Observations on the Caesarean section and on other obstetric operations : with an appendix of cases.

  • Radford, Thomas, 1793-1881.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    dence of tlie infant's death, when no cardiac sounds are perceived through it. The audibility of the placental sow^ei directs us to investigate the quarter from whence the murmurs proceed; and by- attention, we may nearly always assure ourselves in what vicinity of the uterus the placenta is fixed. If this sound is not heard, we have a right to conclude that this organ is not within the reach of the knife if the infant be still alive. If it be dead, no gTeat risk •v\dll be incurred if the placenta be divided, as the vascular function of this organ will then, doubtless, have ceased. The position and direction of the external incision has varied. In 57 cases, it has been made longitudinally; in 11 of which number, it was made on the right side; in 24 cases, it was made on the left side; and in 22 cases, it was made in the centre of the abdomen. In 2 cases, it had a transverse direction on the right side. In one, it was made obliquely on the right side. In 17 cases, the situation and direction of the wound is not recorded. I prefer the wound to be longitudinal, and on the left side. There are no tissues concerned in the operation which require very slow or nice dissection; therefore, unnecessary tediousness should be especially avoided. If the uterus be slowly incised, the stimulus of the knife instantaneously throws this organ in violent and irre- gular contraction, which separates the placenta, and entails mischief on both the mother and the infant. Every precaution having been taken, we ought to strictly observe the motto, Cito et tuto'\ The incision should be made on the body of the uterus, because this portion of the organ is eminently contractile, and ought to extend well towards the fundus, but not into it. It ought not, however, to be carried too far down into the cervix uteri, because this part possesses dilatable properties which are unfavourable to a diminution in the size of the wound. When the uterine incision is completed, there should be no delay in withdrawing the infant. When it lays in its usual natural posi- tion, with the head over the brim of the pelvis, then the obstetrician should seize its legs with his right hand, and pass his left cautiously and quickly down so as to embrace the face on one side, or the hind part of its head. By this mode, a double power could be effectually exerted: one of traction by the legs, the other by raising the head upwards. If the breech oifer at the incised uterine opening, the practitioner should seize it with his right hand and withdraw it, and at the