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:
- 1847
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.)
26/634
![18. Various causes have been assigned for this relaxation or sepa- ration of the pelvic bones: 1. Serous depositions in the cellular meshes, or interstices of the connecting media. 2. Tumefaction of the cartilaginous extremities of the ossa pubis. 3. The child in transitu acting like a wedge on the bony circle which bounds the upper strait. 4. Mechanical violences, as falls, blows, instrumental delivery, &c. 19. When mere relaxation exists, the symptoms, though pretty • permanent, are not so violent, as when there is a separation. A painful tottering walk, with a greater or less inability to stand, and more especially on both feet with equal firmness, mark very cer-. tainly this condition of the pelvis: and this is sometimes detected even before labour. When it happens during labour, it is always attended with a painful sensation at the relaxed part, together with an inability to exercise the auxiliary powers concerned in this ope- ration. This latter circumstance is worthy of notice; as it would seem to decide at once, that this yielding is not intended to benefit parturient women. When the injury is greater, and a real separa- tion has taken place, it has been found, that it is by the destruction of the ligamentous tissue which connects the bones, and thus per- mits them to retire farther from each other than mere relaxation would have done. When it is the symphysis of the pubes which suffers this accident, an entire separation of the cartilaginous epi- physis from the extremity of the os pubis takes place; for agreeably to Baudelocque, no power is capable of breaking the ligamentous substance which connects these two bones. 20. When this last condition obtains, it is usually followed by a melancholy train of evils—pain, inflammation, suppuration, caries, gangrene, and death. 21. The mode of treatment of these evils is reduced to great sim- plicity, though far from equal certainty—the indications are, 1. To reduce the parts, as nearly as possible, to their natural position, and to secure them thus as efl^ectually as possible. 2. To obviate inflam- mation and its consequences, as far as may be practicable. 3. To relieve pain. 4. To give strength at a ]:)roper time to the system gen- erally. - 22. The first indication must be fulfilled by the proper applica- tion of bandages; and we are of opinion, that the simple calico roller is as eflfectual as any of the more complicated machinery contrived for this purpose. It should be applied as high as the crislse of the ilia, and a little below the trochanters of tlie thighs—its length should be so ample, as to secure a number of turns round the parts; and it should be drawn sufficiently tight to fulfil the object for which it is applied. The patient must be confined to a horizontal position, and employ her lower extremities as little as possible, at least in the beginning of the plan. woman, but that even in them some slight relaxation does take place. (Principles and Practice of Obstetricy, p. 6.) We would ask for information, has this relaxation been proved to take place; as we do not think, without some evidence and that positive, this opinion should be received upon the mere ipse dixit of any man j especially as no good can be derived from it ,](https://iiif.wellcomecollection.org/image/b21114572_0026.jp2/full/800%2C/0/default.jpg)
