Compendious system of midwifery : chiefly designed to facilitate the inquiries.

  • Dewees, William P. (William Potts), 1768-1841.
Date:
1824
Catalogue details

Licence: Public Domain Mark

Credit: Compendious system of midwifery : chiefly designed to facilitate the inquiries. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    does not follow, however long we may have waited ; for, at the cpd of four hours, (Dr. Denman's* rule,) it may be just as im- proper to deliver as it was fifteen minutes after the birth of the other child; and if contraction will justify us to deliver at the end of four hours, it ought to justify us at any intermediate peri- od it may take place. And if we are to act at the end of four hours, be the condition of the uterus what it may, (for nothing is said of the state of this organ,) we shall as certainly do mischief by our interference, if the uterus be not contracted, as if we had acted at any other antecedent period. If then we do not insure the contraction of the uterus by waiting, we gain nothing by wait- ing ; and it will, therefore, be proper to act whenever we are as- sured that the powers of the uterus are in full and healthy play. 1342. Should any of the enumerated accidents (605) complicate a labour of twins, we must act as in any other case ; taking care, at the same time, to distinguish the proper feet, if we turn and the membranes are ruptured ; and if they are not ruptured, and we discover it to be a twin case in proper time after we have com- menced our operation, not to rupture the membranes of the re- maining child. If the breech, feet, or knees offer, we must bring down the feet, or act upon them as has been directed—or if the head present, and the labour be far advanced, we must use the forceps, though we are certain it be a twin case. Or should any thing untoward take place during the transit of the second child, we must act as the nature of the case requires, without reference to its being a twin. 1343. Mr. Burns,! we think, lays down two very dangerous rules for the management of twin cases—the first is, that if ef- fective pains do not come on in a quarter of an hour, the child ought to be delivered by turning. The second is, if the posi- tion of the second child be such as to require turning, zve are to lose no time^ but introduce the hand for that purpose before the liquor amnii be evacuated, or the uterus begin to act strongly on the childP 1344. If we were to act agreeably to these directions, we should constantly almost have cause to repent the enterprise; for we certainly would do mischief, by plunging the uterus into a state * Introduction, Francis' ed. p. 540. f Principlesj James' ed, p. 40&.