. The science and art of midwifery. Fig. 224—Base ot skull: M M,bimastoid diameter. TREATMENT OF CONTRACTED PELVES. 501 place, the amount of force that can be employed without producingfatal lesions is often something astounding. Thus, Rokitansky,* ex-perimenting with the bodies of still-born infants, found the utmoststrength put forth by two men upon the trunk was insufficient tocause rupture of the vertebral ligaments and separation of the artic-ulations. It is usual, however, to combine pressure from above,exercised by a skilled assistant upon the head through the abdomi-nal walls, with tra
. The science and art of midwifery. Fig. 224—Base ot skull: M M,bimastoid diameter. TREATMENT OF CONTRACTED PELVES. 501 place, the amount of force that can be employed without producingfatal lesions is often something astounding. Thus, Rokitansky,* ex-perimenting with the bodies of still-born infants, found the utmoststrength put forth by two men upon the trunk was insufficient tocause rupture of the vertebral ligaments and separation of the artic-ulations. It is usual, however, to combine pressure from above,exercised by a skilled assistant upon the head through the abdomi-nal walls, with tractions from below. Schroeder states f that thispractice is coeval with podalic versiou. It was known to Celsus and. Fig. 225.—Method of employing supra-pubic pressure. (Munde.) Head in the pelvic cavity. recommended by Ambroise Pare. It has found warm advocates inPugh, Wigand, Martin, Kristeller, and in this country in Taylor andGoodell. Both the latter gentlemen have made valuable suggestionsregarding the technical management of difficult cases, which are wellworthy of special mention. Dr. Taylor J at first draws the body di-rectly backward, while the head is forced by supra-pubic pressuredownward and backward into the pelvis. So soon, however, as thehead begins to advance, he raises the body of the child and directspressure upon the head to be made downward and forward in the axisof the outlet. In case of failure or delay, he has sometimes succeededby intentionally directing the back of the child to the sacrum, andthen causing the occiput to be pressed downward and backward into * Rokitansky, Wien. mcd. Presse, 1874, No. 45. f Schroeder, Ilandbuch, 6te Aufl., p. 301. % Taylor, What is the Best
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