The measurements of the pelvis of Jane Foster, who was saved by the. Cmsarian sec tion by Mr. Barlow, are given as follows :— From the fibrocartilage between the 4th and 5th lumbar vertebrm (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. Frona the same point, to the centre of the superior ramus of right pubes, *of an inch, of clear available space. The same measure ment on the left side, 1* inch. From the same point, to the right acetabulum * of an inch ; to the left acetabulum 11 inch. The greatest available space is, from the left side of the sacral promontory to the left ilium, and amounts to 11 inch. The greatest lateral space, following the curve, is inches. At the outlet, . the distance between the sciatic tuberosities is 11- 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 21 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 Cmsarian 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, * of an inch ; to the right pectineal eminence, * of an inch. The transverse diameter of the brim, 21 in ches ; both the oblique, 31 inches. Cavity : —antero-posterior diameter, 3k inches ; trans. verse diameter, 2* inches. Outlet :—antero posterior diameter, 31 inches ; transverse diameter, 2* 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 protnontory, and the bend in the pubis, to 1* inch. The same measurement on the left side of the promontory, 2*inches ; on the right side, 21 inches. The longest transverse diameter is 41 inches. At the outlet, the nearest points of the ischial tuberosities are as close as 1* inch ; but from the tip of the coccyx to the lower border of the pubic symphysis measures 41 inches. In the opinion of this author, a fcetus might be extracted from this pelvis by craniotomy.
In Dr. Cooper's case of Cmsarian section, the pelvis was affected with the angular de formity to the extent of reducing:the conjugate diameter of the brim to 11 inch.; and the trans verse diameter of the outlet to Ian inch only,.% In Dr. Kellie's unsuccessful case of Cmsarian 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 of an inch ; the left, 1125. Between the lumbar vertebra , and the bend of the pubic rami, was only -r8u of an inch. At the outlet, the intersciatic distance was only 2,7D- ; antero-posterior, 314zs 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 unguccessful cases of hysterotonly, the deformities were both from malacosteon, and the form rostrated. In one, the circle of space at the brim was only about of an inch in diameter ; the openirny Y . P shaped. The distance between the sciatic tu berosities was 11 inch, and the sub-pubic arch reduced to a small slit. The subject had previ ouslyundergonenine natural deliveries, and one by craniotomy,. In the other case, the conjugate diameter was reduced to * 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 pubic rami being approximated at the angular bend to of an inch.
In a ca.se which was operated on by Dr. Iimbeke, and described in L'Experience (No. 140.), the inferior pelvic outlet was nearly closed up entirely, the ischial tube rosities being approximated to within two lines only, and the coccyx and pubes-admitting only one finger between them.* In Mr. Kinder Wood's case, the deformity was rostrated, the niost available space at the brim being a circle of 1 inch diameter to the left of the projecting promontory. The antero posterior diameter was It inch, but less than t of an inch when the soft parts were at tached.t A somewhat remarkable variety of the ros trated pelvis is figured by Dr. Churchill (fig. 119.). In this pelvis the superior pubic rannis is bent at its centre, so as to be nearly ap proximated to the opposite pubis at that point, and the symphysis projects in a rostrum. The upper part of the sacrum and the pro montory is, however, thrown back, the cotylo sacral arch spread out, the antero-posterior diameter increased, and the transverse lessened, somewhat in the same manner, and, doubtless, by the same mechanical conditions, modified only by the yielding of the pubis, as in the oblong pelvis before described. The acetabula in this pelvis are directed principally forwards and outwards.