A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge.

  • Dührssen, Jacob Alfred, 1862-1933.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge. Source: Wellcome Collection.

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

    278/346 (page 256)
    slioiild wait for the dilatation of tlie os before proceeding- to internal version. If the membranes rupture prematurely, as commonly happens in cross-births, then on the other hand version should be jjerformed at once as previously stated. The preparation of the accouclieur and of the patient is the same as in every operation. Deep narcosis is liere of special value. Since extraction must often follow on version, and the child is brovight into the world more or less asphyxiated, one should see that there is tepid a;id cold Avater, as well as warm flannels placed ready, that a piece of tape for tying the coi-d is boiled and the tracheal catheter is a thand. The tape may be used as a loop intui'ningif necessary. The author prefers the lithotomy position for turning, but the lateral position on the side of the feet is recom- mended to the beginner, especially when the belly of the child is directed forward. That hand is chosen for in- troduction which looks towards the side on which the feet are when one stands in the middle line. One uses the left hand for the right side of the patient and vice versa. The operator sits between the thighs of the patient when she is in the lithotomy position, and behind the patient when she is on her side. Turning is divided into three stages. (1) Inti-oduction of the hand through the vagina and the OS uteri at the end of a pain. (2) Grasping a foot. (3) Pulling the child round or rotation. 1. The hand, folded up into a cone shape and disin- fected with lysol (which renders a lubricant unnecessary), is passed through the vulva with pressure directed to the side. In a primipara, the vulva may be so narrow that the hand will not pass at all, and the vagina may be so rio-id that the arm will cause it to burst. In such a case