A treatise on the science and practice of midwifery . by Dubois, and, according toTarnier, was the secret of his great success in the operation. Pajotsmethod of repeated crushings, in the greater degrees of contraction,is based on the same idea, and he recommends that the instrumentshould be reintroduced at intervals of two, three, or four hours,according to the state of the patient, until the head is thoroughlycrushed; no attempts at traction being used, and expulsion beingleft to the natural powers. This, he says, should always be donewhen the contraction is below 2J inches, and he maintains
A treatise on the science and practice of midwifery . by Dubois, and, according toTarnier, was the secret of his great success in the operation. Pajotsmethod of repeated crushings, in the greater degrees of contraction,is based on the same idea, and he recommends that the instrumentshould be reintroduced at intervals of two, three, or four hours,according to the state of the patient, until the head is thoroughlycrushed; no attempts at traction being used, and expulsion beingleft to the natural powers. This, he says, should always be donewhen the contraction is below 2J inches, and he maintains that it isquite possible to effect delivery by this means when there is only 1Jinches in the antero-posterior diameter. The repeated introductionof the blades in this fashion must necessarily be hazardous, exceptin the hands of a very skilful operator ; and I believe that if asecond application fail to overcome the difficulty, which will only bevery exceptionally the case, that it would be better to resort to themeasures presently to be Foetal Head crushed by theCephalotribe. 496 OBSTETRIC OPERATIONS. Fig Fig. 179. Should we elect to trust to the craniotomy forceps for extraction,one blade is to be introduced through the perforation, and the other,in apposition to it, on the outside of the scalp. In moderate deformi-ties, traction applied during the pains may of itself suffice to bringdown the head. Should the obstruction be too great to admit ofthis, it is necessary to break clown and remove the vault of thecranium. For this purpose Simpsons cranioclast answers betterthan any other instrument. One of the blades is passed within thecranium, the other, if possible, between the scalp and the skull, andthe portion of bone grasped between them is then broken off; thiscan generally be accomplished by a twisting motion of the wrist,without using much force. The separated portion of bone is thenextracted, the greatest care being taken to guard the maternal struc-tures, du
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Keywords: ., bookcentury1800, bookdecade1870, bookidtre, booksubjectobstetrics
