Thomsonian practice of midwifery : and treatment of complaints peculiar to women and children / By J.W. Comfort, M.D.

  • Comfort, J. W. (John W.)
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Thomsonian practice of midwifery : and treatment of complaints peculiar to women and children / By J.W. Comfort, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    55/234 (page 41)
    castile soap or lard, is to be introduced into the vagina during a pain. You cannot fail to reach the os uteri, (mouth of the womb) if the finger be passed up along the posterior wall of the vagina, and the point of it brought forward towards the symphysis pubes. If the waters have not broken, the finger should not be pressed hard upon the membranes if it be in the early stage of labour and before the mouth of the womb has be- come well dilated, for by rupturing the membranes too soon we retard the labour. Often the pressure of the child's head upon the neck of the bladder occasions frequent and involuntary dis- charges of urine which leads the patient to believe that the wa- ters are broken. £i The head is usually recognised without difficulty by its globular shape, the peculiar hardness of the parietal bones, and by the sutures. If the finger touches the sagittal suture, midway between the fontanelles, (see ex- planation of technical terms at the end of the work) u the edges of the parietal bones will be distinctly felt through the mem- branes. If you feel the hard edges of the parietal bones, you can have no doubt about the presentation, although neither fon- tanels be touched. In no case is it necessary or proper at the commencement of labour, before the membranes are ruptured, and the first stage completed, to endeavour to discover in what position the head of the child is placed relatively to the pelvis of the mother; it is enough to know with absolute certainty that the head presents; and this information should be possessed in every case; no doubt should be felt on the subject, before the finger is withdrawn. Having ascertained that the head pre- sents, we have obtained all the know ledge that can ever be of any use in practice. Any attempt to determine in w Inch of the numerous positions described by some others, the head is placed at the brim of the pelvis, would only endanger the rupture of the membranes, and disturb the regular order observed by na- ture in the process. I am greatly at a loss to discover what benefit could result from knowing during the first stage of la- bour, provided you can touch the vertex (crown) with the point of the fingers, in which of the six or eight positions of Boude- locque, and other foreign authors, the head is placed. The im- portance attached by some writers to a knowledge of these po- G