PELVIS. 



201 



opposing ones ; the ankylosed innominate 

 bone appearing as if pushed upwards. 



A remarkable peculiarity of this deformity 

 is, that, with the exception of the difference in 

 the side where the ankylosis had taken place, 

 the pelves affected with it were extremely like 

 each other. The strength, texture, and ap- 

 pearance of the bones were perfectly healthy ; 

 there was no limping gait observed in the 

 patients affected with it; nor any history of 

 accident, rickets, or malacosteon. 



Examples. Naegele collected, with incre- 

 dible industry, notes of thirty-five examples of 

 this disease in female pelves, and two in male 

 pelves. Of these, two (one male and the 

 other female) were in the collection of Pro- 

 fessor Montgomery, of Dublin, and the others 

 in the various collections of France, Germany, 

 and Italy. 



In one case, which was observed during 

 life by the author himself, he observed 

 a slight halt in the gait of the patient, who 

 otherwise was apparently well-built, healthy, 

 and active. In her first labour, at the age of 

 eighteen years, the foetal head in the early 

 stage was found placed very high, and easily 

 moveable, and the sacral promontory could 

 not be reached by the finger. The patient 

 was delivered, on the third day, with extreme 

 difficulty by the aid of the forceps, and died 

 fifteen days afterwards from puerperal fever. 

 The pelvis was found affected with the oblique 

 deformity, but in strength, weight, and texture 

 perfectly healthy (fg. 123.). the sacrum was 



Fig. 123. 



Pelvis oblique ovata. (After Naegele.) 



composed of four pieces only, and measured 

 in length 2 inches 11 lines. The coccyx had 

 six pieces, and measured 1 inch 10 lines. The 

 left sacro-iliac joint was ankylosed, and the 

 same side of the sacrum was shrunk and con- 

 tracted, so as to measure from the sacral pro- 

 montory to the usual position of the sacro- 

 iliac joint, only 1 inch 4- lines ; whereas the 

 same measurement on the right side amounted 

 to 2 inches 2 lines. The length of the left 

 iliac crest was 3 lines less than that of the 

 right. From the sacral promontory to the 

 left superior anterior iliac spine measured 

 only 3 inches 1 1 ^ lines. The same measure- 

 ment on the right .ide amounted to 5 inches 

 4 lines. At the brim of the pelvis the mea- 

 surements were: 



in. lines. 



From the sacral promontory to 

 the upper border of the ob- 

 liquely placed symphysis pu- 

 bis - - - - 3 9 



Left oblique diameter -47 



Right, ditto, ditto - - 3 5 



From the sacral promontory to 



left acetabulum - 1 10 



From ditto to right acetabulum 3 6 



A direct line drawn forward from the sacral 

 promontory cut the left pubis at the junc- 

 tion of its superior and inferior branches, an 

 inch external to the centre of the pubic sym- 

 physis. In the pelvic cavity the measurements 

 were : 



in. lines. 



From the centre of the sacrum, 



to that of pubic symphysis - 4 4 



Between the cotyloid walls - 3 1 1 



ischial spines - 2 ll 



At the outlet, the measurements were : 



in. lines. 



Between the sciatic tuberosities 3 

 lower border of the pubic 

 symphysis and apex of sacrum 4 4 



The lowest oblique diameter in these pelves 

 described by Naegele, was found in one in the 

 Museum of the Hospital of St. Catherine at 

 Milan, in which the left oblique diameter was 

 2 inches 10 lines only ; while the right was 

 4 inches 6 lines. In the same pelvis, the right 

 sacro-cotyloid measured only 1 inch 8 lines ; 

 and the left 3 inches 1 line. In one case, the 

 left, and, in another, the right sacro-cotyloid 

 diameter, was as low as 1 inch 6 lines. In one 

 instance, the distance between the tip of the 

 coccyx and the tuber ischii of the ankyloid 

 side, was only 1 inch. The left side was the 

 one most frequently affected by the ankylosis, 

 but the right side was also found affected in 

 many of the specimens, and, among others, in 

 the pelvis of an Egyptian female mummy. 



In addition to the foregoing, three female 

 pelves are described by the same author, in 

 which the oblique deformity was present, but 

 the diminution of the diameters not so great as 

 to produce any great obstacle to parturition. 



One of these is in the Museum of St. Bar- 

 tholomew's Hospital, and is rather above the 

 medium size. The right side of the sacrum is 

 imperfectly developed. The left oblique dia- 

 meter is nearly 1 1 lines less than the right ; 

 and the right sacro-cotyloid distance, 10i lines 

 less than the left. A line drawn directly for- 

 ward from the sacral promontory cuts the right 

 pubis 1 inch external to the centre of the sym- 

 physis ; and the distance from the sacral pro- 

 montory to the symphysis is 4 inches 10 

 lines. One of them, in Naegele'sown collection 

 has six instead of five sacral pieces. 



In none of these three pelves, however, is 

 there ankylosis of either of the sacro-iliac 

 joints, although the imperfect development of 

 one side of the sacrum is evident. 



In a male pelvis, on the contrary, there was 



