PELVIS. 



179 



of taller stature ; the height of the individual 

 being dependent, chiefly, upon the length of 

 the lower extremity and spinal column, which 

 in these cases are disproportionate. 



The pelvis of the true dwarf, however, in 

 common with, and in proportion to, the osseous 

 system generally, is contracted and stunted in 

 growth. In the* Museum of the Edinburgh In- 

 firmary, is the skeleton of a male adult dwarf, in 

 which the pelvic pieces and epiphyses are not 

 united by bone, but there is no distortion. The 

 jaws are infantile. The pelvic bones in the well- 

 known skeleton of the female dwarf in the 

 Hunterian Museum are in a similar incom- 

 plete condition. Sudden and universal "ar- 

 rest of development" is apparently the cause 

 of this curious immature condition. 



In Naegele's collection is the pelvis of a 

 female dwarf, aged thirty-one years, whose 

 height was 3 feet 6 inches, the measurements 

 of which are given as a specimen of a distinct 

 kind of " pelvis equabditerjusto minor" by that 

 eminent author in the Appendix to his valu- 

 able work " Das schrag verengte Jfecken," as 

 follow 



in. line.* 

 Between the sacral promont. and tip of 



coccyx - -33 



Between the sciatic tuberosity and iliac 



crest - - 5 5 



Between sciatic tuberosity and linea 



innom. - -27 



Superior opening, conjugate diam. - 3 

 transverse do. - 3 7 



Cavity anlero-postr. do. - 3 3 



transverse do, - 3 



Inferior opening, transverse diam. - 3 

 Length of pubic symphysis - - 1 1 

 The pelvis was perfectly regular and nor- 

 mal in symmetry and proportion, presenting 

 all the appearances, in these respects, of the 

 adult " standard.''' The sub-pubic arch, the 

 sacral curves, the direction of the ischia and 

 the curvature of the pectineal line were per- 

 fectly regular. The sacral bones, however, 

 and the three pieces of the innominate bones, 

 were united by cartilage only, ossification not 

 having taken place. In this respect only is 

 this pelvis allied to the class of deformities re- 

 sulting from imperiect development, or to an im- 

 mature pelvis. These peculiarities may possibly 

 be explained by supposing the " arrest of de- 

 velopment" which dwarfed ihe woman, to have 

 taken place after the age of puberty, and the 

 development of the sexual orgyns, 'but before 

 the union of the sacral and innominate pieces, 

 that is, between the fourteenth ynd sixteenth 

 years. Th's supposition is moreover strength- 

 ened by the fact, that tlie isohio-pubic rami 

 were firmly united, that the woman had men- 

 struated at the proper period, and that all 

 the limbs were in normal proportion to the 

 body. Neither in the history of the case, 

 nor in the appearance of the skeleton, was 

 there any sign of rickets. The woman had 

 become pregnant, and by the advice of the 

 medical attendants, premature labour was in- 

 duced at the sixth month, and the patient was 

 safely delivered by the forceps, but died ten 

 * Rhineland. 



days afterwards from the consequences of in- 

 discretion in diet. 



Out of the three cases of pelvis equabilifer 

 justo minor given by Professor Busch *, and 

 quoted by Dr. Rigby, there was a fatal termi- 

 nation in two instances. In one case, the 

 pelvic diameters were universally half an inch 

 below the standard size. In another, which 

 resembled that of a child, they were contracted 

 in every direction three quarters of an inch. 

 The last ought, probably, to come under the 

 denomination of an infantile pelvis. 



In the above cases, the contraction of the 

 pelvic diameters is marked and absolute ; but 

 there is a considerable class of cases, included 

 among the variations of measurement of 

 normal pelves, in which the diameters are 

 diminished in a much less degree, and yet 

 their relative disproportion to those of a 

 bulky fcetal head may be so great as to call 

 for instrumental aid in parturition. Naegele, 

 however, concludes that the contraction of 

 the pelvis itself (without any complication 

 with unusual bulk of foetus) should be con- 

 sidered, in most cases, as the cause of the 

 difficulty of labour, and that this kind of 

 faulty pelvis merits the especial attention of 

 the accoucheur as much as others, and the 

 more, that from the absence of evident ex- 

 ternal symptoms, the difficulty of diagnosis is 

 greater than in rickets or malacosteon. 



The came of most of the cases of propor- 

 tionably contracted and enlarged pelves is 

 only to be looked for among those of Nature's 

 aberrations which result in heads, extremi- 

 ties, &c. disproportionate to the rest of the 

 body. The small pelvis maybe considered 

 as one in which the development in shape has 

 gone on to completion, but the development 

 in size arrested by some cause. This cause 

 has been attributed by Mr. Shawf to a general 

 rickety disease in many cases. 



In addition to its effect in seriously im- 

 peding the passage of the foetal head, a small 

 pelvis of this kind is said by Ramsbotham to 

 cause retroversion of the uterus in some 

 cases. 



Irregular-Hies from imperfect development. 

 Infantile pelvis This form of pelvis is cha- 

 racterised by the persistence of the form of the 

 pelvis which is normally but transitorily pre- 

 sent under the age of puberty. Its appear- 

 ance corresponds, in some degree, with the 

 characters of the infantile pelvis described in 

 the first section of this article, of which, in 

 the respect under consideration, the most im- 

 portant are, the preponderance of the antero- 

 posterior diameters, which are larger than the 

 transverse-, the contraction of the sub-pubic 

 arch ; the shallow and diminished cavity ; the 

 approximation of the ischial tuberosities ; the 

 flat, expanded, shallow, and rounded ilia, and 

 the increased obliquity of the superior plane. 

 The pieces of the sacrum and innominate 

 bones are generally incompletely united by 

 ossification. 



In a pelvis described by Naegele J, taken 

 from an idiot girl aged twenty-one years, who 



* Xeue Zeitschrift fur Geburtskunde, t xv. 1837. 

 t Op. cit. J Op. cit. 



N 2 



