A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . patient should be thoroughly under the influ-ence of the anaesthetic and the buttocks drawn over the edgeof the table, as has been described. After thorough asepsis on the part of the operator and hisassistants and the external genitals and vagina of the patient,the entire hand, which has previously been dipped into 1 to 100creolin solution, and corresponding to the position of the occi-put, folded upon itself cone-shape, should be introduced intothe vagina. All force imparted to th
A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . patient should be thoroughly under the influ-ence of the anaesthetic and the buttocks drawn over the edgeof the table, as has been described. After thorough asepsis on the part of the operator and hisassistants and the external genitals and vagina of the patient,the entire hand, which has previously been dipped into 1 to 100creolin solution, and corresponding to the position of the occi-put, folded upon itself cone-shape, should be introduced intothe vagina. All force imparted to the hand should be gentle VERSION. 103 and at first directed downward and backward, then forwardand upward, till the cervix is felt. Counter-pressure with the unemployed hand can be madeover the fundus of the uterus by the operator better than anyskilled assistant can do for him. This counter-pressure answerstwo purposes: the vaginal attachment to the uterus is not puton an undue amount of strain and the cervix is forced nearerthe examining finger. If one finger only can be introduced, proceed to dilate with. Fig. 46.—Grasping the Knee. the index finger, if previous dilatation has not taken place (). As soon as two fingers can be introduced the head issought and pushed up toward the side to which the occiput isdirected, while with the other hand the buttocks are broughtdown in the opposite direction. If extension of the head hastaken place the chest of the child will be felt, which should bepushed upward in the same way as in case the head is felt. Assoon as the head is raised beyond the reach of the fingers theknees are sought, which should now be within reach. The 104 OBSTETRIC SURGERY. knee must be carefully distinguished from the elbow beforetraction is made upon it. There will be no difficulty in doingthis if the operator remembers that the flexed elbow pointstoward the buttocks and the flexed knee points toward thehead. It is not necessary to waste time looking for
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Keywords: ., bookcentury1800, bookdecade1890, bookpubli, booksubjectobstetrics
