An essay, historical and critical, on the mechanism of parturition.

  • Leishman, William, 1834-1894.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: An essay, historical and critical, on the mechanism of parturition. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    FOUETH SPECIES. (^Head in right oblique diameter—-face forwards.) In this species the sagittal suture lies in the oblique diameter; the posterior and superior fontanelle answers to the connection of the right ilium with the sacrum, the anterior being directed to the cotyloid cavity of the left ilium. The left ear is to the right and forwards. The progress of the head in this species is the same as in the second. In this alone it differs, that the posterior fontanelle, which in the second species descends looking to the sacrum, in moving towards the centre of the pelvis, is turned in the direction of its connection with the right ilium. Scarcely has the head reached the apex of the sacrum, the coccyx, and the perineum, than the centre, or almost the centre, of the left parietal bone answers to the superior part of the sub-pubic angle. It not unfrequently happens that the head, being forced to this depth into the cavity of the pelvis, describes, in consequence of the activity of the uterine contractions, the eighth part of a circle (semiquad- rantem circuli) from left to right, by which rotation this species is converted into the second, and sometimes into the third. But in the latter case the head describes a quarter of a circle and a half (quadrantem circuli cum semisse) from right to left. A happy issue of the labour requires a wide pelvis and powerful uterine contraction; if either of which should be absent, one is compelled by absolute necessity to call in the aid of art. In tlie above description it is quite clear how he assumes the change into the second position to take place. It is by no means so easy, however, to follow his meaning with reference to the change into the third. If he means that, to attain the third posi- tion, the head must describe a quarter of a circle and a half more after having reached the second, the thing would be obvious enough; but then the change would be a continuation of the movement from left to right, and not from right to left as described. There can be little doubt, however, that this was his meaning, but it is to be regretted that there is so much confusion in the expressions used. FIFTH SPECIES. {Head in left oblique diameter—face bachoards.) The sagittal suture follows the direction of the oblique diameter, the posterior fontanelle being placed towards the right cotyloid cavity, the anterior to the left sacro-iliac synchondrosis, &c.