. A system of midwifery, including the diseases of pregnancy and the puerperal state. of someyielding of the bones of the diseased pelvis, so as to admit of parturi-tion, or of operative assistance which would otherwise be case of this kind is given by Osiander, who, being about to performthe Caesarian section in a malacosteon pelvis, made a final attemptby the hand—an attempt which, owing to such relaxation as is heredescribed, actually succeeded. The condition and circumstances of the patient at the period of theoccurrence are such as to exercise a very important influence on t
. A system of midwifery, including the diseases of pregnancy and the puerperal state. of someyielding of the bones of the diseased pelvis, so as to admit of parturi-tion, or of operative assistance which would otherwise be case of this kind is given by Osiander, who, being about to performthe Caesarian section in a malacosteon pelvis, made a final attemptby the hand—an attempt which, owing to such relaxation as is heredescribed, actually succeeded. The condition and circumstances of the patient at the period of theoccurrence are such as to exercise a very important influence on thenature of the distortion. Rickets, in most cases, comes on before thechild has begun to walk, so that the most likely mechanism of distor-tion in these instances is a force acting through the spinal column, aswe have already observed, upon a pelvis which, in comparison withthe adult model, has a greater inclination and a conjugate diameterexceeding the transverse. In malacosteon, on the other hand, thepatient may walk or stand during the process of softening, and the Fig. Rachitic pelvis. weight of the whole trunk is thus transmitted to the heads of the thigh-bones. This difference in the nature of the forces or mechanism ofpelvic deformity is well shown in the characteristic features of rachiticand malacosteon pelves. In a typical case of the former variety thereis, as shown in Fig. 138, a marked projection forwards of the sacrumby the operation of the cause above alluded to. This is by far the mostfrequent of all the varieties of deformity which have been may (as shown in the figure) or may not be associated with flatten-ing of the anterior wall, and projection backwards of the symphysis 446 DEFORMITIES OF THE PELVIS. [chap. pubis, but the effect, in every case, is a more or less marked diminu-tion of the conjugate diameter of the brim. Different varieties of thisdistortion have been described as masculine, heart-shaped, andfigure of eight deformities o
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectobstetrics, bookyear1
