The Principles and practice of obstetric medicine and surgery, in reference to the process of parturition : illustrated by one hundred and forty-eight figures

Front matter

THE

ABNER WELLBORN CALHOUN

MEDICAL LIBRARY

Preface

TO THE

SECOND EDITION.

When this volume was completed, and published in its entire state, in the year 1841, I did not expect to be so soon called upon to put forth a second edition, considering that two thousand five hundred copies of the first were thrown off". But the patronage which it has obtained has compelled me to appear again before the professional public ; and I do so with mixed sentiments of pride and gratitude.

Since, however, I feel that I might be liable to the imputation of indolence or carelessness, were I merely to superintend a reprint. of the book, as it first appeared, I have made some trivial alterations and additions to the original text ; and I have added a short Essay on the Diseases of the Pregnant and Puerperal States, and on the interesting subject of Abortion. Some statistical tables, afforded by the practice of the Royal Maternity Charity, will also, be found appended.

I do not profess to offer any thing new; nor is it likely I should, after the many valuable treatises on these topics which have recently been published both in Europe and America ; but I have so far extended the work, with the hope of rendering it more useful to the student, for whose guidance it was in the first instance more particularly designed.

14, New Broad Street.

Oct. 1844.

DIRECTIONS TO THE BINDER.

Plate I. to face the Title

. 304

XLIX. L

LI.

LIL

LIII.

LIV.

LV.

DESCRIPTION OF THE PLATES.

Plate Fig.

I. 1. Outline of the male form. 2. Outline of the female form.

II. 3. Os Innominatum, left side, in early life. View of the

inner surface.

4. Os Innominatum in adult. View of outer surface.

5. Os Innominatum in adult. View of inner surface.

6. Sacrum.

7. Trunk and pelvis of a human subject.

8. Pelvis of a cat.

III. 9. Front view of the male skeleton pelvis.

10. Front view of the female skeleton pelvis.

11. Brim of the female pelvis,

IV. 12. Outlet of the female pelvis.

13. Section of a male skeleton pelvis.

14. Section of a female skeleton pelvis.

V. 15. Front view of the foetal skull.

16. Side view of the foetal skull.

17. View of the anterior fontanelle.

18. View of the sagittal suture.

19. View of the occiput and posterior fontanelle.

VI. 20, 21. Slightly deformed pelves.

22. Excessively deformed pelvis — Angular distortion.

VII. 23, 24, 25. Excessively deformed pelves — Angular distor-

tion.

VIII. 26, 27. Excessively deformed pelves — Elliptical distortion,

IX. 28. Pelvimeters applied.

X.

XI.

XIL

XVI DESCRIPTION OFT HE PLATES.

Plate Fig.

IX. 29. Mode of measuring a deformed pelvis by the index

finger.

30. Mode of measuring a deformed pelvis by the whole

hand.

31. Mode of measuring a deformed pelvis by the first two

fingers of the left hand. N External organs of generation in the female.

Internal organs of generation in the female.

Lateral section of the unimpregnated uterus.

Infantile uterus laid open.

Cavity of the adult uterus.

Ovary without a corpus luteum.

External surface of the ovary with a corpus luteum. 39, 40, 41, 43. True corpora lutea. 42, 44. False corpora lutea.

XIII. 45. Lateral section of the female pelvis, with its contents.

46. View of the floor of the female pelvis — regarding it from the abdomen.

Arteries of the Uterus.

Nerves of the uterus.

Portion of jthe deciduous membrane ; face next the ovum.

50. Portion of the deciduous membrane; face next the

uterus.

51. Double layer of deciduous membrane, surrounding an

ovum about seven weeks old.

52. 53. Ova about five and six weeks old; the former shows

the filamentous vessels entirely surrounding it ; the latter partially.

54. An ovum about eight weeks old showing the placenta

when first formed.

55. A blighted ovum, about seven or eight weeks old.

XVL 56. An ovum of five months of age within the uterus.

57. An ovum of five months of age, enclosed in the amnion,

which is unopened and separated from chorion and placenta.

58. Umbilical vesicle in the ovum between five and six

weeks old. o9. Umbilical vesicle in an ovum between seven and eight weeks old.

XVII. 60. Placenta, foetal face.

XIV.

XV.

DESCRIPTION OF THE PLATES.

XVII

Plate

Fig.

XVII.

XVIII.

XIX.

XX.

XXI.

XXII.

XXIII.

XXIV.

XXV.

Placenta, maternal face.

Longitudinal division of a portion of the funis umbilicalis, to show the cells containing the gelatine.

Twin placentae.

Battledore placenta, taken from an injected specimen.

Arteries of the umbilical cord twisted.

Gravid uterus opened, to show the natural position of the fcetus within the cavity.

Uterus at the commencement of the fifth month of pregnancy.

The os uteri at the end of the third month of gestation.

The os uteri at the end of six months.

The os uteri at the end of nine months.

Gravid uterus at the full period of pregnancy in the abdominal cavity.

Side view of the uterus and pelvic cavity ; the os uteri entirely dilated ; the membranes protruding into the vagina as in labour.

Festal skull adapted to skeleton pelvis, vertex presenting, forehead to right ilium.

Foetal skull adapted to skeleton pelvis, vertex presenting, forehead to left ilium.

Fcetal skull adapted to skeleton pelvis, vertex presenting, forehead to right sacro-iliac synchondrosis.

Fcetal skull adapted to skeleton pelvis, vertex presenting,

forehead to left sacro-iliac synchondrosis.

Fcetal skull adapted to skeleton pelvis, vertex presenting, forehead to right groin.

Fcetal skull adapted to skeleton pelvis, vertex presenting, forehead to left groin.

Fcetal skull adapted to skeleton pelvis, vertex presenting,

forehead impinging on the sacral promontory.

Fcetal skull adapted to skeleton pelvis, vertex presenting,

forehead above the symphysis pubis.

Labour considerably advanced ; head in the pelvis ; the

face to right sacro-iliac synchondrosis.

Face turned into the sacral cavity ; vertex external ; forehead distending the perineum, the right shoulder entering the pelvis towards the right groin, the left towards the left sacro-iliac symphysis.

XVIII

DESCRIPTION OF THE PLATES.

Plate XXVI.

XXVIII. 87.

XXIX.

XXX.

XXXI.

XXXII.

XXXIII.

XXXIV.

i

XXXV.

Perineum distended; the vertex protruded between the labia.

Head expelled ; face turned to the right thigh ; the right shoulder behind the symphysis pubis; the left occupying the sacral cavity.

Examination in labour; index finger of the right hand, the os uteri just opening.

Examination in labour, with two fingers of the left hand, os uteri more dilated.

The forehead passing under the pubes ; the shoulders occupying the cavity of the sacrum ; the original presentation having been with the face to the right groin.

Brow presentation, adapted to a skeleton pelvis.

Face presentation adapted to a skeleton pelvis.

Chin appearing under the pubes ; the original presentation having been that of the face.

Ear presentation adapted to a skeleton pelvis.

An enlarged ovary, blocking up the pelvic cavity in labour.

A polypus occupying the pelvic cavity in labour.

The bladder distended and prolapsed before the head of the child.

A dropsical head.

A dropsical head adapted to a skeleton pelvis.

Short forceps, a. The instrument closed, b. Back view of a single blade.

Forceps applied to the head, the face being the hollow of the sacrum.

Forceps applied to the face towards the right sacro-iliac synchondrosis.

Forceps applied to the face towards the right groin ; the bladder slightly distended.

Lowder's Vectis.

Application of the vectis in a face presentation, the chin impinging under the symphysis pubis.

Long forceps, a. The instrument closed, b. Back view of a single blade.

Long forceps applied ; the right brow towards the right sacro-iliac symphysis.

DESCRIPTION OF THE PLATES.

XIX

Plate XXXV.

106. 107. 108.

XXXVI.

109. 110.

XXXVII.

113. 114.

XXXVIII

.115

XXXIX.

116, 117,

XL.

118. 119,

Smellie's scissors, a. Front view. b. Side view of the point.

Crotchet.

Blunt hook.

Craniotomy forceps ; a. the entire instrument ; b. the cup blade with indentations to receive the teeth of the other.

Davis's Osteotomist.

Craniotomy by means of Smellie's scissors ; the pelvis distorted.

Craniotomy ; — the use of the crotchet.

One form of Prof. Davis's guarded crotchet ; a. the instrument closed, b. the crotchet blade which is to be fixed on the outer part of the skull.

Craniotomy; — the craniotomy forceps applied.

The head of a premature foetus passing through the brim of a distorted pelvis.

Breech presentation ; the foetal face towards the mother's spine.

Breech passing through the external parts.

Feet presentation ; the back of the foetus towards the mother's spine.

Knee, foot, and funis presentation.

The breech expelled; the right hand of the attendant engaged in drawing down a loop of the umbilical cord.

The foetus had here been placed in utero with its back towards the mother's spine, as in fig. 117. Plate XXXIX.

To exemplify mala praxis, the body of the child having been extracted, the attendant is endeavouring to draw the head through the pelvic brim, with the forehead against the promontory of the sacrum, the occiput above the symphysis pubis; — the long diameter of the child's head being in the direction of the short diameter of the brim of the pelvis.

Relieving the left arm from the pelvic cavity, the right having been already extracted.

Extracting the head through the outlet of the pelvis, the point of the index finger of the left hand being inserted into the mouth, the first two fingers of the right surrounding the neck.

XX

Plate

Fig,

XLII.

XLIII.

XLIV.

126,

XLV.

XLVI.

XLVII.

XLVIII.

134,

XLIX.

135,

L.

LI.

LIL

LIII.

LIV.

LV.

Breech presentation ; the blunt hook applied.

The left shoulder presenting; the membranes unruptured.

The back presenting: the liquor amnii evacuated.

Abdominal presentation.

Hand, foot, and funis presenting.

Shoulder presentation ; to exemplify the spontaneous evolution.

Exvisceration.

Ramsbotham's decapitating hook. The smaller figure shows a section of the cutting portion of the blade.

Decapitation.

Placental presentation. - . »

Partial placental presentation, the membranes unruptured.

Partial placental presentation, the membranes broken.

Placenta retained in utero after the child's birth ; globular contraction.

Placenta retained in utero after the child's birth ; a part of the fibres of the fundus contracted round a portion of the placenta.

Placenta retained in utero after the child's birth; hour-glass contraction.

The funis prolapsed by the side of the head.

Hand prolapsed by the side of the head.

Monstrosity. Two fcetal bodies joined together, by the sternum and abdomen.

Monstrosity, with two heads, four arms, and two legs.

Twins in utero: the head of one presenting, the breech of the other.

Secondary foetus three months of age.

Retroversion of the uterus.

Ovarian extra-uterine pregnancy.

Parietal, extra-uterine pregnancy.

Diseased ovum of seven weeks age.

Healthy ovum of fourteen weeks age.

Contents

Advertisement to first Edition . v - . - - viii

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