. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. at the vulva, a fingershould be passed into the vagina and the cord drawngently downward until enough has been gained to pre-vent any further dragging upon the navel. If the arms remain folded upon the chest it is an easymatter to hook a finger successively into each elbow andextract them ; but if, as is usual, they become extendedabove the head by friction against the walls of the canal,their release becomes a more difficult matter. In easyversions it is general
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. at the vulva, a fingershould be passed into the vagina and the cord drawngently downward until enough has been gained to pre-vent any further dragging upon the navel. If the arms remain folded upon the chest it is an easymatter to hook a finger successively into each elbow andextract them ; but if, as is usual, they become extendedabove the head by friction against the walls of the canal,their release becomes a more difficult matter. In easyversions it is generally possible to bring the shoulders 635 REFERENCE HANDBOOK OF THE MEDICAL SCIENCES. outside the vulva by simple traction upon the thighs ; thebody of the child is then dropped toward the floor anddrawn as far backward as the perineum allows, andtwo fingers are then passed over one shoulder and alongthe upper surface of the arm to the bend of the arm is then pushed downward and backward acrossthe face of the child by pressure in the bend of the el-bow, and as the elbow appears at the vulva the fingers. Fig. J5T4.—Combined Traction on the Face and Shoulders. slide along the forearm to the hand and easily sweep itoutside the vulva. The other hand of the operator then repeats the sameprocedure with the other arm. The child is then laid astride of one forearm, and thehand which belongs to it is passed into the vagina untilits first and second fingers lie upon the canine fossae ofthe child, while the other hand is hooked over the shoul-ders with the neck between its first and second fingersand their tips upon the supraclavicular region. The as-sistant, then presses the head downward by suprapubicpressure in the axis of the superior strait, and both handsof the operator make simultaneous traction as nearlyas possible in the same direction, the internal hand atthe same time exerting itself to preserve the necessaryflexion of the head (Fig. 4574). As the head
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
