File:A system of midwifery, including the diseases of pregnancy and the puerperal state (1875) (14580011798).jpg

Identifier: systemofmidwife00leis (find matches)
Title: A system of midwifery, including the diseases of pregnancy and the puerperal state
Year: 1875 (1870s)
Authors: Leishman, William, 1834-1894. (from old catalog) Parry, John S., 1843-1876, (from old catalog) ed
Subjects: Obstetrics
Publisher: Philadelphia, H. C. Lea
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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n, with the concavity of the bladeturned towards her, the point downwards and to the left, the handleupwards and to the right. If thus held, it will correspond to the leftoblique diameter, and from this it should not deviate or twust in anyway during its introduction. Two or three fingers of the left hand,which have been duly anointed, are then to be passed into the vagina,over the left ischial tuberosity, in the direction of the correspondingsacro-sciatic ligaments, with the palmar surface upwards, until the headis reached. The blade is then passed along the fingers, and, if the osis still distinguishable, it is to be carefully guided within it. If the XXVIII.) INTRODUCTION OF THE LOWER BLADE. 477 handle is now gradually depressed, and at the same time gently pushedonwards, it will generally glide over the convex surface of the craniumwithout the slightest difficulty or danger. Should the blade turn ortwist in the direction either of the hollow of the sacrum or of the fora- FlG. 158.
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Introduction of the lower blade. men ovale, it is on no account to be replaced forcibly, but is to be par-tially withdrawn by raising the handle, and reintroduced with greatercare. The handle is then carried towards the perineum, and intrusted toan assistant while the introduction of the upper blade is being effected.The operator should take the second blade with his left hand, so thatit diagonally crosses the breech as before, but with the point above andto the right, and the handle downwards and to the left. The fingersof the right hand are then passed in the direction of the right foramenovale until the head is reached, and along their palmar surface, whichis turned downwards, the blade is then to be introduced. The reasonfor bringing the woman quite to the edge of the bed now becomes ob-vious, as it is only in this way that the handle of the upper blade canbe sufficiently depressed to admit of its easy introduction. This bladeis introduced, as will be observed, in front of the low

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