A treatise on the science and practice of midwifery . lly to the difficulties of the case, sincethe blades have a tendency to fall into thedeep channel already made in the cranium,and so it is by no meansalways easy to seizethe skull in a new direction. Before reapply-ing them, if the condition of the patient begood and pains be present, it may be well towail an hour or more, in the hope of the headbeing moulded and pushed down into thepelvic cavity. This Mas the plan adopted byDubois, and, according to Tarnier, was the secret of his great success inthe operation. Pajots method of repeated cru
A treatise on the science and practice of midwifery . lly to the difficulties of the case, sincethe blades have a tendency to fall into thedeep channel already made in the cranium,and so it is by no meansalways easy to seizethe skull in a new direction. Before reapply-ing them, if the condition of the patient begood and pains be present, it may be well towail an hour or more, in the hope of the headbeing moulded and pushed down into thepelvic cavity. This Mas the plan adopted byDubois, and, according to Tarnier, was the secret of his great success inthe operation. Pajots method of repeated crushings in the greaterdegrees of contraction is based on the same idea, and he recommendsthat the instrument should be introduced at intervals of t\\. three,or four hours, according to the state of the patient, until the head isthoroughly crushed, no attempts at traction being used, and expulsionbeing left to the natural powers. This, he says, should always !>«• donewhen the contraction i> below 1\ inches, and he maintains that it is. Foetal Head crushed by the< lephalotribe. 508 OBSTETRIC OPERATIONS. Fig. 187. quite possible to effect delivery by this means when there is only 1|-inches in the antero-posterior diameter. The repeated introduction ofthe blades in this fashion must necessarily be hazardous, except in thehands of a very skilful operator; and I believe that if a second applica-tion fail to overcome the difficulty, which will only be very exception-ally the case, it would be better to resort to the measures presently to bedescribed. Destruction of the Base of the Skull from Within by the Basilyst.—professor Simpson of Edinburgh1 has recently suggested the use of aninstrument which he calls a basilyst. Its object is tobreak up the base of the foetal skull from within, afterthe method originally proposed by Guy on. The screw-like portion of the instrument (Fig. 187), which is in-serted through the perforation made in the cranial vault,is driven through the
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
