398 DYSTOCIA. 



particular manceuvre. If it be living, the head may be, 1. Upon the 

 point of clearing the inferior strait; and in that case we need only- 

 urge the woman to bear down upon the pains as hard as she can; 



2. In the excavation, and the labor may go on but slowly; the re- 

 duction is here impossible, and if, after trying it, we find the pulsa- 

 tions of the cord diminishing, we must hasten to apply the forceps; 



3. Lasdy, scarcely engaged; here we take hold of the cord, and roll 

 it up into a kind of ball which we endeavor to return by pushing it 

 up by the side of, or even above the head, if possible, and if there 

 is any tendency for it to fall down again, it should be kept there until 

 the contractions have firmly fixed the cranium in the strait. Pro- 

 vided the introduction of the fingers were found too difficult, or in- 

 sufficient, some mechanical means might be tried; such as the instru- 

 ment of Ducamp, or Dudan's, or what is still better, the portecordon 

 in the shape of a fork, invented by M. Guillon. Rather than pro- 

 ceed to turning, recourse ought to be had even to the method recom- 

 mended by Dr. Croft. 



On this subject Madame Lachapelle, as well as many other mo- 

 derns, says that the precept of the English surgeon ought not to be 

 followed, inasmuch as, where the hand is introduced, it would be 

 quite as speedy to draw down the feet. For my part, I am not of 

 that way of thinking; the life of the child is too much endangered in 

 forced delivery by the feet, for us not to prefer delivery by the head 

 whenever it is possible. 



When compelled to extract the fcstus by the hand or by the for- 

 ceps, it is important to conform to the precept of Boer, which is, that 

 previously to acting either upon the feet or the head, we ought not the 

 less to endeavor to return the cord, which, without such precaution, 

 could scarcely fail to be very much compressed, either by the hand 

 of the accoucheur, or by the hips, the shoulders, or some other solid 

 part of the child. 



§. IV. dystocia from Excessive lieng^th or 

 Sliortiaess of tBie UBM^jJUicai Coi'cl. 



910. Shortness. Until the time of Baudelocque it was supposed 

 that the delivery of the foetus might be prevented, or at least con- 

 siderably retarded by a very short cord. When the placenta is 

 attached to the fundus of the womb, if the cord is less than six or 

 eight inches in length, says De la Motte, the head, which is forced 

 towards the inferrior strait during the contractions, is found to rise 

 upwards again during the intervals between the pains; the occiput 

 is seen to engage in the vulva, to be on the point of clearing the 

 strait at every effort made by the woman, and then, as soon as the 



