Obstetrics : the science and the art . one can roll it upon its axis and turn the face backwards. In the second position of the left shoulder presentation, the head ison the right side of the pelvis, looking backwards, the left shoulderis down, and the hand or elbow prolapsed or not; it is indifferentwhether they be or be not prolapsed. Figure 108 explains the operation; the left hand is employed, forits fingers go out towards the pelvicextremity of the child, and its palm,in easy pronation, adapts itself to itsanterior aspect. If the Student shoulddraw the child down by the right infe-rior ex
Obstetrics : the science and the art . one can roll it upon its axis and turn the face backwards. In the second position of the left shoulder presentation, the head ison the right side of the pelvis, looking backwards, the left shoulderis down, and the hand or elbow prolapsed or not; it is indifferentwhether they be or be not prolapsed. Figure 108 explains the operation; the left hand is employed, forits fingers go out towards the pelvicextremity of the child, and its palm,in easy pronation, adapts itself to itsanterior aspect. If the Student shoulddraw the child down by the right infe-rior extremity, he would roll it on itsaxis. This would be wrong, since thechilds face is already backwards; lethim, therefore, make his chief tractionsby the left limb, in order to bring theleft hip to the symphysis, which, afterit is born, should be rotated towardsthe right ischium, to bring the faceinto the hollow of the sacrum at last. I ought not to omit some advertenceto an accident that occasionally happens, whether in version or in33. 514 PRETERNATURAL LABOR. original pelvic presentations. I allude to the locking of the headabove the brim of the pelvis, which becomes keyed there by the fore-arm ; the elbow being elevated, and the hand projecting backwardsbehind the nucha, it serves as a key to prevent the head from sinkinginto the excavation. When the pressure, in consequence of aggravatedcontractions of the womb, becomes very great, it is nearly impossibleto disengage the hand from behind the neck, by depressing the elbowby means of the ringers in the way formerly pointed out;—it is easierto break the delicate bone of the humerus than to bring the elbowdown. Dr. Deweess method, one upon which he strongly insisted inhis lectures, was to pass two ringers upwards in front of the shoulder-joint, and two fingers up against the opposite scapula. By means ofthe pressure in contrary directions of these two opposite hands, thethorax of the child is made to revolve upon its axis one
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