INTRODUCTION. By the term Midwifery is understood the knowledge and art of treating a woman and her child during her pregnancy, labour, and the puerperal state. We employ it in this extended sense, because most systematic writers of later times have adopted this arrangement. The terms, Art des Accouchemens of the French, the Ostetricia, and Arte della Parteria, of the Italians and Spaniards, and the Geburtshülfe of the Germans, are restricted to the process of parturition, although they have been, and continue to be, used in the same extended sense as that in which we propose to use the term Midwifery. Although pregnancy and parturition, strictly speaking, are perfectly natural functions, yet they involve such a complication and variety of other processes, and also changes of such extent, that the whole system is rendered more or less subservient to them during the periods of their existence: hence, therefore, their number and variety must ever render them more or less liable to deviations and irregularities of action, which will necessarily be aggravated by the effects of civilized life, and in many instances are productive of derangement in the general economy of the system. Under such circumstances the irritability of the system increases at the expense of its strength and vigour, and not only increases its liability to these derangements, but diminishes its power of resisting their effects. In order that we may render the nature and treatment of the changes and phenomena, which take place in the human system during the periods above alluded to, more intelligible, we shall take a short anatomicophysiological view of the structure, form, arrangement, and function of these parts and organs which are more or less directly concerned in these important processes. This will form the first part of the present work, embracing the subject of embryology, a department of physiological knowledge, which, though it has lately been much enriched by valuable discoveries, still affords a rich field of investigation and research. The second and third parts will be devoted to the diagnosis and course of healthy pregnancy, and its various diseases, terminating with the subject of healthy parturition and its treatment. The fourth part is devoted to midwifery operations. Parturition properly speaking will come under two separate heads, eutocia and dystocia; the one signifying natural or favourable labour, the other unnatural, faulty, or unfavourable labour. The latter is a subject of such extent and importance as to require for its consideration nearly the whole of the fifth part, which will also contain a short account of some of the more important diseases which occur to the female during the first month after parturition. Ossa innominata.-Sacrum.-Coccyx.-Distinction between the male and female pelvis. Diameters of the pelvis.-Pelvis before puberty.-Axes.-Inclination. 17 Difficulty and importance of the subject.-Diagnosis in the early months.-Auscul- tation. Changes in the vascular and nervous systems.-Morning Sickness.- Changes in the appearance of the skin.-Cessation of the menses.-Areola.-Sen- sation of the child's movements.-"Quickening."-Auscultation.-Uterine Souf- fle.-Sound of the fœtal heart.-Funic souffle.-Sound produced by the movements of the fœtus.-Ballottement.-State of the urine.-Violet appearance of the mu- cous membrane of the vagina.-Cases of doubtful pregnancy.-Diagnosis of twin Sympathetic affections of the stomach during pregnancy.-Morning sickness.-Con- stipation. Flatulence.-Colicky pains.-Headach.-Spasmodic cough.-Palpi- Difficulty of the subject.-Signs before labour.-Motion of the fœtus.-Sound of the fœtal heart.-Uterine souffle.-Signs during labour where the head presents.- where the face, the nates, the arm, or the cord, present.-Fetid liquor amnii.—Dis- toms to be observed during and between the pains,-Character of a true pain.- Formation of the bag of liquor amnii.-Rigour at the end of the first stage.-Show. -Duration of the first stage.-Description of the second stage.-Straining pains. -Dilatation of the perineum.-Expulsion of the child.-Third stage.-Expulsion State of the bowels.-Form and size of the uterus.-True and spurious pains.- Treatment of spurious pains.-Management of the first stage.-Examination.— Position of the patient during labour.-Prognosis as to the duration of labour.— Diet during labour.-Supporting the perineum.-Treatment of perineal laceration. -Cord round the child's neck.-Birth of the child, and ligature of the cord.- Importance of ascertaining that the uterus is contracted after labour.-Manage- ment of the placenta.-Twins.-Treatment after labour.-Lactation.-Milk fever and abscess.-Excoriated nipples.-Diet during lactation.-Management of lo- Turning. Indications.-Circumstances most favourable for this operation.-Rules for finding the feet.-Extraction with the feet foremost.-Turning with the nates foremost. Turning with the head foremost.-History of turning. |