The attitude and position natural and preternatural of the foetus in utero, acts of the reflex or excito-motory system / [Sir James Young Simpson].

  • Simpson, James Young, 1811-1870
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: The attitude and position natural and preternatural of the foetus in utero, acts of the reflex or excito-motory system / [Sir James Young Simpson]. Source: Wellcome Collection.

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    are by no means uncommon. In the Maternity Hospital of Paris, Professor Paul Dubois found, that out of 121 fcetuses, born alive or dead before the end of the sixth month, 65 presented by the head; 51 by the pelvis; and 5 were cross-births, or presented by the arm or shoulder. Further, the position of the head towards the os uteri, appears to be taken up more and more frequently and certainly from the end of the sixth month onwards. Out of 73 instances in which the child was born prematurely but alive, dur- ing the currency of the seventh month, Dubois found it present- ing by the head in 61 cases, by the pelvis in 10 cases, and by the shoulder in 2 cases. Hence, while before the end of the sixth month the proportion of head presentations amounted to 55 in the 100, during the course of the next month, they were found already amounting to 82 in the 100; at the full time they amount, as we have previously stated, to 96 or 97 in the 100. But at whatever period of the pregnancy the attitude of the foetus is supposed-to be taken, the whole idea of its head being placed lowest and opposite the os uteri, by physical gravitation merely, is a doctrine to the adoption of which there are the follow- ing insurmountable objections. 1. The doctrine presupposes that the mother’s body is in the vertical or upright position, in order that the gravitation of the foetal head may have the effect attributed to it. But during her hours of sleep and rest her body is placed horizontally and not ver- tically, and ought to afford many more chances than the statistical results show, of the head falling by mere gravitation into other posi- tions and localities, than its usual and normal locality in the cavity of the cervix uteri. Besides, most practitioners have repeatedly seen patients restrained to the horizontal position for months before labour came on, without this position of the mother producing any deviation from the common position of the foetus. 2. The doctrine further presupposes that the child is suspended in the uterine cavity by the umbilical cord.!. But this is not in ac- 1 <The fetus,” says Capuron, “ is generally suspended from the uterus by the umbilical cord, and represents a kind of lever or hydrostatic balance with two arms immersed in the liquor amnii. These two arms commence at the umbilicus, and terminate the one at the apex of the head, the other at the heels or feet of the foetus. * * * The head, which is placed at the extremity of the super-umbilical arm of the balance, must obey the gravitation which forces it down to the neck of the uterus.” —Mémoire sur la Situation du fetus pendant la Grossesse ;—Journal Universel et Hébdomadaire, &c., tom. x. p. 487. “The reason,” says Hunter, “why the child’s head is commonly down- wards may be supposed to be this: the child is specifically heavier than the liquor amnii, and therefore, in the various attitudes of the mother, is always in contact with and supported upon the depending part of the uterus. This, in the more common attitudes, is the cervix uteri. The child’s head and upper part of the trunk contain more matter, in proportion to their surface, than the lower part of the body ; thence the head will more generally fall down to the