Two cases illustrative of the advantages of turning as an alternative or substitute for craniotomy and the long forceps in certain cases of pelvic contraction / by J.G. Wilson.

  • Wilson, J. G. (James George)
Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases illustrative of the advantages of turning as an alternative or substitute for craniotomy and the long forceps in certain cases of pelvic contraction / by J.G. Wilson. Source: Wellcome Collection.

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    The Two following Cases were originally published in the Edinburgh Medical Journal, for October, 1856, and were copied into Braithwaite’s Retrospect of Medicine, for January, 1857. Case I .—July 17, 1855.—Called to see Mrs. -, aet. 42, resident in Calton, who, as I learned from the student in attend¬ ance, had been in labour for the greater portion of History. two consecutive days. The uterine action had been powerful and regular during the greater part of that period, but had gradually become weaker and more inter¬ mittent. The membranes bad been ruptured, and the liquor amnii evacuated about twenty-four hours before my seeing her. On my arrival, I found the woman weak and exhausted, with a small and rapid pulse. Examination per vaginam, detected a considerable jutting forwards of the sacro-vertebral angle, and which had the effect of materially diminishing the antero-posterior diameter of the pelvic brim. The greater bulk of the infant’s head was still at the inlet of the pelvis, whilst a large sealpy tumour projected into the cavity, firmly embraced in front and behind by the pelvis. The os uteri seemed dilated to its full extent. This state of matters had continued for twelve hours— the only difference being that the tumour was slowly enlarging, whilst the patient’s strength was becoming hourly more depressed, and the action of the foetal heart fainter and weaker. Under these circumstances, it was evident that something must be done to relieve the patient, and that without delay. Three methods of operative procedure presented themselves for adoption, viz., long forceps, craniotomy, and turning, and delivering by the feet. As considerable difficulty and danger was anticipated from the use of the long forceps, from the high position and altered form of the head, as well as from the contracted brim, the idea of having recourse to them was abandoned. The fact of the infant being still alive, as indicated and ascertained by the increasing swelling of the scalp, as well as by auscultation, was, in my estimation, an adequate reason for discarding the idea of craniotomy. Think¬ ing that the case was in all respects one well adapted for testing the merits of the operation of turning in such cases, it was agreed to give the woman the chance of delivery by that method. After having administered a stimulant to the patient, I Operation. passed the left hand up through the vagina to within a short distance of the fundus uteri, where