. The principles and practice of obstetricy, as at present taught, by James Blundell ... To which are added, notes and illustrations. By Thomas Castle ... se described in the last cut, if the child is small, the head willbe pushed lower with the labor pains, and gradually stretch the lower part of the vagina andthe external parts; by which means the os externum will be more and more dilated, till thevertex comes out below the pubes, and rises up on the outside; in which case the delivery isthen the same as in natural labors. But, if the head is large, it will pass along with great diffi-culty,
. The principles and practice of obstetricy, as at present taught, by James Blundell ... To which are added, notes and illustrations. By Thomas Castle ... se described in the last cut, if the child is small, the head willbe pushed lower with the labor pains, and gradually stretch the lower part of the vagina andthe external parts; by which means the os externum will be more and more dilated, till thevertex comes out below the pubes, and rises up on the outside; in which case the delivery isthen the same as in natural labors. But, if the head is large, it will pass along with great diffi-culty, whence the brain, and vessels of the neck, will be so much compressed and obstructed,as to destroy the child. To prevent which, if called in time, before the head is far advancedin the pelvis, the child ought to be turned, and brought footling. If the head, however, is lowdown, and cannot be turned, the delivery is then to be performed with the forceps.—Smellie. * The management of these cases must, in a great measure, be left to nature and time, whichwill gradually effect the delivery; but the bones of the face not being capable of compression,. 184 THE ART OF DELIVERY. Foot or Crural Presentations. By the French obstetricians, the crural or foot presentation is divided intono fewer than six varieties, in practice conveniently reduced to two kindsonly, those in which the abdomen is lying anteriorly more or less, and thosein which it is placed on the back of the mother, whether it bear a little to theright or left, or fall directly on the promontory of the sacrum. Of all the crural presentations, the easiest and most simple is, that in whichwe find the abdomen of the child lying towards the back of the , in cases of this kind, the mode in which the child passes the pelvis isthis: Under strong action of the womb, the legs are gradually pushed beyondthe outlet of the pelvis, when the thighs coming within reach, the accoucheurlays hold of them, a napkin being interpos
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