On a New Method of Version in Abnormal Labour.

Abstract

tion in the dorsal or dorso-lumbar parts of the spinal cord, we may know which of these parts is thelseat of the inflammation by the existence or the absence of frequent fits of general spasms in the various parts of the paralysed limbs. I have insisted upon this point because, as will be shown hereafter, it is important, both for the prognosis and the treatment, to know the seat of an inflammation in the spinal cord.To understand well what we have to say of the symptoms of inflammation of the spinal cord, it is important to bear in mind the following facts:-1st. That the grey matter of the spinal cord in its normal condition is not at all excitable, and that irritations upon it are not followed by sensations or movements; while, on the contrary, when inflamed it is excitable and able to give all kinds of sensations, and to produce cramps or partial convulsions.2nd. That the white matter of the spinal cord is not composed of motor and sensitive fibres coming from or going to the brain.3rd. That a pressure upon the spinal nerves, or upon the spinal cord, able to produce a paralysis accompanied by cramps, may either produce anaesthesia, or not, while it causes various sensations.* * It is not our intention to speak here of the acute myelitis accompanied by fever, as in almost all cases of that kind there ' , is at the same time an acute inflammation of the spinal meninges, ' , and also because we only intend to show what the symptoms are in those cases of paralysis of the lower limbs of long standing that depend upon a chronic inflammation of a part of the spinal cord in the middle or lower parts of the dorsal regions.The characteristic symptoms of this local myelitis are: 1st. A constant pain at the part of the spine corresponding with the upper limit of the inflammation of the cord.2nd. Whether a constant pain exists in a very marked degree or not, it is almost always found that pressure upon the spinous process of the vertebras (sometimes even a slight one), when made at the upper limit of the inflammation, causes an acute pain.3rd. The passage of a sponge, filled with warm water, along the spine, gives a normal sensation of heat in all the parts above the seat of the inflammation, but a burning sensation at its upper limit.4th. The passage of a small lump of ice along the spine gives the natural sensation of cold everywhere, except at the level of the inflammation, where the sensation is that of burning.5th. Most patients complain much of a sensation as if there were a cord, or some other ligature, tied round the body, at the limit of the paralysis. In a few patients there is but a very slight sensation of that kind. This symptom seems to exist in all cases of myelitis, and to depend chiefly, but not entirely, upon a state of cramp of some part of the muscles of the abdomen or the chest.

British Maternal Mortality in the 19th and Early 20th Centuries

“…If the cervix was dilated, Braxton Hicks (1823-1897), an obstetrician of Guy's Hospital, had described in 1860 a combined bipolar version of the baby and then passing a finger through the low lying placenta, bringing down a leg. 8 This was tied with a tape to a weight over the end of the bed and thus the half-breech was plugged down into the pelvis to reduce or even stop the bleeding. Once the lower segment had been compressed with the half-breech, it was important not to make a rapid delivery of the baby, but to allow the haemorrhage to settle.…”

Two Hundred Years of Progress in the Practice of Midwifery

“…1]. 4 "A great deal has been written in the past few years about the advisability of performing a cesarean section in cases of placenta previa. Tait 5 reported the first such case of treatment of 'unavoidable hemorrhage' by means of Porro cesarean section in Great Britain 13 years ago in the Lancet.…”

John Braxton Hicks (1823-97) and painless uterine contractions

“…Enthusiastic, inventive, intelligent and hard working, he also paid meticulous attention to detail. Recognised as a pioneer in midwifery, with 133 medical publications to his name, he is best known for being the first physician to describe bipolar version of the fetus2 and the painless rhythmic contractions of the uterus that occur throughout pregnancy 3…”