On the statics of pregnancy / by Matthews Duncan.

  • James Matthews Duncan
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On the statics of pregnancy / by Matthews Duncan. Source: Wellcome Collection.

    11/28 page 7
    earlier direction. In the supine position, we find the uterus (see Figs. 7 and 8) to be not horizontal, but inclined to the horizon at an angle greater than that assumed in the erect attitude of the female. This angle is between 60° and 30°, probably much nearer 60° than 30°. In this way, it is evident that the uterus is more nearly vertical in the hori¬ zontal position of the woman, than in the erect. In both cases it is in an oblique position ; and by this beautiful ar¬ rangement, the uterus is preserved, in a uniform condition, free from many statical variations which might otherwise affect it suddenl}^ and injuriously. The fact, that in none of the ordinary positions of the female is the uterus vertical, insures for the organ a consi¬ derable hydrostatical advantage. If the uterus were at any time vertical, then the lower part of the organ, the part least supported and perforated by the os, would be liable to be subjected to the pressure of a column of liquor amnii of about twelve inches in height, or equal to the longest diameter of the uterus. But by inclining the organ from the vertical position, the vertical height of the column of water is dimi¬ nished, and with it the amount of the fluid pressure on every part of the walls of the organ. Before leaving this portion of my subject, I wish to pointout one practical application of it. In the third quarter of preg¬ nancy, when the foetus has acquired considerable firmness and weight, and before it has become at all closely adapted in form and dimensions to the uterine cavity, it may be made, by a very small amount of force, to bob about in the liquor amnii. Various positions of the female have been recom¬ mended as best adapted for successful repercussion or bal- lottement, as this bobbing of the foetus is called. Numerous authors, especially those of the French school, advise the practitioner to place the woman in the erect position ; others recommend the horizontal position on the side, on the back, with the shoulders raised, or on the knees and elbows. But a little attention to the configuration and attitude of the uterus will show that, on mechanical grounds, there is one position decidedly preferable to the others. This position is that of course where the operation can be best accomplished ; in other words, where there is most room and freedom for anterior surface lying against the peritoneal lining of the abdominal parietes —a relation of parts which continues unchanged throughout the whole period of pregnancy.” “ In the erect position of the body” (says Robert Lee, Lectures on Midwifery, p. 91), “ especially if the abdominal muscles are relaxed, the fundus uteri falls forward, so that the axis of the uterus forms a great angle with the spinal column and brim of the pelvis, and approaches the horizontal line.”
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