A compendious system of midwifery : chiefly designed to facilitate the inquiries of those who may be pursuing this branch of study, illustrated by occasional cases / by William P. Dewees.

  • Dewees, William P. (William Potts), 1768-1841.
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: A compendious system of midwifery : chiefly designed to facilitate the inquiries of those who may be pursuing this branch of study, illustrated by occasional cases / by William P. Dewees. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    government of those, whose ill luck may put them in possession of such cases—1st. Whenever Ihe tumour is moveable, it should be pushed above Ihe brim of the pelvis at the commence- ment of labour, and prevented from again descending before the child. 66. 2d. That we should never permit the labour to be long protracted, but early to resort to the means of relief. 67. 3d. As it is impossible to decide with certainty on the nature of the contents of many of these tumours, we should in all cases, where we cannot push them up, try the effects of punc- turing with a trocar. If the contents be fluid, we evacuate them more or less completely; if solid, we find the canula,when with- drawn, empty, or filled with clotted blood; if fatty, or cheesy, the end of the tube retains a portion, and we are thus informed of its nature. 68. 4th. When the size of the tumour cannot be sufficient- ly or considerably diminished by tapping, I am inclined, from the unfavourable result of cases where the perforator has been used, and from the severe and long-continued efforts which have been required to accomplish delivery, to recommend the extir- pation of the tumour, rather than the use of the crotchet. There may, however, be situations where the incision ought to be made in the vagina; but these are rare. But extirpation cannot in any mode be proposed, if firm cohesions have been contracted between the tumours and vagina or rectum. 69. 5th. If the extensive connexions, extent, or nature of the tumour, or danger from hemorrhage, prohibit extirpation, or the patient will not submit to it, and it has been early ascertained that tapping is ineffectual, I deem it an imperative duty to urge the perforation of the head, or extraction of the child, as soon as the circumstances of the case will permit. 70. 6th. Much and justly as the Caesarean operation is dread- ed, it may with great propriety be made a question, whether in extreme cases, that would not be less painful, and less hazardous to the mother, than those truly appalling sufferings which are sometimes inflicted by the practitioner for a great length of time, when the crotchet is employed; whilst it would save the child, if alive at the time of interference. I am aware that it may be objected to this opinion, that in those cases, the tumour being softer than bone, the same injury will not be sustairfed, as if the soft parts had been pressed with equal force, and for the same time, against the bones of a contracted pelvis, and that, in point