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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    Dr. Hamilton passed his finger througli the os and upwards be- tween the membranes and the uterus, and then round so as to detach them; and had the utmost confidence in it. His success was great. Of forty-sis infants thus prematurely brought into the world, forty-two were born alive. Although this method is safer than the older for the infant, several days sometimes elapse before uterine contraction is excited. The vaginal douche has the confidence of many obstetricians. It consists of a forcible and continuous stream of water, sometimes warm and sometimes cold, being directed against the os uteri, so as to wash out the mucous plug. Although this is comparatively a safe measure, it is not always certain in its effects, and is also somewhat slow in acting. The uterine douche, or injecting water into the uterine cavity by means of a syringe and an elastic tube passed between the membranes and uterus, has the approval of some practitioners. A considerable quantity of fluid has been thrown up by some ; but this is a most hazardous experiment. Others have only injected three or four ounces. The risk of separating the placenta and throwing air into the uterine vessels renders the uterine douche rather objectionable. Mechanical dilatation of the os by expanding instruments has been recommended; but such a plan ought never to be done ; it is attended with great hazard. Sponges, prepared so as to easily pass through the os, and left to expand, are comparatively safe, and may sometimes be employed as preparative measures. Distending the vagina with sponge-plugs, or by the introduction of a bladder which is afterwards filled by a syringe with water. One formed of caoutchouc is better adapted for the purpose. These latter methods are useful, precursory to other plans. Elastic bags of various sizes have been contrived by Dr. Barnes, which are to be distended with water when they have been passed through the os uteri. As dilators, these contrivances are both safer and more efficacious. The attempts to dilate the os uteri should be both gentle and gradual, and made to resemble as nearly as possible the method Nature pursues in opening this part. Forcible dilatation, without preparation, is at all times most mischievous. In cases of labour in which the hand has to be introduced through the os uteri, this opera- tion ought not to be undertaken until this part (the os) becomes