Operative midwifery : a guide to the difficulties and complications of midwifery practice . aching this subject of the forces as a factor of dystocia,one is arrested at the very outset, by the fact that there is no standardfor, or means of, estimating the forces. With dystocia associated withthe passage and passenger, we shall see that it is quite otherwise, forby investigation and careful consideration the degree of difficulty maybe fairly correctly surmised. I have said that there is no means of estimating the forces. Bythat, I mean, there is no practical method of doing so beyond thesimple
Operative midwifery : a guide to the difficulties and complications of midwifery practice . aching this subject of the forces as a factor of dystocia,one is arrested at the very outset, by the fact that there is no standardfor, or means of, estimating the forces. With dystocia associated withthe passage and passenger, we shall see that it is quite otherwise, forby investigation and careful consideration the degree of difficulty maybe fairly correctly surmised. I have said that there is no means of estimating the forces. Bythat, I mean, there is no practical method of doing so beyond thesimple expedient of applying a hand over the abdomen and estimatingthe frequency, duration, and effect of the uterine contractions. Onecannot measure the forces, and say that one has a force of so manymillimetres of mercury too little or too much. There have been many attempts to measure the forces of and Poppel, for example, estimated the resistance of themembranes to a bursting force. Others attempted to measure themby attaching a dynamometer to the forceps, and so estimating 5. Fig. L—Schatzs Tokodynamomete PRECIPITATE LABOUR 7 the amount of force required to extract the child. It is, however,unnecessary to discuss results obtained by such methods, for it is atonce apparent that no exactness could possibly be obtained by suchdevices. The earliest and most scientifically constructed instrument forcalculating the uterine force is the tokodynamometer of Schatz(Fig. 1), described some forty years By means of it, and itsmodifications, many interesting observations and tracings have beenmade by different observers, showing the features of normal andabnormal uterine contractions. In recent years Schaffer2 has giventhis subject special consideration, and by means of his instrument hasalso made many tracings. Schaffers instrument (Fig. 2) has theadvantage of being more easily applied, although, of course, oneoperativemidwife00munr
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Keywords: ., bookcentury1900, bookdecade1910, bookpubli, booksubjectobstetrics
