A theoretical and practical treatise on midwifery, including the diseases of pregnancy and parturition / by P. Cazeaux ; rev. and annotated by S. Tarnier.

  • Cazeux, Pierre, 1808-1862.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: A theoretical and practical treatise on midwifery, including the diseases of pregnancy and parturition / by P. Cazeaux ; rev. and annotated by S. Tarnier. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    54/1140 (page 50)
    mcnt, which is more marked in the female than the male, favors the descent of the head. The arch is three and a half to three and three-quarter inches l»road at the base; but only one and a quarter to our and a half inches at its apex ; in height, it is about two, to two and a half inches. Hence the area of the inferior strait will not present a uniform plane (should it be desirable to ascertain the irregularities it exhibits), because all parts of its margin are not upon the Bame level. However, to obviate the difficulty met with, in determining the direction of this plane, Duges has divided the str::'n into two nearly equal portions, the one anterior, and the other pos- terior, meeting at the tuberosities of the ischium, and each presenting a distinct plane and axis: hut as this method of proceeding uselessly com- plicates the question, we prefer considering the terminal plane of the pelvis, as r< presented by the coccy-pubal line, thus leaving out the lateral projec- tion- altogether. The question is then reduced to these terms: What is the direction of the line that extends from the point of the coccyx to the inferior part of the symphysis pubis? Writers, likewise, variously describe this; for instance, according to the majority of the French accoucheurs, the plane of the inferior -trait i- slightly oblique, from below upwards, and from behind forward.-, so that it would unite with that of the superior strait (if prolonged) in front of the symphysis pubis. On the other hand, M. Na?gele concludes, from his numerous researches, that the inclination of the antero-posterior diameter of this strait is from 10° to 11° from the horizon, and that the point of the coccyx is found, as a mean, from a half to three-quarters of an inch higher than the summit of the pubic arch; and, therefore, the coccy-pubal line is a little oblique from above downwards, and from behind forwards. The lower extremity of the axis of this plane of the inferior strait would cut the coccy- pubic diameter at right angles, and terminate above at the sacro-vertebral angle. As a further result of his labors, he has found that, in live hundred well-formed persons, of different stat- ures, four hundred and fifty-four have the point of the coccyx more elevated than the inferior portion of the sym- physis; in twenty-six it was lower, and in twenty individuals both points were on the same level. -M. Yelpeau remarks, as we think with sonic n ason, that, at the moment of delivery, — the only time, after all, when it is requisite to form an idea of the direction of this plane, — the point of the COCCVX, being pushed downward- and back- Wards by the passage of the head, is at least on a level with, if not lower than ' The plane of the in t]u, inferior pact of the symphysis. a b The udi t the In- ,r. . . ' tnit lli«' assertion oi M. Nsegele, there-