Buffalo medical and surgical journal (1893) (14596893578)

Identifier: buffalomedicalsu3318unse (find matches)
Title: Buffalo medical and surgical journal
Year: 1894 (1890s)
Authors:
Subjects: Medicine General Surgery
Publisher: Buffalo : Joseph Warren & Co., Printers
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities



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g paragraphs : This position is not uncomfortable, and it combines the advan-tages of both the knee-chest and side (Sims) postures ; it may becalled the exaggerated Sims. The knee-thigh-chest posture.—The patient mounts the stepwith the left thigh towards the table, lifts her drapery upon thetables top, in order that it may not bind her limbs as she reclines,or obstruct the operator. Reclining, she rests her left thigh acrossthe tables end, carries her left arm backward, parallel with thebody, places her left ankle upon the rest and draws the right limb 88 DAGGETT : CONCERNING POSTURE. over and beyond its fellow. She will posture herself unaided afterone or two lessons. The arms should not be carried upward, as this movementdraws upon the thorax, causing tension of the abdominal muscles.The head is placed upon a pillow, a little beyond the middle line,so that the body is slightly flexed, relaxing the abdominal mus-cles. The left thigh and leg are flexed to, or slightly beyond, right
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angles, and the right are more fully flexed, the knee dipping down-ward. These flexures relax the pelvic muscles. In this position, upon a horizontal plane, it is evident thereis very little dip to the abdominal cavity, and its visceramoving by respiration in a horizontal line press upon the pelvicorgans. SURGERY. 89 To avoid this, the table top is given a double tilt. The highlateral tilt inclines the body so that the patient turns upon the leftthorax, and the knees rest upon the side rail, the longitudinal tiltaccentuates this position, which gives a decided dip to the longdiameter of the abdominal cavity, and the viscera settle towardsthe diaphragm. For this position, the side tilt should be raised to an angle oftwelve or more degrees from the horizontal line ; the long tilt toan angle of five or six degrees ; more than this for the long tiltrenders the patient uncomfortable and is unnecessary. The tilting is to be done after the patient is placed as described.A line drawn through