TURNING. 449 



Previously to doing any thing of that sort, we ought, in the absence 

 of a pain, to push up the breast, and take hold of the chin with two 

 fingers of the right hand, disengage it and direct it towards the sacro- 

 iliac symphysis, while with the left hand on the hypogastrium we 

 favor, first the rotation, and then the flexion of the entire head; after- 

 wards we proceed as in the former case. 



B. Right occipito-iliac position, 



1008. In the third and sixth positions of Baudelocque, we might, 

 strictly speaking, use the left hand with the same facility as the right; 

 but the latter is preferred because it terminates the delivery in the 

 first position of the feet, which appears to be rather more advanta- 

 geous than the second, and because we can generally manoeuvre with 

 it better than with the other hand. 



1009. Whether, therefore, the occiput be towards the pubis, the 

 sacrum, the right acetabulum, or the right sacro-iliac symphysis, the 

 right hand ought always to be made use of, in a supine position in 

 the first case, prone in the second, half supine in the third, and in a 

 state of semi-pronation in the fourth. By placing the thumb on the 

 left temple, and the fingers on the opposite temple and side of the 

 face, we can embrace the head in the hand, raise it up in the axis 

 of the superior strait, push it towards the right iliac fossa, and then 

 reach the ear of the same side, so that the hand may be supine, and 

 the thumb brought close to the radial side of the index finger; the 

 hand, being then flattened out, may slip all along the child's right 

 side, and as it becomes prone, get hold of the feet, and act in all 

 respects as the left hand does in a left occipito-iliac position. 



1010. When the face presents first, the manoeuvre does not sen- 

 sibly differ from that which is used for the positions of the vertex. 

 The right hand is always to be introduced where the chin is to the 

 left, in front, or to the rear; or to speak more generally, and perhaps 

 also more correctly, the right hand is to be employed in all cases 

 where it seems easier to push the forehead towards the right iliac 

 fossa than towards the opposite one — and the left hand in all other 

 cases. 



1011. The other inclined positions, that is to say, those of the 

 temples and posterior part of the occiput, when they cannot be early 

 reduced to the corresponding ones of the vertex, are classed among 

 the positions of the trunk of the body, whence it manifesdy follows, 

 that in turning by the feet there can be only two positions of the 

 head; therefore, as these two positions themselves, as to iheir prac- 

 tical indications, differ only in one requiring the right hand more 

 particularly, and the other the left hand, and as it is only necessary 



39* 



