. On the theory and practice of midwifery . xes upon 2| inches as the diam-eter rendering craniotomy necessary. M. Alphonse Le Roi says that 3£,Dr. Atkin 3, Dr. Jos. Clarke 3£, Dr. Burns 3\, Dr. Ritgen 2, and 2\ to 3 inches, is the smallest antero-posterior diameter throughwhich a living child can pass. As to the other limit of the operation, that is, the smallest diameterthrough which a child can be extracted after craniotomy, Dr. Osbornfremarks: Whenever there is a space from pubis to sacrum, or from the fore tothe hind part of the upper aperture of the pelvis, equal to an inch and
. On the theory and practice of midwifery . xes upon 2| inches as the diam-eter rendering craniotomy necessary. M. Alphonse Le Roi says that 3£,Dr. Atkin 3, Dr. Jos. Clarke 3£, Dr. Burns 3\, Dr. Ritgen 2, and 2\ to 3 inches, is the smallest antero-posterior diameter throughwhich a living child can pass. As to the other limit of the operation, that is, the smallest diameterthrough which a child can be extracted after craniotomy, Dr. Osbornfremarks: Whenever there is a space from pubis to sacrum, or from the fore tothe hind part of the upper aperture of the pelvis, equal to an inch and ahalf, I am convinced it will be always practicable to extract a child bydie crotchet, after the head has been some time opened, and the texture dibles are rounded, in order that they may not pinch any tissues except those intendedto be included in the bite, which, on account of the serrae, is very sure and strong.—(See Obstetrics — The Science and the Art, 2d edition.) DR. MEIGSS EMBRYULOIA INSTRUMENTS OR PLIERS. Fig. 116. Fig. * Essays on Midwifery, p. 194. | Ibid, p. 200. 348 CRANIOTOMY. of the childs body is softened by putrefaction (as recommended above)and the whole of the parietal and frontal bones are picked away. Baudelocque says that the crotchet is inadmissible when the diameteris only 1§ of an inch; Dr. Dewees, when it is less than 2 ; Dr. Hull andDr. Burns believe that it may succeed when the diameter is If; and Hamilton when it is l£; and Dr. Davis when it is 1 inch. 549. The nature of the operation is simple, but the aid afforded mayvary in degree. 1. In the case of dead children, the older practitioners used the crotchetalone as an extracting force, without opening the head. 2. In some cases where the sutures are very loose, the evacuation ofthe brain will be sufficient, as the bones of the cranium collapse so muchunder the influence of the pressure downwards, that the child may beexpelled by the natural powers. But in this case, it is a
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