Some problems in obstetrics
Sandstein, Alfred Charles
Volume 1: the estimation of the length of the transverse, and true conjugate diameter of their pelvic brimIn every obstetric case to which the physician is of the problem. called the examination of the patient, no matter what it is, no matter Whether it is by sight or touch, by abdominal or by vaginal examination, has for its ultimate object, the solution of the problem - "HOW SOON WILL THIS LABOUR END IF LEFT TO NATURE." In every Case, as her mental state has such a powerful influence over the muscular efforts made, and as the estimation of the probable duration is so difficult to make accu -, rately, his politic answer to the patient's anxious inquiry, will be that "that depends upon yourself" while at the same time assuring her that "all is well."But during the examination,his active mind, and deft fingers have been busy in the pursuit of details that will answer this question. For, be it the condition of the Powers of Labour, be it the condition of the Passages concerned in Parturition, or be it the condition of the Passenger, its only import can be that it will or will not affect the duration (and successful termination) of the labour. Even if the labour be complicated by Haemorrhage, by Eclampsia or Prolapsus Funis, still the problem remains the same, by whatever devious way or by -path it is arrived at.It is very evident that all future conduct of the case in question, depends on the answer to this question, which includes in itself the placing of the labour under one of the various categories, Natural, Laborious, Preternatural or Complex. And according as it is mentally placed in one class or another, so is the treatment applied.Volume 2. a study of the operation of symphysiotomy and the true significance of section of the pubic symphysis and the subsequent movements of the innominate bones.