The principles and practice of obstetric medicine and surgery : in reference to the process of parturition : illustrated by one hundred and forty-two figures / by Francis H. Ramsbotham.

  • Ramsbotham, Francis H. (Francis Henry), 1800-1868.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of obstetric medicine and surgery : in reference to the process of parturition : illustrated by one hundred and forty-two figures / by Francis H. Ramsbotham. 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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    considerable movement. Proceeding from the symphysis, in a direction downwards, outwards, and rather backwards, to be joined by ossific union with the ramus ischii, there is another flat, thin, and narrow sheej of bone —the descending ramus of the pubes (s). This bone is, like the other two, rough externally, and smooth within: from the outer surface some of the adductor muscles of the thigh take their rise. On the interior, running along the upper margin of the horizontal ramus, there is a ridge, some- times rather sharp, which is a part of the brim of the pelvis, and at its inner extremity it terminates in a little eminence—the spinous process (i). To this is attached the pubic end of Poupart's ligament, near it the pecti- neus; the oblique and transverse muscles, the pyramidalis, and rectus abdo- minis, are also inserted into different portions of the upper edge of the pubes. The pubes is connected with the ilium and ischium in the aceta- bulum, with the ischium at the junction of their rami, and with its fellow bone of the opposite side by the symphysis.* When the os innominatum is again regarded as a whole, the attention cannot fail to be arrested by a large oval aperture in the fore part, formed by the ischium and pubes—the thyroid or obturator foramen (u). In the recent pelvis it is almost entirely filled up by the obturator ligament, which consists merely of two layers of periosteum, one externally, the other within, continued from the bone across it. The space is entirely covered by this extension of the periosteum, except at the uppermost part, where a hole is left, not larger than would permit the passage of a small bougie: through it the obturator vessels and nerve escape from the pelvis. This ligament supplies the place of bone; for the obturator externus, one of the rotators of the thigh, arises from its outer surface. It appears to be placed here for the purpose of rendering this part of the body lighter than it would be, were a thick piece of bone present instead. There is another point, in regard to these three divisions of the os innominatum, worthy the consideration of the obstetrician; namely, the relation which each bears to those parts of the pelvis, hereafter to be more particularly described,—the brim and outlet. The ilium forms a consi- derable share of the brim, but none of the outlet; the ischium forms a part of the outlet, but none of the brim ; while the pubes enters very largely into the composition of both the brim and outlet: so that the ilium might be greatly deformed, and yet the brim alone suffer; a distorted ischium would only involve the outlet; but if the pubes were of vicious formation, both brim and outlet must necessarily be implicated. * The term pubes was applied to this bone in consequence of its intimate connexion with the external organs of generation; and that of pecten from its fancied resemblance to a comb, when the two are united.