. The science and art of midwifery . s of the pelvic bones may be the source of pelvic deform-ity, either by producing permanent displacement of the bones, or byleading to such extensive deposits ofcallus as to obstruct the parturientcanal. Multiple exostoses of the pelvicbones are of comparatively frequent oc-currence, and are usually attended bymultiple exostoses of the entire osseousframework.* The pelves in which theyare found are, as a rule, either of theoblique-ovate or of the rachitic variety,and the combination of these deform-ities La naturally a serious one, sincetin- maternal soft p
. The science and art of midwifery . s of the pelvic bones may be the source of pelvic deform-ity, either by producing permanent displacement of the bones, or byleading to such extensive deposits ofcallus as to obstruct the parturientcanal. Multiple exostoses of the pelvicbones are of comparatively frequent oc-currence, and are usually attended bymultiple exostoses of the entire osseousframework.* The pelves in which theyare found are, as a rule, either of theoblique-ovate or of the rachitic variety,and the combination of these deform-ities La naturally a serious one, sincetin- maternal soft parts are liable to con-tusion and perforation at many pointsduring parturition. The ilio-pectinealeminence is sometimes so unusuallyprominent and sharp as to offer anobstacle to parturition. The <;ime is true of the pubic crest and spine. Osteo-lihromata, sarcomata, en-chondromata, and carcinomata connected with the pelvic hours con- * Leopold, Arch. f. Gynaek., Bd. i\. 1872, p. •:::<•; Kormann, Ibid., Bd. \i. 1874,p. Fig. 21(1. Osseous tumors filliiiL: pelviccavity. (Naegele.) ;,;;} THE PATHOLOGY OF LABOR stitute tumors of rare occurrence. They usually spring from thesacrum or from the symphysis,* and arc of various of them almost completely conclude the parturient canal, andmay constitute formidable obstructions to delivery. In this connection may be mentioned as of rare occurrence anchy-of the coccyx, a condition which materially shortens the antero-posterior diameter of the outlet. IX. Absence of tin: Symphysis. In this variety of deformed pelvis the symphysis is congenitallyabsent, and is replaced either by Strong fibrous hands extending be-tween the opposing surfaces of the pubic bones, or by the muscles andconnective tissue of the perinaeum. It is accordingly designated byLitzmann the split Morbid Anatomy.—It is usually attended by ectopia vesicas and byhiatus of the abdominal wall in the linea alba. In rare cases an ab-dominal
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