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Show 188 DISLOCAIION or The run; or THE rans, DISLOCA'I‘ION or THE rrrvrs. side of the throat with the fingers of one hand, while the fore: When the symphysis pubis separates in pregnant women, a weakness and pain of the loins are remarkable symptoms previous to labour; and after delivery there is an inability of finger of the other hand is put into the mouth, and as far as possible over the root of the tongue, so that the tongue, and consequently the body of the os hyoides, may be pressed for~ ward. , I am at some loss, however, to understand how a bandage can be applied here so as to keep the bones in their due relation. DISLOCATIOX OF THE CARTILAGE OF THE BIB FROM T1111 r,,-.-."fl:‘- "rgrawwar N-.. .... M I" %e‘.~'*."'- 'm‘c'rw‘ 5",. .i __ J. STERNUM. A YOUNG man playing the dumb bells, and throwing his arms behind him, feels something give way on the chest; and one of the cartilages of the ribs has started and stands prominent. To reduce it we make the patient draw a full inspira~ tion, and with the fingers knead the projecting cartilage into its place. We apply a compress and bandage: but the luxation is with difliculty retained. OF THE DISLOCATION, OR DIASTASIS, OF THE BONES OF THE PELVIS. In the many dissections which I have made of women who have died in delivery, I have not seen one instance of sponta- neous separation, or looscning oi the bones of the pelvis-- Though I have dissected three women who have died, I may say of distorted pelvis, (since the difficulty of the birth from the narrowness of the pelvis was the cause of death,) and, though after opening the womb I have with great difficulty pulled the head of the compressed child from the bones of the mother, yet I have not found the joining of the ossa pubis loosened or relaxed. If there had been any provio sion in nature in the dilatability of the bones of the pelvis for the easy birth of the child, surely it must have been apparent in the only case which could require such a provisiom viz. where the pelvis is distorted, and the diameters dimi- nished. 189 moving, or standing, all which indicate disease, and not a na~ tural provision for easy labour. I believe then, that the se~ paration of the bones of the pelvis may be considered as a spontaneous, but not a natural loosening of the bones; and that the force of labour succeeding to this looseness of the joinings actually burst them up. When the bones of the pubes separate in labour, the symptoms are, (besides what I have already mentioned,) a jarring of the bones felt during delivery ;:x< pain and fever succeeding the delivery; when the woman attempts to rise she cannot stand, or even sit for any considerable time ; hec- tic fever succeeds, and she is for a long time bed-ridden. If the separation of the ossa pubis has been considerable, then the posterior symphysis of the pelvis also sufl'ers; and if the disposition to disease be great, suppuration may take place, both behind the pubis, so as to be discharged from the vagi~ na, and on the hip from the sacro iliac symphysis. When there has been much suppuration, it is possible that the bones may at last unite, and anchylose by a medium of bone. By neglect, if I mistake not, in cases where there is less tendency to caries, this species of sublimation produces a moveable joint where there should be a symphysis, or firm union by cartilage. I have not attended a case of diastasz's, or separation of the bones of the pelvis; but I have ascertained, by dissec- tion, the effects of the spraining of the joinings of the pelvis. I found an abscess within the pelvis, the ilium and sacrum were disjoined, and the cartilage was wasted, and the liga~ ments destroyed, and the bones extensively carious. Such was found to be the consequence of the operation of the eectio symphysis pubis when that horrid operation was per petrated in France. " See Denman, vol. i, p. St ‘ "We 100le M0997 |
