OF THE PELVIS. 37 



monly produces a disposition that it is highly important to notice. 

 If, for example, the contraction occurs on the right side, the left 

 may present an excess of amplitude. In this case, it is clear, that 

 if the head presents Avith the occiput turned to the right, the labor 

 might not come to a conclusion without assistance; whereas if it had 

 presented to the left, nature would have sufficed for her own relief. 

 This remark indicates with sufficient clearness, that in order to pro- 

 cure an easy delivery for a woman with such a conformation, it is 

 only necessary to turn, and bring down the child in the first or se- 

 cond position of the feel; so that the occiput may correspond to the 

 largest side of the strait. It also explains why a woman who has 

 been spontaneously delivered of her first child, may not perhaps get 

 through, in a second labor, without symphysiotomy or the Caesarian 

 section, and vice versa. 



88. In 1825, 1 was requested to attend a woman who had been in 

 labor for two days; the head would not engage; I sought for the 

 feet, and terminated the labor. In 1826, the same woman was 

 brought to the hospital de la Faculte, having been four days in labor. 

 The waters were gone off, and the head was strongly engaged; the 

 womb, being very closely applied to the foetus, would not allow the 

 operation of turning; the application of the forceps was attempted by 

 MM. Desormeaux, Deneux and myself, but nothing could induce 

 the head to descend. This woman, who became pregnant again in 

 1827, gave me timely notice when her labor came on; I felt for the 

 feet, and every thing was promptly and happily terminated. The 

 different issue of these three labors depended upon this, that in one 

 case, the back part of the head presenting to the right, where the 

 pelvis was greatly contracted, could not pass through the strait, 

 while in the other, by turning the occiput to the left, where the 

 natural dimensions were preserved, the passage of the head was not 

 impossible. 



89. Unless the sacrum itself be contracted, it is rarely that a les- 

 sening of the transverse diameter of the abdominal strait is capable 

 of interfering with the escape of the child. There are almost always 

 to be found more than four inches between the iliac fossae, and this 

 kind of deformity only occasions an increase of sacro-pubal diameter, 

 by giving to the strait the form of an oval, or a greatly elongated 

 heart. 



90. Sometimes the narrowing affects only one side of the pelvis, 

 as is seen in a specimen in the museum of the Faculte: in that case 

 the deformity comprises both the greater and lesser basin. 



91. All these deformities may be combined in various ways, or 

 exist singly, and in very different degrees. Charles Bell tells us 

 that in the pelvis of a woman who had been long affected with osteo- 



