 2nd he

will

frequently

r.nd

the back put of lhe neck, or one C3r, at

the rorepart,

lowards

the Gdc

of lhe pelvis :

whc:n

tl:e

filu:nion is known, he needs

nOI

Ilrerch

extcrr.un

and raire the

he.ad

ílS

formerly rlireéled; bUI he may in·

troduce the forceps, and

tht:y

l::eing properly joincd, and

their hand:es

tied, rull

gendy during

every

paio

oc-

the

p2ins are. gone,

at lhe

inlcrval of four or five minutes,

that

lhe

pans may be

flpwly

dilated,

they are in (he

naturallabour: -bUI,

when

the útuation cannot be kno\\'n,

the head ought to b.

r~ifed.

Tho fame metllad may alfo

be taken whcn the face prcfents, and

l.ow

in lhe pelvis,

except when the ehin is toward

lhe

back

pan:

and

this

caCe, the head ought to be raifed likewiCe.

Almoll

.JI

theCe dircélions .,e to be follo\VeJ , excepe

when the head is Cro.U, in \Vhi, h c.,fe it may be broughe

.Iong by.the force of pulling: but this onlr happéns when

the woman is reduced, and the labour·pains are not fuf·

fident tO deliver the ehild; for, (he lower part or the

urerus may be Oronpl y contr.élcd before the thoulders,

and fo c10fe to the neck of Ihe chilJ, as tO prevent il.

advancing, eveo when the head

fo loofe

the pelvis.

that we can fometirrie.s puCh our fingers all round

i[:

and

ihis is orlendl the oecarioo or preventing the head', being

delivered wheo lo," in the pelvi.. The d¡f6eullY, \Vheo

high

up, is rrom the rellraint at Ihe brim;

and

when

pil{fes that, the head is CeJdom retained in the Jower pan,

unlefs the patient is weak.

this cafe, we oeed DOI wail,

bccaufe we

are

commonly cenain of relieving the woman

immediately wilh the forcep., by which you prevent the

danger that may h'ppen bOlh to the mother and child, by

the head's cooliouing to lodge there too long. This cafe

fhould be

eaution againll breaking the membranes too

foon, becaufe Ihe uterus

may

contraét lOO forcibly aDd

too long before tbe Ihoulders; wheo the he.d in this caf.

i••dv.nced one third or

h.lf

way on the

oUIC.de

of lhe

externum, if tbe paios ar:e arong. this laH ¡nconveni.

cnce is frequently remedied by introducing

YOUt

·t\Vo fin–

gcrs into the reélum, a. formorly direéled: by theCe

rules, delivery may (for the mofl pa,,) be performed

wilh eafe and f.fely: nev<r,helef., the head is Come–

times fo Cqueezod and lócked iD the pe.lvis, .od .he hairy

fcal p Co much fwclled, that it is impraélicable to raife"p

the head fo as tO come at the ears or os ¡ntanum; or

to dillinguith the futures of the lkuJl, fo as

know how

the he.d. preCeo...

.his cafe, Ihe .forceps mun t!e

introduced at random, and the uncertainty of lhe poritioo

generally

removed by remembering. thar in thore

res,

where .he he.d i. fqllcczed dolVo wilh creat diffi.:uhy, .he

ears -are for tlle moft paTt towards lhe

pubis and

Ca~.

crum; and

that

the ro.rehead feldom turns into the hol–

low

of lhe {acrum. hefare the occiput is come down to

the lower part of the ¡fchium; and then rife-!' gradually

towards the under pan of lhe os. pubis,

aod

the peri.

n;cum and anus are foreed

duwn

befo

it, in form

of a

large tumour.

fu eh oec. fions, the woman being

I.id

on ber fide,

if one

ear

is to the (acrum and lhe other tO the os puh:s,

lhe blades of Ihe forcep. are. to be introd\lCed; .nd if

they Olert with any rc(j(tance at the poinu, they mutl not

be forcibly thrull up. le(llhey paf. on th

outfide of

I~e

os Ílleri , and lear .the vagina, which, togelher wilh Ihe

11'0mb