Second. Premature labour induced. Second stage rather protracted, but on being summoned to assist, found a band of cervix intercepted between the head and brim. On its being pressed up above the brim the head came down and she was safely delivered of a living child. CASE 5.-Mrs H., short, healthy woman. First five pregnancies in country, embryotomy. Sixth. Premature labour in town, under another doctor; child lived seventeen hours. Seventh. In 1828, premature labour, under the same doctor; boy, lived ten days. Eighth. Premature labour in country; girl, lived three hours. Ninth. Under my care. Last catamenia on 16th May 1830. On 12th January 1831, when it was supposed she had passed seven periods and ten days, the os uteri was opened up by the finger and the membranes separated round the os. Repeated on 17th, 19th, and 22nd, when they were still further separated by means of a blunt bougie. On 23rd had slight pains, which passed off. On 25th, pains not having come on, a small puncture was made into the membranes, several inches above the os uteri. On 27th this was repeated; a considerable flow of liquor amnii on each occasion. Slight occasional pains till the 29th; strong in evening. The head continued about two hours above the brim, care being taken to support the os above it; it then passed through with a jerk, and she was soon delivered of a male child, weighing 5 lbs.; at first still-born, but soon recovered and did well. There was in this case not only projection of promontory of sacrum, but a bony ridge along the symphysis of the pubes internally, narrowing the passage to what appeared no more than 2 inches. Tenth. In tenth pregnancy made arrangements to come to Edinburgh at end of seventh month. The evening previous to her intended visit pains of labour came on and she was safely delivered of a living child. MATERNAL MORTALITY. There were 143 accouchements; many very severe, and all with malformed pelvis. Of these, 2 died of septic poisoning, how induced I have no notion. In one it was the fifth time, and in the other the third time, that labour had been induced. Antiseptics were unknown in my days of practice, and none had ever been had recourse to in any of my patients. For some years in the latter part of my practice I had lost, in the class of cases to which I am referring, neither parent nor child, and was very proud of my success; but at last came the fall in the loss of my third last, and last cases. Still the annexed table is of some value as showing how at least 66 lives were saved, which, but for the treatment employed, must have been lost: many of the children so saved are now strong and healthy, and themselves parents. HISTORY OF THIRTY-ONE CASES OF MALFORMED PELVIS TABLE I. in which Premature Labour was Induced. By JOHN MOIR, M.D., F.R.C.P., Edinburgh. LABOUR AT FULL TIME, OR 9 MONTHS. REMAINING TWENTY-NINE CASES. Three Children. Living. Dead. 4 ... །* ཚི བས་ཆབ ACCOUCHEMENTS, DEATHS, . Both deaths were from septic poisoning, one in her fifth, the other in her third premature confinement. INDEX. Baboons, uteri and appendages of, 42. Ballantyne, Dr J. W., showed fœtus case of foetal bone disease, 84; on Barbour, Dr A. H. F., on Leopold's Buist, Dr R. C., showed malignant Cæsarean section, four cases of, 125. 115. Carcinoma of cervix, uterus with early Caromilas, G., on modern gynecological | Fibro- myomatous tumour and four surgery, 81. Catarrh, senile uterine, 85. Cervix and attitude of the fœtus, 106. Church, Dr H., showed garment for Colporrhaphy, anterior, recent modi- Congenital teeth, three additional Craig, Dr W., makes annual statement months' pregnant uterus, 115. Fœtus, anencephalic, with spina bifida, 51. Foetus sympus dipus, description, 54. Foetus with exomphalos, large sacral Fœtus with large encephalocele, 37. Foetuses, anencephalic, two, 82. Fordyce, Dr W., read letter from Dr 142. Genital tract, analogues of male and Genito-urinary organs of foetal deer, 141. Gestation, early extra-uterine, 52. Gynecological surgery, modern, 81. Fallopian tubes, double fimbriated ex- Hart, Dr D. Berry, on Dr J. W. Fallopian tubes, tubercular, 100. Fibroid removed by abdominal hyster- Fibroid removed by myomectomy, 115. Fibroid tumour of fundus uteri, 100. 41. Fibro-myomata, total hysterectomy for, Ballantyne's paper, 80; on the Haultain, Dr F. W. N., communicated Hernia, diaphragmatic, and anen- Hysterectomy, abdominal, large tumour |