1000000031

is ex:rted in the

rame

rnaDn~r

upon the kead and neck of

the ehild: if the inflrument begins to Jofe its hoJd, he

nlu(l pUOl ir

f.\nher

-{]p,

and

fixing

ag~in,

repeat

his

e/fons, appJying it flill higher aod hlg ler, uotil the body

is extraétl.!d.

o¡

PRETERNATORAL LABOO ItS .

E TE. RNATU RAL

labour happens, whcn, infiead ofthe

head. fome other part of [he body preCents to the

uleri .

Preternatur.¡1 labours are more or

It:rs

difficult according

to the prefenution of lhe

child, and

lhe conrraétion of

,he oterus round in body. The nearer the head and

lhoulders are lhe

interoum or lower pan of che ute–

rus, lhe more

difficult

is lhe cafe

whereas,

when lhe

head is

towdrds lhe

fundus, and lhe

reel

or breech

Dear

lhe os ¡n(eroum,

is more eafy to

luro

aud dehver.

Td begin with the eafiefl of thefe lirfl, il may be pro··

per to divide them into (hree

claJres .

FarU,

how to ma·

nage when the feet, breech, or Jower pans preCent.

Seco¿>d)y. how 'o b.have in violeo, floodings; and, wheo

th·e

child

prefenu wrang befare the membranes are broke,

how to fave tbe waters io the uterus, (hat the (cetus may

be ,he more e.fily turned: and what method

follo'Y

e'f'eo aFter the membranes are

broke~

when

al1

the waterS

are not eVAcuated.

Th¡rdly~

how tO deliver when (be ute·

rus is Ilrongl

eontr~aed,

the child prefenting ei,her witn

the

fare

or back pans ; and Iying in a circular farOl, or

with lhe Chouldcrs, breaíl, neck, (ace, ear, or 'f'ertex.

and Jying in a longilb form, with the

fe~t

and breeel¡ to–

wards the Fundus of the womb, wbich is contraéted like

a long Ibeath, clofe tO the body of ,he f""us ; and when

,he fore-par.. of ,he ehild lie towards ,he fide, fundu.,

fore or baek part of the uterus.

T h.

jirft

eI.jI

o¡

I'RET ER NATORL LABO ORS.

Whm

Ih,

I~d, hr~(Ch,

lo'W~r

parlJ

Jhe

fcetl1s

pr~font,

IInd ¡he head, jho"ldcrJ, alJr!

upp~r

parJ! are loward!

Ih.

fuodm.

TH ESE,

for the man pan, ' are accounted the earien,

even although ·the uterus Ibould be flrongly eootraaed

round the body of the ehiJd, and all the waters dif–

charged.

the knees or fee! of the ehild prefent to the os\ in·

ternum, which is not yet fufñciendy diLHed ta allow them

and the body to come fanher down; or,

the \IIoman

is weO\k. \Vore out with long labaur, or endangered by a

flboding; let the operalor inlroduce his hand into the va·

gina, pulb up and IIreteh ,he o. uteri, and bring aJong

the fl!et; which being extraaed, let him wrap a linen

c10th raund them, and pull unti! the breeeh ' ppea rs 00

the oU(

G.de

lhe.os

eXlernum: if lhe face or fore.part

of the feetus is aJready towards lhe back of the men1S,

Je, him perfifl in pulling in the fame direaino; bu" if

.hey are towards ,he os pubis, onoooe fideo ,hey mufl be

roed

the back' part of lhe Ulerus ; .and as the head

do•• DOt move round equal with the body. he mufl make

:lllowa nce for the diffcrence in lurning, by bringíng lhe

JaH one quaner farther ,han the plaee at wl¡ieh the head

;s 'o be plaeed; fo that the faee or for<head whieh wa.

.oward. one of the groins will be foreed 'o rhe fide of

WJ.e faerum, where

joins with the ifehium. This 'tuar-

ter turn of the body Olufl be again undone, w¡t"out a(fee–

, ine the pofi ,ion of ,he head ; a cloth may be w.rapped

round the brccch, for the convenience of holding

more

firmly; lhen, pl.lCing a thumb ?Iong eaeh Gde of the

fpine, and with hlS fingers grarping the beJly, let hi,n

pull along !he body from fide tO fideo with more or Jefs

force, according lO the rclinance : when the child is do–

livered as far as lhe

{hou.lder~

Jet him nlde his hand

fl.a·

' ened (fuppof. the right, if Ibe lies on her ba<k) be–

t \Ve,n its brea{l and the perinreum, coecyx, and f.\cruRl

of the woman, and introduce lhe fore or middle (ioger

(or both, if neeelf.,y) into rhe mouth of the f""us; by

which

m~aDS,

the chin \ViII be pulled to the brean, and

the forehead into the hollow of ,he faerum. And this

expedient \ViII alfo raife upwards the hindhead, \\'hieh

reHs at the os pubis.

\<;rhen the forehead is eome fo Jow as to protrude tbe

perinreum, jf lhe \yoman líes o.n her baek, Jet tile ope–

rator lhod up, aod pull the body and head of ,he ehiJd

upwards, bringing the forehcad with an balf. round turo

fro~

the under.pan of the

externum, which wilJ thu,

be defended from Jaeeration . Tbe appJieation of the

fingen in the chdd's mouth will

contri~Jute

to bring the

head out in

~his

manner, prevent tbe os ex.tcrnum from

hi,ebing 00 the ehio, help along the head, and guard the

neek.

from being overllrained ; a misfortune which would

infallibly happen, if the foreh,ead Ibould be detained

the uppcr part of lhe facruOl: nor is lhere any great force

required to obviAte this inconvenience, or th·e lean dan–

ger of hurting the mouth . if the head is DOt Jarge: for,

ir.

the head canaot be brought along with moderate force,

and lhe operator is afraid afinjuring or over-firaining ,the

Jower j.w, Jet him pulb his fingers fanher up, and prefs

00 eaeh fide of the nof. , or on Ihe inferior edges of the

foekeu of the eyes . If .he legs are, eome ou', and the

breech pulled into the vagina, lhere

no o ccaGon for

pulbing up tO open , but only tO pull aJong and man1tge a.

.bove direéted; flill remembring to raife the forehead

llowJy from the perin:Eum. whieh may be prelfed baek

wi-th the fingers of his other hand.

In lhe

e.de

narrow pelvis, or large head, which

cannOl be brought ;¡Iong without lhe rifk of ·over.flraining

the neek, Je, him llide up his fingers and hand ,into the

vagi~a,

and bring down one of the child's arms, al 'the

{ame time pulling the body to the eontrary fide, bywhieh

.means the lbouJder will be brought lowcr down : Jet hiln

run his fingers along tbe arm, until they reach .th: dbo\1J",

whieh mull be pulled downwards wi,h ,.n haJf round lurn

to .he OIher fide , bolo \V the breall. This mllfl not be

done widr a jerk, but Clowly and ear.tiouf1y, in arder tO

prevent·thed:lloeatioo, beoding. or breaking of,heehiJd's

armo

Let him again guide his fingers into the chil.d's mouth,

and try if the head will come aloog: if this \ViII not

fueeeed, Jet ,he body be pÍllled 'o Ihe o,her fide, fo as tO

bring down the other !houlder; then nide up his left

hano, and, eXlraéling the other arnl, endea\'our tO deliver

the head.

one finger of his right hand be fixed in ,he

chitd's momh, let th\= body ren on that arm : Jet him

plaee the Jer, hand aboye the Ibolllders, .nd PUt a finge r

00 eaeh !ide of the neek: if the forehead is tow3rds one

Ld~