1000000031

Code at the upper part of ,he pelvis, let him rull it lo",er

do",", and gradual ly turo

into the hoJlow of

Ihe

f....

crum; Ihen fl.t on up, and, in p!-llling, raire the body. fo

bring,

VUI

lhe head

half.rou"d

uuo.

:".5

aboye

di reél_d.

Vvhcn the forehcac\ is hindcrt>d from coming dowo in·

fa lhe

lowcr pan of

the

facrum

ltnC\)01ma n

Chape

lhe head or

pel,vis.

and

w c!

cannal

cxtraét

.hringi ng

il OUt

with an half. rouud mm

che

pubis,

\Va

mull

try

m:\ke rhis turo in the contrary di, t:étion; and in–

llcad of introducing our fiñgers ioto the child's mouth,

l<t ,he breal! af i, reU on ,be Valon af your lef, hand ,

(,he woman being an he. back,) and placing ,he righ, on

iu fh oaldcrs,

Wilh che

fingers on eaeh ' de of the neck.

prefs

downwards

the perinreum . In

conr~qucnce

thts

prelfurc, the

Cace

ano chin being .within lhe perio3!um.

will move more upwards, aDd the head come OUl with an

half· round lurn (rom bt-Iow

th~

pu~is :

for lhe centre

mal ion

is now where rhe (ofe-pan of the neck prelfc!s

at lhe

perin~\lm

¡,whereas, in th'e other ¡;ncthod. the back

p3n of the n(ck is againfl the lower pan

tbe os pubis,

on which lhe bead luros .

the forehead is nOl turoed to one Cide, bUl llicks at

,he Upper pa" of lhe faerun." efpeciaJly when ,he pelvis

is n:\rrow; Jet him endeavour

whh his finger in lhe

mouth,

Oto

turD it tO ooe fide of the jetting io of the

Ca·

crum, becaufe the pelvis is wider at lhe lides of tbe brim

and bdng i, along:\s before.

If ooe of lhe ehild's arms, ioflead of being pJaced a

long lhe Codes of lhe bead, is ,uroed io betweeo lhe face

and fa cruOl. or betweeo the hindhead and'Os pubis, lhe

fame difficulty of f xtraéling occurs as in a large head or

narrow pelvis; aod this pofition frequently enfues, when

lhe fore. p.", of lhe ehild's body are turoed from ,he os

pubis down ' o lhe faerum : if lhey are ,urned to the lef,

fide of the woman, lhe lerl h.. nd and arm are commonly

broughl in before (he f&ce, and

V Ice

":ul";

bUl, in thefe

cafes, lhe elbow ¡s, for the mon pa n, e.dily come at,

,becaufe it is low down in the vag:na, and lhen

ther~

is a

necefTity for hringing down one or bOlh arms before: the:

head can be: ddi"crrd: from whenclo'! we may conclulfe,

that lhofe amhors are: rometimes in the wrong, \\ ho ex·

prefsly forbid us lO pull do",n lhe arms. I ndeed , i( ,he

pelvis is not narrow, nor lhe

hc~d

very large , and lhe arms

lie .Iong the

'es of ,he head, lhere is feldom occaCoon

to pull Ihem down ; becaure, the pel vis is widefl: at the

fidc:s, and rhe

membrar.es

and 1i2aments that ri ll up lhe

fVa.. becwi"l ,be fac rum and iiehia yield 'o the prcC.

fure, and m..kc room for the paCf.tgc uf the hCdd : but

when [bey Are fq ',cezed bctw(t'n the: head and the f.l.Crllnl,

ifc~ia.

or arrA. pubis, olnd the:

h~ad

CScks in lhe pel,'is,

..hey cenainl y tluj.!ht lO

brought down, or even when

the head eom • aloog ",i,h dillieulty . . Neilher is lhe . 1-

Il!dged conlrall:ion of the

int('(cum round the oeck of

,he ehild fo frequent a. hach beco imagined; becaufe,

for {be mon part, the contraaion embraces the heaJ and

DOt lhe neck: but, fhould the neck

~Ione

furrer,

th.tt

in·

eonvenieDce may be: r.::moved by introd'Jcing the hand in·

to lhe vagina, and a finger Or lWO ¡nlo t!l.: child's mouth,

oro 'ln eaeh Code of ¡he nofe: by wnich means alfo. Cu f-

6C1cot dihl"lioD wiJl be prcftrvcd iD lhe o, exteroum,

which"frequendy contraéls on tRe neck

as foon as lhe

arms <tre brought out.

l :hl::

diameter, from Ihe face or forehead to lh.e ver ..

tex, beiog greater lhao lhat. from Ihe forcbead tO the

back P"" of the hindh..d or ncck, whcn , he hiodhead

rells oc ,he os pubis, and 'lhe fortbead

the upper pUF

of \he (acrum, the: head e.\o (eIdom be brought dOWD.

unt il {he ope:nlor, 1>y iouoducing a finger ioto the mouth.

mO\'fS the fame la lhe fide, brings lhe chin to (he brean.

and the forehead iOlO lhe hoJlow of lhe faerum; by which

means. lhe hindhead is raifed, aod allowed tO come along.

",i,h grealer eafe : and in pulling, half ,he force only

applied <Olhe neck, che olher half beingexer<ed upoo che

head, by lhe finger ";hieh is fixed in the mou,h \ fo ,hu

the forehead is more eaCo!y brought out, by pulliog up–

wards, Wilh the half-round turn from lhe periozum.

Wheo lhe operator, with his fiogen in lhe child's mouth,

cannot pull down lbe forehead iOlO the hollow of tbe fa–

crum, le< him pulh the fore-finger of his lef, hand betwin

the neck and o. pubis, in order 'o raife ,he hindhead up–

wards; which beiog dooe, ·the forebead

wiU

come down

.wilh lefs dillieuhy, efpeeially if he pulhe, up aod pulJ.

do\yn at the fame time, or ahcrnately .

If i< be diCeovered by the ,ouch, thac ,be b..ech pre–

fents, thal the membranes are

DOI

yet broke, the woman

danger, tbe os ioteroum nOl yet fufficieody diJated..

and ,he laoour·pains llrong ; t11e rnidwife 9ugh, <O wait

unul lhe mcmbnnes, with lhe waters, are pulbed tar–

ther dowo. as in (he oaturallabour : for, as (hey come

down through the' os uterí ioto lhe vagina, tbey llretch.

opeo the pans cootained

lhe peh'is; aod lhe bulk witbin

the uterus being diminifhed, it cootrall:s and comes

cOOlaél Wilh lhe body of lhe ehild; fo lh" ,he breeeh i.

pulhed along by the meehaoical force of the abdomioal–

mufcles openlÍng upoo the womb.

The fame eonCeqwence will follow eveo ahhough the

membranes are broke; for the waters lubricale lhe paru

as (hey Bo\Y off; and lhe brecch,

oot too brge; or the–

pelvis oarrow, is pu!hed down.

Ibis cafe" waen tbe

nates prefc!Dt

~qual

and f..ir to the os uleri, fo it is airo

reafonabl~

to conclude, that when lhe breech prefents,

lies in the fame manner, bUI 'that the fore·pans of

chiJd are rather turned backwards lOone fide of lhe ver–

tebra! of lhe loios: in tbis poridon, one hip will prefent.,

and the other ren

0 0

the os pubis; bUI, whenJorced along.

,~i, h

pains, the

Jal!

wiJl

goadually moved more aod

more:

Ibe groin of that fide. and from thence Clip

dow.rl

lhe Cod. of lhe baCon : lhe lower

the fame lime

will

be forced

lhe other, and the hollow betwix, lhe ' high.

witl ren upon lhe jeuing'io of lhe os (acrum, and come

down in thal manoer ; Ihe lhighs on

eaeh

úde. and the

baek and round pa" of lhe breech palling io below the

arch of lhe os pubis, whieb is the ben poC,lioD: bu, if the

back of lhe ehild is lilted backwards, theo it will be for–

ced

do\\'~

io lhe

c~nt rary

direélioo. and come along with

nwre d:f1:¡cU"lt y,

v/x ,

the thlghs to the os pubis, aod back

lhe fJcrum: \I.·hen

is come down tOotbe middle or

r.ower pUl of (he pelvi, . Jet tbe oper.nor introduce the

fore. finR~r

of (3ch hand, alc\Og (be oudide, to tbe groins,

aod , ,.ktng hold, pull gently along dLHing a flrong pain.

lhe os <x<croum is fo cootra{\<d, lbat he c. onoe

uke