Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman.

  • Herman, G. Ernest (George Ernest), 1849-1914.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman. 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.

    162/488 (page 138)
    might be expected, for the causes that interfere with the due development of one set of bones are likely to influence the development of others also. But the flat pelvis is sometimes seen in women of full average stature, who are otherwise well and strongly built. It has been said to be produced by the practice of carry- ing weights on the head in early life. This may be so, but no evidence of it has ever been brought forward j and the flat pelvis is often seen in women who have never been in the habit of carrying weights. It is com- moner in the poorer classes, because they are the more numerous ; but it has never been shown to be propor- tionately commoner in them than in the rich, It has been said—and I think it probably true—that this form of contracted pelvis is more common in Germany than in England. But no facts have been adduced in support of this, because I know of no English lying-in charity in which systematic measurement of pelves has been so thoroughly cai'ried out as in the well-ofiicered lying-in hospitals of Germany ; nor do the conditions under which English practice is carried on allow pelves to be removed and thoroughly examined after death so frequently as in some other countries. The diagnosis of the slighter forms of contracted pelvis is so difficult that until the pelvis has been measured after death it cannot be said to be always beyond doubt. Characters of the flat pelvis.—In the/a« pelvis the conjugate is the only diameter shortened. A pelvis in wliich the true conjugate is three inches and three quarters or less, the other diametei's being normal, is a flat pelvis. The oblique and transverse measurements may even be larger than in the normal pelvis. The antero-posterior diameters in the cavity and at the outlet are shortened, but not to the same degree as the conjugate. The sacrum is pressed forward as a whole, and not rotated upon its transverse axis, nor altered in shape, as it is in the rickety pelvis (Figs. 57, 58). The posterior sacral spines, owing to the sinking forward of the sacrum, are often depressed slightly below the level of the posterior