PELVIS. 



131 



Burns gives also, in the female pelvis, the 

 following distances: 



1. Between the symphysis pubis and 



inferior iliac spine, 

 nearly - - 4 in. 



2. sacro-iliac joint and 



the pubic crest of 

 same side - - 4i 



3. sacral promontory 



and the obturator 

 notch - - 3 



i. sacral promontory 



and the acetabula 3^ 



5. acetabula anteriorly - 4} 



6. posterior ridge of 



ilium and the su- 

 perior and inferior 

 anterior spines - 5 



7. centre of iliac crest 



and the brim of the 

 pelvis, direct - 3 



One of these measurements was repeated 

 by Velpeau, Stoltz, and Naegele, viz. from the 

 sacral promontory to the centre of the cotyloid 

 cavity, or sacro-cotyloid. Naegele in 54 and 

 Stoltz in 40 female pelves, found the mean 

 distance to be 3 pouces, 3 to 4 lignes (pied 

 du Roi). 



Dr. Murphy, considering that the true 

 salient point or promontory lies on a level 

 above the real pelvic brim, at the sacro- 

 lumbar fibro-cartilage, gives also three more 

 measurements made in the " inclined plane of 

 the promontory," one antero-posterior y be- 

 tween the fibro-cartilage and the upper border 

 of the symphysis, which he places at 4 inches, 

 and two lateral, from the same point to the 

 pectineal eminences, which are on an average 

 about 3^ inches, but which are seldom equal, 

 because of the great tendency to deviation of 

 this promontory from the median line. The 

 latter seem to coincide almost with those given 

 by Dr. Burns between nearly the same points, 

 and the former with the conjugate diameter 

 of the brim. 



External measurements of the female pelvis, 

 made on the living subject, have also been 

 given, though from few data, as follows : 



1. External antero-posterior diameter, 7 to 

 8 inches. 



2. External transverse, between iliac crests, 

 13 to 16 inches. 



3. From great trochanter to the opposite 

 sacro-iliac joint, 10 to 12 inches. 



4. Depth of pelvis from top of sacrum to 

 coccyx, 4 to 5 inches. 



From the first of these, according to Bau- 

 delocque and Velpeau, 3 inches must be de- 

 ducted for the thickness of the parietes, and 

 from the second 4 inches. Boivin and Lacha- 

 pelle doubted the utility of these measure- 

 meter, will show how frequently the diameters are 

 compensator}- to each other ; as this compensation 

 may occur in diameters not usually measured, the 

 circumferential extent seems in many cases to be 

 required. Dr. Churchill gives the circumference 

 of the brim as varying from 13 to 14 inches in the 

 female, much less than I have generally found it on 

 the fresh subject after the soft parts were removed. 



ments generally, because of the great varia- 

 bility in the thickness of the pelvic walls; and 

 Dr. Davis has more recently found the thick- 

 ness of the base of the sacrum to vary from 2 

 to 3 inches in 17 dead subjects. 



The measurements of Naegele and Otto, 

 with a view to determine the presence of 

 obliquely deformed pelves, are of great im- 

 portance in the practice of midwifery, and 

 may be best given in this place. Out of forty- 

 two female pelves of medium size, the best 

 formed they could obtain, these observers 

 found the following measurements : 



Danyan, pursuing Naegele's system, found 

 the great rarity of perfectly regular female pel- 

 ves. Out of eighty female pelves he found fifty- 

 nine differ, in the first measurement, from 1 to 



6 lines. In the second measurement he found 

 a difference, in fifty-eight pelves, of 1 to 11 

 lines ; in the third, fifty-one differed from 1 to 



7 lines ; in the fourth, sixty-two from 1 to 9 

 lines ; and in the fifth measurement, fortv- 

 eight pelves had a difference of from 1 to' 9 

 lines. The table on the next page shows the 

 great variety in the diameters of female pelves 

 which may be considered as normal pelves. 

 In males Dupuytren found the distance 

 between the tuberosities of the ischia, in 

 twenty-three subjects, to vary from 2 to 

 3i inches; and Velpeau, in forty subjects, 

 to vary from 1| to 4 inches. In fourteen 

 subjects I have found the least distance to be 

 3 inches, and the greatest 4 inches in the 

 male, and measuring from the exact centres 

 of the inner margin of the tuberosities. These 

 observations on the male are of some im- 

 portance with a view to the operation of 

 lithotomy, when the stone is of great size. 



INCLINATION OF THE PELVIS. By making, 

 in a well-formed subject, a direct vertical 

 section of the spinal column, and drawing a 

 line through the centres of the bodies of the 

 axis and last lumbar vertebra, and by com- 

 paring with the transverse plane of such a 



K 2 



