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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    during its sojourn in the uterus; and, therefore, the labour should be ended as near as possible to the time we had fixed for its com- pletion, as there is some doubt how soon effective uterine contraction may ensue after means have been employed to induce it. It would, therefore, be most desirable to commence the operation a few days before the computed period for the fulfilment of labour; especially so when some of the measures are adopted for this purpose. So long as the membranes are entire, and the infant is unre- stricted in its movement and floating in the liquor amnii, its life is comparatively safe; but, as soon as the water is discharged, it is subject to more hazard, from the compression it must necessarily bear, and especially so if the os uteri be not dilated. If this be true in ordinary labour, it is more decidedly so when it is artificially induced. Besides, there is no other means so effectual in distending the cervix, and in dilating the os uteri, as the membranous bag filled with the liquor amnii, which acts during each pain as a powerful wedge. If the infant should happen to lie in a bad posisition, and require turning, either the old operation or the internal and external mani- pulation (Dr. Hicks's method) could be undertaken with more ease to the practitioner, and with greater safety to the infant. On these grounds, then, it is of the greatest importance, when labour is artificially brought on, that the membranes should, if pos- sible, be kept entire; and, therefore, those means should be employed which are calculated to accomplish this object. There are various measures proposed to induce premature labour, which I shall very briefly mention. Stimulant injections thrown into the rectum, and abdominal frictions, and the application of a firm bandage round the abdomen, etc., ought only to be considered as aiding others. Secale cornutum, in repeated doses, has been prescribed; but, from its well-known poisonous effects on the infant, it ought never to be employed in these cases. The old, and perhaps the most common method of puncturing the membranes, is certain in its effects, although some days frequently elapse before labour ensues. Although I have formerly frequently adopted this plan, yet it is objectionable, on account of depriving the infant of the protective influence of the amnion fluid, etc. To partly obviate this evil, it has been proposed to carry an instrument through the os uteri and upwards between the uterus and the mem- branes, before piercing them.