A system of obstetrics . th the combined thickness of the pelvicwalls anteriorly and posteriorly. But the only absolutely certain factwhich we reach by measuring this diameter is, that if the distance benotably diminished the true conjugate is less than normal. The circumference of the upper or false pelvis is learned by apply-ing the end of an ordinary tape-measure to the spinous process of the last lumbar vertebra, and car-rying the tape along the iliaccrest of one side, and thence tothe median line at the pubicjoint; similarly, the other halfis measured, the results added,and thus the entir
A system of obstetrics . th the combined thickness of the pelvicwalls anteriorly and posteriorly. But the only absolutely certain factwhich we reach by measuring this diameter is, that if the distance benotably diminished the true conjugate is less than normal. The circumference of the upper or false pelvis is learned by apply-ing the end of an ordinary tape-measure to the spinous process of the last lumbar vertebra, and car-rying the tape along the iliaccrest of one side, and thence tothe median line at the pubicjoint; similarly, the other halfis measured, the results added,and thus the entire circumfer-ence is ascertained. Evidently,if the one measurement isgreater than the other, the pel-vis is asymmetrical. So toosuch asymmetry may be deter-mined by comparing the twoexternal conjugates, or, stillbetter than the latter, measur-ing the distance of the tro-chanter of one side to themiddle of the iliac crest ofthe other, and vice verm. Thenormal circumference of thefalse pelvis is 90 centimeters = Measuring the External Conjugate with MartinsPelvimeter. Next, the diagonal conjugate—that is, the distance from the1wer margin of the pubic joint to the promontory of the sacrum—is foundusually by means of one or two fingers. In the following illustrationthe index and medius of the left hand are extended, the thumb ab-ducted, and the third and fourth fingers folded upon the palm ; the ANOMALIES OF THE PELVIS. 727 extended fingers are carried up and backward in the pelvic cavity untilthe promontory is touched; then, still keeping up this contact, thehand is brought upward until its lateral margin, just below the indexfinger, comes in contact with the subpubic ligament. Next, this lastpoint is marked by the nail of the index finger of the right hand;then the left hand is withdrawn, and the measurement made from thismark to the tip of the finger. Kleinwachter holds that the introductionof the index and medius at the same time ought not to be permitted,except
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
