TURNING. 435 



The objections urged against it are the difRculty of its execution, 

 the sraalhiess of the hold afforded by tlie head to the hand that at- 

 tempts to seize it, and the impossibility of bringing it back to the 

 strait, where the womb is ever so slightly contracted upon the 

 child; that even in the most favorable cases, where turning is once 

 effected the hand cannot assist in the delivery, which must be left 

 to the powers of nature unless recourse be had to the forceps ; 

 "whereas, by acting upon the feet, it is an easy matter to extract the 

 foetus without employing any instrument but the hand that brought 

 them down. Lastly, that as delivery by the pelvic extremity is 

 almost as natural as by the head, it is evidently preferable to turn 

 and deliver by the feet; and that it is the only method that ought to 

 be attempted where it becomes proper to change the position of the 

 child. 



984. To the above, I answer; 1. That it is not always very difficult 

 to take hold of the head while it is in the womb, not to exert a con- 

 siderable degree of power on it where that may be required; 2. That 

 unless the waters have been long discharged, we may often succeed, 

 without much difficulty, in laying hold of the occiput, and bringing 

 it down to the strait, no matter how far it may have been removed 

 therefrom; 3. That in this operation we have not so much to catch 

 hold on the head and compel it to descend, as to push up the part 

 that has engaged in its place; 4. That far from being a simple and 

 desirable case, a delivery by the pelvis, on the contrary, exposes the 

 child to the greatest danger, while that by the vertex, even when 

 assisted by the forceps, is rarely dangerous. M. Flamant seems to 

 have been the first to introduce it in our day; notwithstanding what 

 Osiander says about it, who has attempted to divide the credit of it. 

 In fact, the German professor did not describe it until 1799, whereas 

 it was taught at Strasburgh in 1798; since that time much attention 

 has been paid to it in the north of Europe, and MM. Labbe, Eckard, 

 Wigand, Schnaubert, Siebold, d'Outrepont, M. Wenzel, Busch, 

 Carus, Ritgen, Schweighaeuser, Toussaint, Vallee, Deroche, and 

 Ubersant, have expressed themselves more or less at length upon 

 turning by the head, and endeavored to diffuse the principles laid 

 down by professor Flamant. 



Cephalic version may, therefore, be attempted, 1. In a well formed 

 pelvis, where no other accident has happened except the vicious 

 position of the foetus, and the head is found in an inclined position 

 in the vicinity of the strait; 2. In presentations of the shoulder, back, 

 or anterior part of the thorax, provided the arm is not prolapsed, and 

 the uterus not too much contracted. Lastly, it seems prudent to 

 try it whenever the feet are farther removed from the strait than the 



