Case of delivery, without operative aid, through a pelvis extremely deformed by malacosteon / by J.Y. Simpson.

  • Simpson, James Young, 1811-1870.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Case of delivery, without operative aid, through a pelvis extremely deformed by malacosteon / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    There are no sufficient data to determine at what precise time the infant died. Milk had been discharging from the nipples for three or four weeks before delivery; but whether the child had pe- rished about that period it is impossible to say. Mrs D. deceived herself with the idea that she felt it living and moving up to the time of delivery. The precedingcase is, I believe, unique in the annals of midwifery It will perhaps therefore require no apology if I add one or two brief inferences which the history and details of it appear to suggest. 1. It has taught me, and is, I conceive, calculated to teach others, a strong lesson of caution in regard to our prognosis, under ap- parently even the most desperate circumstances. In such rare forms of complication as this, we must depend for our prognosis, &c., upon the anterior observations and recorded facts of others. Here all such records led me to expect a very different result, and offered no hope whatever of such a fortunate termination as actually occurred. 2. The case affords a new and striking illustration of the just and well-known remark of Dr Denman, that the resources of na- ture in every thing which relates to parturition, are infinite, and constantly exerted for the preservation, of both the parent and child; yet when the two objects are incompatible, the life of the child is almost uniformly yielded to that of the parent. ^ And the mode and mechanism by which nature brought about this unex- pected result in the present instance, are highly worthy of special notice. For, first, she set up a diseased condition of the placenta, which prevented the full and proper nourishment of the foetus, and thus restrained as far as possible its development and growth. Secondly, she carried this state of marasmus to such a degree, as at last proved slowly fatal to the child, without superinducing that expulsive action which generally soon follows the death of the in- fant. Tliirdly, the dead infant was subsequently retained for so long a time in utero, that not only the bones of the cranium, but the bones of the basis of the skull and face were loosened and separ- ated from each other, and the head and other parts of the body thus rendered readily and easily compressible.^ And, lastly, the 1 Practice of Midwifery, p. 415. 2 No individual case in midwifery has given rise to so much discussion, as that of Elizabeth Sherwood. Her pelvis was estimated by Dr Osborne as below the lowest standard which I have given in a preceding page, as capable of al- lowing of the passage of a child by embryulsio, being only about i} of an inch from the sacrum to the pubis ; and yet he delivered her successfully by crani- otomy after working and pulling for three hours with the crotchet. Many authors have stated that Dr Osborne must have undoubtedly under-measured the pelvis of Sherwood ;—and Drs Hull, Burns, Hamilton, &c., have denounced the operation of embryulsio as impracticable if Dr Osborne's measurements were at all true and accurate. Dr Campbell, for instance, observes It would be idle to enter largely on the refutation of tliis extraordinaiy case, since Dr Osborne's narrative of what he thought he had accoiiiplibhed, is irreconcilable