Edward Rigby (1747-1821) of Norwich and his Essay on the Uterine Haemorrhage
Bibliographic record
Abstract
Antepartum haemorrhage has always been one of the most feared complications in obstetrics. William Hunter (1718-1783) said that only two emergencies ever scared him: ‘... one is the flooding and the other convulsions’1. One of the most alarming causes of antepartum haemorrhage is placenta praevia, which can lead to torrential haemorrhage. It was Paul Portal (1630-1703), a physician at the Hotel Dieu in Paris, who was the first to clearly describe the attachment of the placenta to the lower uterine segment in a case of placenta praevia in his 1685 text The Compleat Practice of Men and Women Midwives2. Before his description it was thought that when the placenta was felt at the cervix in cases of antepartum haemorrhage it had fallen down from its fundal attachment3. William Hunter illustrated the true position of placenta praevia in plates 11 and 12 of his Anatomy of the Human Gravid Uterus, published in 17744. During the 17th and 18th centuries obstetricians acknowledged the dangers of placenta praevia even when they did not understand its true nature. It was recognized that the bleeding would continue until delivery of the infant. Thus, the obstetrician would dilate the cervix if necessary, separate the edge of the placenta with the hand until the membranes were reached, rupture them, grasp the leg of the infant, and deliver it by breech extraction. If necessary, the infant was turned inside the uterus until the feet could be grasped and delivered. This technique of internal version and breech extraction was known as ‘delivery of the art’5. If the cervix had to be forcibly dilated to achieve this it became known as accouchement force—a term introduced by the French obstetrician Andre Levret (1703-1780)6. Thus, the principal obstetric texts of the 17th and 18th centuries advocated accouchement force in cases of placenta praevia2,3,7,8,9. However, because there was no clear clinical differentiation between placenta praevia and other causes of haemorrhage, accouchement force tended to be applied to all patients with heavy antepartum bleeding. Since most of these cases were not due to placenta praevia, and accouchement force itself could be traumatic and dangerous, this was neither necessary nor desirable5. Indeed, in a historical review, Noble found a maternal mortality of 33% with no interference compared with 48% with accouchement force10.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.006 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.015 | 0.011 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".