The American practitioner : a monthly journal of medicine and surgery . nt at which we first listen for the fetal heart isabout the middle of a line drawnfrom the iliac anterior superiorspinous process to the the sound at this pointmost distinctly, we recognize thefirst position, and vertex presen-tation in all probability; in allprobability, because, although inface-presentation the heart-soundsare heard at about the same point,yet, such presentation being rare,we arrive at the conclusion men-tioned. In order to facilitate the ex-amination, and to understand thesignificance
The American practitioner : a monthly journal of medicine and surgery . nt at which we first listen for the fetal heart isabout the middle of a line drawnfrom the iliac anterior superiorspinous process to the the sound at this pointmost distinctly, we recognize thefirst position, and vertex presen-tation in all probability; in allprobability, because, although inface-presentation the heart-soundsare heard at about the same point,yet, such presentation being rare,we arrive at the conclusion men-tioned. In order to facilitate the ex-amination, and to understand thesignificance of the maximum in-tensity of the sounds at differentpoints, we have had copied, withsome trifling alterations, the ac-companying cut from Depaul. It will be observed that in thefigure a vertical line passes from the symphysis pubis abovethe umbilicus, and another line crosses this at right anglesjust below the umbilicus. Thus the superficies of the abdo-men corresponding with the enlarged uterus is divided intofour parts, marked respectively A, B, C, D. As previously. Obstetric Auscultation. 25 indicated, the sounds of the fetal heart are oftenest heard inthe space marked D, and they are transmitted in the directionof the oblique line—these lines should have no arrow-heads(the mistake was the engravers)—that is, upward and some-what to the subjects right. But failing in hearing the sounds in D, or not hearingthem most clearly there, we next seek them in C. Heardthere best, the occiput is in the right side of the pelvis, andwe still have in all probability a vertex presentation. Again,heard best in B, we have a pelvic presentation, the childssacrum being probably toward the left ileo-pectineal eminence;but if the sounds are most distinctly in A, still a pelvic pre-sentation, and the sacrum probably toward the right sacro-iliacsymphysis. Finally, if the sounds are heard best low downnear the median line, and are transmitted transversely, theprobability is very decided in favo
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Keywords: ., bookcentury180, bookdecade1870, booksubjectmedicine, bookyear1876
