WRONG PRESENTATIONS. 419 



back the vertex to the centre, by means of the fingers, the lever, or 

 one branch of the forceps; or, where it is a shouUler that is too far 

 advanced, the child should be turned and delivered. 



§. II. Deviated Breech Positions. 



952. The pelvis may, like the vertex, incline in any direction, and 

 give rise to what have, by the authors, been denominated positions 

 of the hips, sacrum, front of the thighs, and genital organs. Pro- 

 duced sometimes by the inclination of the child no longer agreeing 

 with the vertical axis of the womb, and sometimes, which is more 

 common, by obliquities of the uterus, the deviated positions of the 

 breech do not always prove insurmountable obstacles to spontaneous 

 delivery. Nature often succeeds, alone, in transforming them into 

 direct positions, so that if the labor progresses in other respects regu- 

 larly, the assistance of art rarely becomes necessary. 



However, we must not, for fear of acting unnecessarily, remain 

 inactive under accidents or sufferings which it would be easy to pre- 

 vent or alleviate by a skilful manoeuvre. Whilst the membranes con- 

 tinue unruptured, all we ought to do is to restore the womb as far 

 as possible to its natural attitude, either by pushing it with the hand 

 into the axis of the strait, or by causing the woman to assume such 

 or such an attitude, according to circumstances. But if, the mem- 

 branes being ruptured, the os uteri, although soft, should dilate with 

 exceeding slowness; if the pains should be directed with great force 

 towards the reins, or the strength appear likely to be exhausted; or 

 lastly, should any accident supervene, the accoucheur ought to wait 

 no longer: he should try to reach the deviated part with his fingers, 

 or even with the lever, if it be the hip or sacrum, and restore it to 

 the centre of the pelvis; or he may proceed at once to seek for the 

 feet or the knees. 



§. III. Positiosis of the Triisik of the Body. 



It is incontestable that the trunk sometimes presents at the supe- 

 rior strait otherwise than by the head' or pelvis; this has been ad- 

 mitted by practitioners in all ages, and has been a thousand times 

 proved by observation. But it is true that these presentations ex- 

 hibit shades so various and multiplied as has been asserted by the 

 authors? In the first place, it is possible for positions that are frankly 

 transverse, to take place either before or after the discharge of the 

 liquor amnii, when the foetus is at full term and well grown? For 

 that end it would be required that the transverse diameters of the 

 womb should exceed the perpendicular; but even should such a dis- 

 position exist before the commencement of labor, can we conceive 



