Facts and cases in obstetric medicine, with observations on some of the most important diseases incidental to females / by John T. Ingleby.

  • Ingleby, J. T. (John Thomas), 1794-1845.
Date:
1836
Catalogue details

Licence: Public Domain Mark

Credit: Facts and cases in obstetric medicine, with observations on some of the most important diseases incidental to females / by John T. Ingleby. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    54/318 (page 38)
    tion, a moderate uterine contraction, whether natural or convulsive, will most likely of itself occasion the descent of the foetus. The forceps are, in a great measvue, limited in then- application to cases in which the os uteri is opened and relaxed, and the head is low in the pelvis; for, as M. Velpeau remarks, the application of the forceps at the brim of the pelvis is more embaiTassing, and requires more time, than the operation of turning; and the ob- jections against turning, when the eclampsia arises from a spasmodic or diseased contraction of the cervix, apply equally to the use of the forceps under similar states of the organ. But, provided all other things are favor- able, the circumstance of the uterine orifice being only partially open and tlie occiput at the brim of the pelvis, is not absolutely conclusive against the application of the forceps. In determining upon the smallest degree of dila- tation of the orifice which will permit a narrow-bladed pair of forceps being placed within the uterus, and over the face and occiput of the child, I think, if the orifice is soft, actually dilated three inches in diameter, dis- posed to yield further, and the patient offers no violent resistance, the forceps might be both safely and effec- tively applied. When once secured, the further dila- tation of the orifice would be promoted by the very efforts of the uterus consequent upon their action; and should there be a deficiency of power in the uterus to aid the action of the forceps, still there is in all cases, both of spontaneous and artificial delivery, a certain degree of contraction of the fundus which is accompanied by more or less dilatation of the orifice. In a case of very strong convulsions, which arose under the circumstances just mentioned, the practitioner gently forwarded the dila- tation by means of his fingers, and having applied the