American gynaecological and obstetrical journal. . ange place in the sacrum. The transverse axe for the movement ofthe iliac bones lies behind the second sacral vertebra. This axe beingsituated under the promontory, the symphysis must be removed fromthe promontory by the rotation, whilst it approaches the point of thesacrum ; the saggital diameter of the brim being consequently increasedand that of the outlet diminished. The action of the iliac bones islimited partially by the sacro-iliac articulations, partly by the posterior 446 Transactions of Societies. ligament, and somewhat by the muscle
American gynaecological and obstetrical journal. . ange place in the sacrum. The transverse axe for the movement ofthe iliac bones lies behind the second sacral vertebra. This axe beingsituated under the promontory, the symphysis must be removed fromthe promontory by the rotation, whilst it approaches the point of thesacrum ; the saggital diameter of the brim being consequently increasedand that of the outlet diminished. The action of the iliac bones islimited partially by the sacro-iliac articulations, partly by the posterior 446 Transactions of Societies. ligament, and somewhat by the muscles of the abdominal wall and bythe psoas. I need not say that pregnancy will be, generally, favorable to thisdislocation of the iliac bones, but I ought to add that individual condi-tions may diminish, even in pregnant women, this mobility. At the present moment there is no doubt that the conjugata vera in-creases progressively, when the woman is brought successively in thelithotomy position, the obstetrical position and Walchers position. Fig. Difference of opinion exists only as to the degree of the to the researches of Walcher, Diihrssen, Fothergill, andKiister the increase of the conjugata varies from 8 to 15 those who object to those elevated ciphers I quote Varnier, who saysthat there ought not to be made a comparison between the dimensionfound in the lithotomy position, never used in obstetrics, and that ofWalcher, but between the measures found in the latter and in the ob-stetrical position. In this way an increase of 2 or 3 millimeters ad International Congress of Gynecology and Obstetrics. 447 maximum can be obtained, according to his researches. Later experi-ments of Fehling contradict partially Varniers pessimism. The resultsof cadaver experiments by Walcher, Klein, Varnier, Pinard, andKiittner being incongruent, and on the other hand the clinical observa-tions of Kalt, Wehle, and others showing a considerable increase, Ireso
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