1000000031

of Ihe OlOlher,aJjuned, 1, 1 Ihe prop" hand be inlroJu–

c<d, and

Ih~

firfl effún allVay. mode in pufhing Ihe pre–

fcnlin g part up towards the fu ndus , either .. long the

lides, b:tck, or

rore

pan of the

Uler',

a' is

!non

canve–

nicnt.

this endcavour (uccccds, anJ the breech ,

thighs, or legs come dO'Nn, Ihe body moy be dclivered

wilh cafe : bUI if Ihe heod, fh oulder, br..n,' or neck

refe nl, the other pans of ,he b, dy being rt r<leh, d up

ength \Y~ys,

and the uteru,

nron~ly

contraéled around

tbe ehild, Ih, t Ihe prefenling part canno' be raifed up,

or,. though Pllrhed upwards,

immeJ.i<udy

returns before

the legs can be properly feiud or brough, dOlVn; Ihe o'

perator ought, in tha,

e.fe

, 10 fore: up his hond Ilowly

and gradually between the olerus and Ihe ehild : 'if Ibe

refifiance is great, let him reíl a liHle, between whiles,.

lo order to ene the rtrenglh of his hand and arnl, and

,hen proeeed with his efforu unlil he fhall advaDee -hi.

)Iaod a. far as the reet ; for the higher his

h.nd

is pufh-.

~d,

,he more will the uterus be IIrclehed, and ,he more

roo

raoted for bringiog ,be legs a.long : and if, in pufh–

Ing

up his hand, Ihe fingen fhould be enlongled in Ihe

pavel.llring or one of Ihe arm. , le, him bring it • linle

10IVer, .nd pafs it up again on the ou,fide of fueh ineum–

bran::e.

Thehaod being adv.need as high as ,he fundu" let him,

after fome paufe , feel for Ihe breeeh, Ilide his fingen a–

long the ,highs in [eareh of loe legs and feet; of .,hieh

taking h1>ld wilh his whole hand, if pollible, lel him bring

them

dOWD

eitller in a Urei ght lioe or with a half turo

or fhould the eonlraaion of Ihe ulerus be fo f!rong, thal

cannOl

takehold ofthem in thar m<lnner, Jet himfeizc

one or bOlh .ncle. between his finge.. , and pull them

a–

long; bUI if he canDo. bring them down 10 Ihe lower parl

oflhe uterus, fo as to apply Ihe noofe, he mun trY'gain

·to pufh up Ihe body, 'io order flill more to nreleh fhe u–

tcru!l

and obuin frecr fcope: te bring th:m down Jower:

then he may .pply the noofe, aDd IUI n ,he ehild as

abov~

direlled, uOlil Ibe

Ii..

d .nd Iboulde.. are raifed up to

tbe {uadus, and Ihe feet and breeeh d.livered _

If ooe leg only can be broughl down, Ihe ehild being

turoed, aod ,h.t member extroacd Ihrough Ihe os ex–

ternum, let the aeeoueher Ilide his hand up 10 felch the

other; bUI, if Ihi. eannot be dooe, he mufl fix a finger

on Ihe outfide of Ihe groin of that Ihigh whieh i. fold ed

tlp along the belly, and bring along Ihat butloek, as in Ihe

breeeh

c.fe,

",hile he pulls wilh his o,her hand

Ihe

olher leg; .nd the body bdog Ihus .duneed, deliver as

befor, direéled_

When the fhoulder prefen!s, ond Ihe arm lies double

iD Ihe vagioa, let him

PURl

Ihem bOlh up; but, if this

cannol be done, !,nd the hand is prevented from palling

¡Ione. he mu'G bring down lhe arm, and hold il IVilh

one hand, while the other is introduced ; then Jet go and

pUOl up Ihe Iboulder, and as Ihe child is turned, and Ihe

feel brough' dowo, ,he arm will for the otOn part return

into the merus : bU I ir lhe arm that is come down, be fo

much fwelled, tha! it is imprac!l.icable to inlroduce lhe

hand, [o

'o turn "nd deliver Ihe <hi ld, hé mun fepa–

rate it at the joint of the fh ouldcr, if it be fa low down;

or at ,he elbow, ir he eannol re. eh Ihe lhoulder,

the

limb be mueh mortifird, il may be Iwitled off; olherwife,

may be

fDipt .nd fcparated Wilh the feilfa rs.

Ihe fh,uldcr, by Ihe imprud<ncc an,1 ignorance of

th: unfl,;¡fll l. \\Iha pull, in expc\.'lilioD of deli ,,:ring in

that \\'?y. is forced into the v¡¡&ina, and part of it ?ppears

on the outGde of lhe os eXICTI1Um, a viii fo rce 1-5 req\1i–

red tO rcturn it into lile

uter~s

;

becaufe, in chis

caJe,

che

Iboul",r, pa" or Ihe rib. ,

bre.tI

, and fide, . re already

pulled

O~I

of lhe Uleru., "hieh mufl be ext ended fo as

nat ooly to receive them ¡¡gaio, but alCo to admit lhe haod

ond o"ti of Ihe aeeoueheor , If Ihi. dlitenfion .annol pof–

fibly be effeaed,

muf! r, x a erolehel above Ihe fleroum,

and ,urn Ihe ehild by pufhing up Ihe fhoulder and pulling

down with the crotchet; or

fl~ie

his fingers to the neck

of Ihe ehild, and wilh the [cifr... divide Ihe head fronl

lhe body; Ihea deliver firft Ihe fepualed he.d , or

brin~

along the body by pulling al Ihe arm, or, if oeed be,

with the affil1ance of the crotchet .

WheD the forehead. f.lce, or ear prefents. and canDot

be altered with tht hand iDto

the

natural pofition

í.

not advanced to tbe os extcrDl1m, fo as lhat we cao affift

with the forceps

lhe head

Rlull:

be returned , and die

ehild delivcred by Ihe feel : but if Ibi. eannot be done,

and rhe \Voman is

irnm ioeot danger, .recourfe mull: be

h.d to tI,e erotehe,_

If Ihe n..el·llri ng comes dOIVn by the ehild', bead.

and rhe pulratíon is feh in the

~rterie$,

(here ¡s a neceffi ..

Iy for lurning wilhout lor, of time; for unlefs Ihe head

advances fan, and the delivery ¡s quick, the circulation

in lhe velfel, will be entirely obllruaed, aod Ihe ehild

roofequeDtly perifh ,

lhe head is low io the pelvis, Ibe

foreeps may be fueeef.fully ufed,

No dOQbr,

the pelvis is very narrow, or lhe bead

too large, it would be wrong to turp: in that care, we

ought to try if we can pollibly raife the head, fo a. to

r"duee the funis above it, ond .fler Ibal let the labour

00:

bllt,

lhe

walen

are

.11

gone, and a hrge por ..

tion of the funis falls down, it i. impollible 10 raife ir, fo

as to keep it up, even ."hough w< eO\Jld eafily raife Ibe

head ; beeaufe,

one pan of lhe funi s i. pufhed up with

rhe fingers, another part

(alJs

down, and e...ades the re ..

duétion; Oled tO raife it up to ,he fide, and Dot above lhe

h.ead, \ViII be to no purpofe; when a liule onty je.. dowo

at the fide of lhe head, our endeavours will, for Ihe mol!

part, be fueeefsfu!.

The aocients, as well as fome of lhe moderos, advife",

in all eafes when Ihe upper pans, fueb

Ihe fhoulders,

brean, neek, faee, or ear of Ihe ehild prefenl, 10 pufh

them upwards, and b.ring in tlle head as in the natural

way; obferving, lhat the fa:lus ougbl never to be deli–

vered

the Ceel, except in the prefeotalion of the Jower

pans, fu eb

. s

Ih e fmal1 of Ihe baek, belly, fide, b«eeh,

or legs .

Were it praaieable al all ,imes to bring Ihe

head iDfo tbe right pofi lion, a gre'l deal or fatigue "'oulri

be faved to tbe operator, much

pajo

to tbe wom:ln, and

imminent danger tO tbe child: he therefore ought

at–

temp! Ihis method, and may fu ceeed IVhen be is ealled

before lhe membranes are broke, and feel. , by lbe looeb,

that ,he race, cae, or any of tbs upper P¡¡ rts, prefeots;

in th:;t cafe. Jet him opeo the os exrernum Oowly- duriog

every pJin, and when the os internum i5 fulndendy di–

lated by the deCcent of the waters and membranes, Jet

him introduce bis hand ioto the uterus, as

before

direéled,

betwix, the IVomb and Ihe membraoe3. whieh mufl be

brokq