File:The principles and practice of obstetrics (1864) (14760179416).jpg

Identifier: 67240830R.nlm.nih.gov
Title: The principles and practice of obstetrics
Year: 1864 (1860s)
Authors: Hodge, Hugh L. (Hugh Lenox), 1796-1873
Subjects: Obstetrics Obstetric Surgical Procedures Pregnancy
Publisher: Philadelphia : Blanchard and Lea
Contributing Library: U.S. National Library of Medicine
Digitizing Sponsor: Open Knowledge Commons, U.S. National Library of Medicine

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we have enunciated,that version by the breech should be undertaken, in alarge number of cases, by the crotchet, when the childis dead in utero, has never been distinctly inculcated byauthors. Most writers content themselves with sayingthat, if manual assistance be impracticable, embryotomymust be resorted to; others, that the crotchet may heemployed, but give no specific direction ; others, again,as Dr. Robert Lee, that the shoulder should be removed,the thorax opened, the viscera extracted, the hookapplied, and the child be delivered double, as inof evolution. Others, that traction effort should be madeupon the arm, using it as a lever. M. Parmat, asreported by Cazeaux, advises to perforate the chest,fixing the crotchet on the ribs, and then, by traction,cause the body to revolve, and thus to be delivered, Uin cases of evolution. Dr. Leed, of London, reports thatin 1814, and subsequently, he delivered patients, by re-moving the arm, and perforating the thorax, into which Plate XXXII
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Presentation of ShoulderYer sion by the Br e e ch, Bicephalic Foetus. ARTIFICIAL VERSION AND EVOLUTION. 3G9 he directed a blunt hook, which he fixed on the lowerpart of the spine, and by steady traction effort deliv-ered the children double. Drs. Churchill and Col-lins say we should never wait for spontaneous change,but should eviscerate the chest and deliver by thecrotchet. These are the indefinite directions given by the bestauthorities in obstetrics as regards instrumental de-livery, in cases of shoulder presentations. One im-portant exception to this remark will be presentlynoticed. That the child, owing to its great flexibility, may bedelivered double by the sharp or blunt hook, fixedupon the spine, especially after the viscera have beenremoved, there can be no doubt. It is manifest, how-ever, that all attempts to finish labor, in these unfor-tunate cases, by fixing the hook upon the spine of thechild, are unscientific—they are not founded uponnatures fundamental law, that one

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