File:The science and art of midwifery (1897) (14740590016).jpg

Identifier: scienidw00lusk (find matches)
Title: The science and art of midwifery
Year: 1897 (1890s)
Authors: Lusk, William Thompson, 1838-1897
Subjects: Obstetrics Women Pathology
Publisher: New York, D. Appleton
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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sterilized cotton. Recently, Dr. Edward A.Avers has reported four casesof symphysiotomy in whichthe subcutaneous method wasemployed. The mothers all recovered. In one instance twins were delivered; both survive*). Inanother instance a child weighing seven pounds was born, and is stillliving. Two of the children were born dead. Dr. Ayerss operation consists in raising the clitoris and passing be-neath a narrow sharp-pointed scalpel through the mucous membranefrom below upward in the line of the symphysis, to within a half inchof the upper pubic border. A straight blunt-pointed bistoury is thensubstituted, and is employed to cut through the tissues of thejoint. Meantime the bladder and urethra should he held to one sidewith a sound, and a finger in the vagina Bhould follow the bluntpoint of the bistoury during its descent through the tissues of thejoint. Theoretically, the advantage of preserving the integument intactdoes not seem to justify the sacrifice of the steps by means of which
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Fig. 258.— Tying the sutures, while the bones areheld in place by Faraboeufs foroepa 746 APPENDIX haemorrhage is surely guarded against, and the hladder and retrosym-physeal space are protected. Doubtless the weak side of symphysiotomy is the imperfection of allthe methods thus far devised to secure coaptation of the parted sur-faces after the operation. Ordinary bandages and binders becomequickly soiled and require frequent changes. Metallic contrivances toexercise pressure on the hips and plaster-of-Paris bandages chafe theskin and lead to the formation of bed-sores. To a less extent the sameis true of rubber-plaster strips which encircle the pelvis. For this rea-son Dr. Dawbarn recommends not to surround the pelvis entirely, butto use strong adhesive-plaster strapping four inches wide, starting justbehind each trochanter and crossing over the pubis. If, then, the firststrap is re-enforced by two further thicknesses of plaster, he states thata very reliable splint is produced.* Th

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