Diameters of the Female Pelvis. The diameters of the pelvis may be stated as follows:1Antero-posterior, taken at the brim, from the upper part of the posterior surface of the symphysis pubis to the centre of the promontory of the sacrum; in the cavity, from the centre of the symphysis pubis to a corresponding point in the body of the third piece of the sacrum; and at the outlet, from the lower extremities of the symphysis pubis to the tip of the coccyx. Oblique, taken at the brim, from the sacro-iliac joint on either side to a point of the brim opposite the ilio-pectineal eminence (that starting from the right sacro-iliac joint being called the right oblique, that from the left the left oblique); in the cavity, a similar measurement at the same level as the conjugate; while at the outlet, an oblique diameter is not usually measured. Transverse, taken at the brim, from a point midway between the sacro-iliac joint and the ilio-pectineal eminence; in the cavity, from corresponding points in the same plane as the conjugate and oblique diameters; and at the outlet, from the centre of the inner border of one ischial tuberosity to the other. The average measurements are the following: Brim. - The facts here detailed are extracted from the recent work of Dr. W. S. Playfair, of London, on the Science and Practice of Midwifery, Philadelphia, 1876, p. 33, etc, Diameters of the Fatal Skull. These are measured from corresponding points opposite each other, and may be briefly stated as follows:Occipito-mental, from the occipital protuberance to the point of the chin, 5.25" to 5.50". Occipito-frontal, from the occiput to the centre of the forehead, 4.50" to 5". Sub-occipito-bregmatic, from a point midway between the occipital protuberance and the margin of the foramen magnum to the centre of the anterior fontanelle, 3.25". Cervico-bregmatic, from the anterior margin of the foramen magnum to the centre of the anterior fontanelle, 3.75". Transverse or bi-parietal, between the parietal protuber. ances, 3.75" to 4." Bi-temporal, between the ears, 3.50". Fronto-mental, from the apex of the forehead to the chin, 3.25". Presentations and Positions of the Fœtus. HEAD PRESENTATIONS.-The positions of the foetal head after it has entered the brim, are First, or left occipito-cotyloid. The occiput points to the left foramen ovale, the sinciput to the right sacro-iliac synchondrosis, and the long diameter of the head lies in the right oblique diameter of the pelvis. Second, or right occipito-cotyloid. The occiput points to the right foramen ovale, the forehead to the left sacroiliac synchondrosis, and the long diameter of the head lies in the left oblique diameter of the pelvis. Third, or right occipito-sacro-iliac. The occiput points to the right sacro-iliac synchondrosis, the forehead to the left foramen ovale, and the long diameter of the head lies in the right oblique diameter of the pelvis. (This posi tion is the reverse of the first.) Fourth, or left occipito-sacro-iliac. The occiput points to the left sacro-iliac synchondrosis, the forehead to the right foramen ovale, and the long diameter of the head lies in the left oblique diameter of the pelvis. (This position is the reverse of the second.) PELVIC PRESENTATIONS.-The positions of breech presentations may be divided as follows: First, or left sacro-anterior (corresponding to the first position of the vertex). The sacrum of the child points to the left foramen ovale of the mother. Second, or right sacro-anterior (corresponding to the second vertex position). The sacrum of the child points to the right foramen ovale of the mother. Third, or right sacro-posterior (corresponding to the third vertex position). The sacrum of the child points to the right sacro-ilac synchondrosis of the mother. Fourth, or left sacro-posterior (corresponding to the fourth vertex position). The sacrum of the child points to the left sacro-iliac synchondrosis of the mother. FACE PRESENTATIONS.-The positions, classified according to the part of the pelvis to which the chin points, may be stated as follows: First. The chin points to the right sacro iliac synchondrosis, the forehead to the left foramen ovale, the long diameter of the face lies in the right oblique diameter of the pelvis. (This corresponds to the first vertex position.) Second. The chin points to the left sacro-iliac synchondrosis, the forehead to the right foramen ovale, and the long diameter of the face lies in the left oblique diameter of the pelvis. (This is the conversion of the second vertex position.) Third. The forehead points to the right sacro-iliac synchondrosis, the chin to the left foramen ovale, and the long diameter of the face lies in the right oblique diameter of the pelvis. (This is the conversion of the third vertex position.) Fourth. The forehead points to the left sacro-iliac synchondrosis, the chin to the right foramen ovale, and the long diameter of the face lies in the left oblique diameter of the pelvis. (This is the conversion of the fourth vertex position.) SHOULDER PRESENTATIONS.-These include two divisions, those in which the back of the child looks to the abdomen of the mother, and those in which the back of the child is turned towards the spine of the mother. Each of these is subdivided into two classes, according as the head of the child is placed in the right or left iliac fossa. In dorso-anterior positions, if the head lie in the left iliac fossa, the right shoulder of the child presents; if in the right iliac fossa, the left. In dorso-posterior positions, if the head lie in the left iliac fossa, the left shoulder preseuts; if in the right, the right. BRIEF RULES FOR CLINICAL EXAMINATION OF THE URINE. The following rules for the examination of a specimen of urine will be found of value to the practitioner as a guide to the proper method of investigating the abnormal conditions of that fluid.' 1. Color. Whether pale from being dilute, dark from being concentrated, dark or greenish from presence of bile, smoky from blood. 2. Smell.-Fragrant from the existence of cystin, or sugar, etc., or fetid from alkalinity. 3. Quantity passed in twenty-four hours, to be measured; observe whether there is excess or diminution. 4. Specific Gravity.-Take the specific gravity, if pos sible, of the mixed urine. Normal sp. gr. 1020. If high, suspect sugar; if low, suspect albumen. If ex If 5. Reaction. If acid, is it normally so or not? cessively acid, examine for crystals of uric acid. alkaline, ascertain whether the alkali is fixed or volatile. 6. Heat.-Heat a portion in a test-tube. If a precipitate appear, it may be albumen or phosphates. Add a drop or two of nitric or hydrochloric acid. If precipitate dissolve, phosphates; if not, albumen. If a deposit disappear on heating, we have urates. If it do not disappear, add a drop of nitric acid. If now dissolved, we have phosphates; if not, cystin. 7. Bile.-Test for bile pigment and bile acids, if necessary. Arranged and condensed from J. Hughes Bennett's Text-Book of Physiology, pp. 478-485; Philadelphia, 1873. |