3o6 



MATERNAL DYSTOKIA, 



wrist. If this movement is such, that the cubital border of the hand, to 

 the right at first (Fig. 73, position A), becomes inferior (little finger 

 downwards — position B), then internal, so as to arrive at a state of supina- 

 tion (palm upwards — position C), then the torsion is to the right. 



On the contrary, if the hand, in following the spiral folds in the vaginal 

 canal, rotates in the opposite direction, of course the torsion is to the left. 

 For instance, as in the other case,- the hand is introduced in a state of 



Right Uterine Torsion: 

 Manipulation. 



Fig. 74. 



Left Uterine Torsion; 

 Manipulation. 



pronation (Fig. 74, position A), but instead of the thumb turning upwards 

 and round to the right, it inclines downward to the left (position B), the 

 little finger ascending until it is uppermost, and the palm of the hand 

 is turned outwards (position C). 



This is a very simple matter, apparently ; and yet in practice it may be 

 very important. It may be sufficient, then, if we impress upon the young 

 obstetrist the fact, that when the palm of the hand turns to the left, or 

 inwards, the torsion is to the right ; and when it inclines outwards, or to 

 the right, then the twist is to the left. 



3. The Degree of Torsion, — To ascertain the degree of torsion is more 

 difficult than to discover its existence or direction ; though every endeavor 



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