188 



PELVIS. 



the pubic symphysis was 2^ inches. The 

 distance between the superior pubic rami at 



Fig. 118. 



Pelvis o Isabel Redman. 



the point of angular bend, was $ of an inch. 

 From the 4th lumbar vertebra at its upper 

 anterior border, to the left acetabulum, was 

 only f of an inch ; on the right side f. The 

 greatest transverse diameter was 5f inches. 

 At the outlet, the distance between the sciatic 

 tuberosities was 3| inches ; between the 

 spines 2f. The greatest contraction of sub- 

 pubic arch was at the sciatic rami, which 

 were only T 7 ^ of an inch distant from each 

 other ; above this, the arch bellied out. The 

 sacrum was bent double, so that the tip of the 

 coccyx was only l T T n inch from the sacral 

 base. The pelvic bones were quite soft, and 

 lighter than natural. 



The measurements of the pelvis of Jane 

 Foster, who was saved by the* Caesarian sec- 

 tion by Mr. Barlow, are given as follows : 

 From the fibro cartilage between the 4th 

 and 5th lumbar vertebrae (which is sunk 

 down so as to occupy the normal position 

 of the sacral promontory), to the outside of 

 the projecting pubic symphysis, is 3 inches. 

 From the same point, to the centre of the 

 superior ramus of right pubes, f of an inch, of 

 clear available space. The same measure- 

 ment on the left side, If inch. From the 

 same point, to the right acetabulum of 

 an inch ; to the left acetabulum 1^ inch. 

 The greatest available space is, from the 

 left side of the sacral promontory to the 

 left ilium, and amounts to 1 inch. The 

 greatest lateral space, following the curve, is 

 5| inches. At the outlet, the distance 

 between the sciatic tuberosities is 1 inch. 

 The coccyx and lower part of the sacrum 

 are bent upwards, so as to bring the tip of the 

 coccyx to within 1 inch of the sacral pro- 

 montory, and to 2i inches from the point of 

 contact of the ascending ischial rami, which 

 are so close as to obliterate entirely the sub- 

 pubic arch. 



The dimensions of the rostrated pelvis of 

 Elizabeth Thomson, who underwent the 

 Cassarian section at the hands of Mr. Wood 

 of Manchester, and died in consequence, 

 are given by Dr. Murphy, as follows : 



From the most projecting point of the 

 sacral promontory to the pubic symphysis, 

 2 inches. From the same point to the 

 left pectineal eminence, f of an inch ; to 

 the right pectineal eminence, f of an inch. 

 The transverse diameter of the brim, 2 in- 

 ches ; both the oblique, 3^ inches. Cavity : 

 antero-posterior diameter, 3 inches ; trans- 

 verse diameter, 2 inches. Outlet: antero- 

 posterior diameter, 3 inches ; transverse 

 diameter, 2f inches. The sub-pubic arch mea- 

 sured 10 only. 



In a specimen of rostrated pelvis given by 

 Dr. Ramsbotham, the antero-posterior diame- 

 ter of the brim is diminished by the projection 

 of the sacral promontory, and the bend in the 

 pubis, to If inch. The same measurement 

 on the left side of the promontory, 2f inches ; 

 on the right side, 2 inches. The longest 

 transverse diameter is 4 inches. At the outlet, 

 the nearest points of the ischial tuberosities 

 are as close as If inch ; but from the tip of 

 the coccyx to the lower border of the pubic 

 symphysis measures 4 inches. In the opinion 

 of this author, a foetus might be extracted 

 from this pelvis by craniotomy. 



In Dr. Cooper's case of Caesarian section, 

 the pelvis was affected with the angular de- 

 formity to the extent of reducing'the conjugate 

 diameter of the brim to 1^ inch.; and the trans- 

 verse diameter of the outlet to an inch only.* 

 In Dr. Kellie's unsuccessful case of Caesarian 

 operation, the pelvis was of the rostrated kind; 

 the superior pubic rami being as if fractured 

 in the centre, and held only by ligament. 

 The lumbar curve was to the right side, and 

 the 4th vertebra was sunk below the plane of 

 the pelvic brim. The right lumbo-cotyloid 

 diameter was only T % of an inch ; the left, 

 1^. Between the lumbar vertebra , and 

 the bend of the pubic rami, was only T % of 

 an inch. At the outlet, the intersciatic 

 distance was only 2 T 7 o ; antero-posterior, 

 3 T 4 o inches. The sacrum was doubled, so 

 that the tip of the coccyx was but 1 inch 

 from the sacral base. The pelvic bones were 

 soft ; but the joints and cartilages healthy. In 

 this case, the patient was only twenty-seven 

 years old, and had borne four children ; the 

 last, three years before her death. 



In Dr. Radford's two unsuccessful cases of 

 hysterotomy, the deformities were both from 

 malacosteon, and the form rostrated. In one, 

 the circle of space at the brim was only about 

 f of an inch in diameter; the opening Y-- 

 shaped. The distance between the sciatic tu- 

 berosities was li inch, and the sub-pubic arch 

 reduced to a small slit. The subject had previ- 

 ously undergone nine natural deliveries, and one 

 by craniotomy. In the other case, the conjugate 

 diameter was reduced to f of an inch ; and 

 the superior rami were also bent so as to be 

 parallel anteriorly. The patient had borne seven 

 children with great ease previously ; the last 

 case four years before the operation.f 



Dr. Hamilton's case was also rostrated, the 



* Med. Observ. and Inq. vol. v. p. 218. 



f Edinburgh Med. and Surg. Journal, vol. Iv. 



