A treatise on the science and practice of midwifery . e done with scissors or a wire ecraseur, after which the second childis expelled without difficulty, leaving the head of the first in utero tobe subsequently dealt with. Another mode of managing these cases is, to perforate the upperhead, and draw it past the lower with the cephalotribe or craniotomyforceps. This plan has the disadvantage of probably sacrificing bothchildren, since the other child can hardly survive the pressure anddelay, whereas the former plan gives the second child a fair chance ofbeing born alive. Double Monsters.—In co
A treatise on the science and practice of midwifery . e done with scissors or a wire ecraseur, after which the second childis expelled without difficulty, leaving the head of the first in utero tobe subsequently dealt with. Another mode of managing these cases is, to perforate the upperhead, and draw it past the lower with the cephalotribe or craniotomyforceps. This plan has the disadvantage of probably sacrificing bothchildren, since the other child can hardly survive the pressure anddelay, whereas the former plan gives the second child a fair chance ofbeing born alive. Double Monsters.—In connection with the subject of twin labor wemay consider those rare cases in which the bodies of the foetuses arepartially fused together. The mechanism and management of de- 1 American Journal of Obstetrics, January, 1877. DYSTOCIA FROM FCETUS 357 livery in cases of double monstrosity have attracted comparativelylittle attention, no doubt because authors have considered themmatters of curiosity merely, rather than of practical importance. Fig. Shows Head-locking, first Child coming feet first ; Impaction of Heads from Wedging in Brim. (After Barnes.) D. Apex of wedge. E, c. Base of wedge which cannot enter hrim. A, B. Line of decapi-tation to decompose wedge, and enable head of second child to pass. The frequent occurrence of such monstrosities in our museums,and the numerous cases scattered through our periodical literature,are sufficient to show that they are not so very rare as we might beinclined to imagine ; and, as they are likely to give rise to formidabledifficulties in delivery, it cannot be unimportant to have a clear ideaof the usual course taken by nature in effecting such births, witha view of enabling us to assist in the most satisfactory manner shoulda similar case come under our observation. Unfortunately the authors, who have placed on record the birth of 358 LABOR. double monsters, have generally occupied themselves more with adescription of the structu
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