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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    well dilated or easily dilatable, the hand should be passed into the cavity of the uterus, so that the extent of injury be well un- derstood. But should the os uteri be firmly contracted, so as to refuse the hand to be admitted without the application of much force, the point should be given up, as nothing can justify a vio- lent entry into the cavity of the uterus. 1390. When the laceration takes place at the neck of the ute- rus, or at its union with the vagina, the child, with its appurte- nances, almost always passes into the cavity of the abdomen ; in either of these cases, the presenting part will immediately remove itself from the superior strait; when this happens, we should, as quickly as possible, ascertain whether the accident has taken place, to which this circumstance would instantly give the sus- picion of. In cases like these the examinations to this effect are more easily conducted, than where the body or fundus is the sub- ject of the laceration ; as the parts involved in the mischief can- not contract like the uterus itself—the uterus, under such circum- stances, will be found, for the most part, firmly contracted either on the posterior or anterior portion of the pelvis, as it may hap- pen to be either the posterior or anterior portion of the vaginal circle that may have sustained the injury—the intestines will fre- quently prolapse through the wound, which removes at once all doubt as to the nature of the accident—it is almost needless to suggest the propriety of a cautious and gentle examination, after ihe hand has entered the abdomen. 1391. When the nature of the accident is ascertained, it behoves us immediately to attempt the relief of the unfortunate woman, and the means for this purpose are, first, to attempt delivery per vias naturales ; and second, to perform the operation of gastro- tomy. 1392. We may perform the first whenever the neck, or its union with the vagina, is the seat of laceration, provided the pelvis is of a good conformation, and the child has escaped in the cavity of the abdomen—the feet of the child should be sought for in the abdomen, and the delivery accomplished as in a case of turning— but should the pelvis be so contracted as not to suffer the child's head to pass, this mode of delivery must be changed for the se- cond. But should the child not have escaped through the rent,