. A treatise on obstetrics for students and practitioners . the basin con-taining the solution of bichloride of mercury, 1 : 2000. When thevertex appears between the vulva the roll should be placed betweenthe patients knees, thus raising her upper, right thigh. The physicianshould then pass his left hand over the patients abdomen and betweenher thighs, so that his fingers may rest upon the vertex of the foetal NORMAL LABOR AND ITS MANAGEMENT. 195 head. With this hand he may govern the rate of expulsion of thehead, maintaining flexion at the same time. The other, his right,should be thoroughly
. A treatise on obstetrics for students and practitioners . the basin con-taining the solution of bichloride of mercury, 1 : 2000. When thevertex appears between the vulva the roll should be placed betweenthe patients knees, thus raising her upper, right thigh. The physicianshould then pass his left hand over the patients abdomen and betweenher thighs, so that his fingers may rest upon the vertex of the foetal NORMAL LABOR AND ITS MANAGEMENT. 195 head. With this hand he may govern the rate of expulsion of thehead, maintaining flexion at the same time. The other, his right,should be thoroughly wet in the 1 : 2000 bichloride solution and thenbe laid transversely across the pelvic floor, the ulnar portion of thehand covering the anus. The radial border of the hand should be ahalf-inch to three-fourths of an iuch below the posterior commissure ofthe vagina. As the head descends to the pelvic floor the right handwill support the pelvic floor, but should leave the edge of the perineumat the commissure free to dilate, or, if needed, to tear. Fig. Protection of pelvic floor and delay of fcetal head. Experience has shown that where the birth-canal is not well devel-oped, or where the head is large and a tear is inevitable, it is better tohave this lesion occur in the median line than to have the pelvic floorinjured, while the skin of the perineum may remain intact. As thehead descends and rotates upon the pelvic floor the vertex will gradu-ally emerge until it is evident that, unless opposed, the head will soonescape from the vulva. There is least danger of tear if the head beexpelled between the paios. With his left hand the physician canregulate the advance of the vertex, while with his right he protectsthe pelvic floor. Should a sudden expulsive effort be made he mayslip one hand over the other, covering the vulvar orifice with both,thus preventing expulsion at that moment. When he decides that sufficient dilatation has taken place, and thatthe head may be born in th
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
