_Rules for finding the feet._ In searching for the feet we must endeavour
to gain the anterior surface of the child, for (unless its position be
greatly distorted) they are usually turned upon the abdomen: in arm
presentations the position of the hand will also guide us, the palm of it
being mostly turned in the same direction as the abdomen, and therefore
points to the situation of the feet; the rule also, as above given by
Boer, of passing the hand along the inside of the presenting arm, is well
worthy of recollection, for this can scarcely fail to guide us to the
anterior part of the child. Where, either from the pressure of the uterus
or other circumstances, it is difficult to distinguish the precise
position of the child, it will be better to follow Dr. Denman's simple
rule, that the hand "must be conducted into the uterus, on that side of
the pelvis where it can be done with most convenience, because that will
lead most easily to the feet of the child." The soft abdomen, the curved
position of the child, and its extremities crossed in front are so many
reasons why there should be more room in this direction.
During all this time the other hand placed externally will be of great
service, not only in supporting the uterus, but in fixing the child and
rendering the different parts of it more attainable. Where the feet are at
some distance, we frequently come first to an arm or thigh, which soon
leads us to the elbow or knee; if the introduction of the hand has been
attended with some difficulty, it will not be very easy to distinguish
these joints from each other, without bearing in mind the following
diagnostic points:--the knee present two rounded prominences (condyles of
the femur) with a depression between them, whereas, the elbow presents
also two rounded prominences, but with a sharp projection (olecranon)
between.
Public-domain text, read in full here on John Shaqi.
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