The Philadelphia practice of midwifery / by Charles D. Meigs.

  • Meigs, Charles D. (Charles Delucena), 1792-1869.
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: The Philadelphia practice of midwifery / by Charles D. Meigs. 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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    smaller than that of another, it is evident that the pelvis may be smaller in one than in another. A woman shall have a pel- vis, which, to all appearance, is perfectly well formed, all its parts bearing a due proportion to each other, whereas, when it comes to be measured, it is found to be of an under size. Such a female would experience far greater difficulty in giving birth to her child than she would if her pelvis had been of a full size? and the difficulty would be just in proportion to the departure from the average or standard size. Such a pelvis will perhaps never be found to give rise to insuperable difficulties; it will only render the labour slow and vexatious, and perhaps exhaust- ing. But the truly deformed pelvis, that in which the pro- portion between the several parts is altered or destroyed, is not unfrequently met with, giving occasion to the greatest embar- rassment to the practitioner, and subjecting the mother to the most dreadful sufferings, danger, and even inevitable death itself. This kind of deformity may have taken its rise in childhood, or may have been produced after the woman had attained to adult age. In the former case it is commonly the result of rickets, in the latter of malacosteon, or exostosis. In the two first named diseases the solid phosphate of the bones is absorbed, to such a degree, as to permit them to yield to pressure, so that, if the subject be greatly affected with the disorder, the long bones, as the os femoris, the tibia, the os humeri, '&c. assume an arcuated appearance, which pro- bably results from the continued action of the muscles, tend- ing naturally to bend or curve them. Thus, the femur is found to be arched by the perpetual action of the strong flexors of the leg, which have this advantage over the ex- tensors, in this case, namely, that the femur is naturally some- what curved in the same direction which the action of the flex- ors tends to give it. If the deprivation of phosphate of lime should extend to the bones of the pelvis, in any case of rickets, a change in the form of that part will result from the superincumbent weight of the body, both in the act of sitting, and standing. If the patient be often or long in a standing posture, the whole weight of that part of the individual which rests on the vertebral surface of the sacrum, tends to crush the sacrum downwards towards the ossa pubis, because the pressure is opposed by the acetabular portion of the pelvis, resting as it does upon, and resisted by the ossa