. On the theory and practice of midwifery . The second position is the reverse of the first: the forehead is turnedtowards the right acetabulum, and the chin to the left sacro-iliac syn-chondrosis (fig. 124). The primary tumour forms on the upper part* ofthe left cheek, and the secondary (if there be two) on its lower part; theface enters the cavity obliquely, and so emerges from the outlet; but thechin makes a quarter turn from left to right anteriorly, and when expelledis under the **rch of the pubis, whilst the head sweeps over the pelvis. MAL-PRESENTATION OF THE CHILD. 379 The older writer
. On the theory and practice of midwifery . The second position is the reverse of the first: the forehead is turnedtowards the right acetabulum, and the chin to the left sacro-iliac syn-chondrosis (fig. 124). The primary tumour forms on the upper part* ofthe left cheek, and the secondary (if there be two) on its lower part; theface enters the cavity obliquely, and so emerges from the outlet; but thechin makes a quarter turn from left to right anteriorly, and when expelledis under the **rch of the pubis, whilst the head sweeps over the pelvis. MAL-PRESENTATION OF THE CHILD. 379 The older writers describe the head as emerging from the lower outletin face presentations, with the chin towards the perineum; and has given a plate in illustration of this. A moments examination Fig. will show that this is mechanically impossible, and the careful observationof Naegele and others has been unable to detect any such Statistics. 1. Frequency. a. British Practice. c. German Practice. Total Face Total Face Author. Number of presen- Author. Number of presen- Cases. tations. Cases. tations. Dr. Jos. Clarke 10,387 44 MM. Moschner and Dr. Merriman 2,947 10 Kursak 12,329 122 Dr. Granville . 640 1 Dr. Carus 2,557 24 Dr. S. Cusack 701 3 Dr. A. E. v. Siebold 1,003 10 Dr. Maunsell . 839 7 Dr. E. C. v. Siebold 494 4 Mr. Gregory . 691 2 Dr. Kilian 9,392 122 Dr. Thos. Beatty . 1,184 4 Dr. Merrem . 157 1 Dr. Collins . 16,414 33 Dr. Naegele . 115 4 Mr. Lever 4,666 24 Dr. Kluge . 799 6 Dr. Reid 3,250 15 Dr. Brunatti 100 2 Drs. MClintockand Dr. Adelmann 57 1 Hardy 6,634 14 Dr. Jansen . 13,365 15 b. French 1 Practice. Mad. Boivin . 20,517 74 Mad. Lachapelle . 15,652 65 M. Ramboux . 491 3 M. Dubois 10,742 30 : 1 ! 380 MAL-POSITION AND Thus, in British practice, out of 48,353
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