Part 28

The immorality of craniotomy, where delivery can be effected by any other method, is gradually becoming acknowledged in Great Britain. A late discussion on this subject, at the Obstetric Society of London, is reported in the Medical Times and Gazette for February, 1859.

CLAY, Obstetric Surgery, p. 68.

SINCLAIR and JOHNSTON, Practical Midwifery, 1858. 130 cases of craniotomy in 13,748 labors.

CLAY, Loc. cit., p. 69.

The subject of justifiable craniotomy has of late been ably though controversially discussed by an anonymous writer (Dublin Review, April and October, 1858,) and Dr. Churchill (Dublin Quarterly Journal of Medical Science, August and November, of the same year). Care must be taken, lest in assenting to the decided and imperative necessity of the operation in certain cases, and by a natural professional sympathy, too great frequency is not allowed to this most horrible and appalling of all the operations to which as physicians we can ever be called.

Review of CLAY’s Obstetric Surgery; Boston Med. and Surg. Journal, November, 1856, p. 283.

Theory and Practice of Midwifery, p. 348.

De jure vitæ et necis quod competit medico in partu. Heidelberg, 1826.

“Where one only can by any possibility be preserved, the female herself may use her right of self-preservation and choose whether her own life or that of her child shall fall a sacrifice.” GUY, Principles of Forensic Medicine, p. 145.

Guy’s Hospital Reports, 1856, p. 12.

Dublin Quarterly Journ. of Med. Science, August, 1858, p. 10.

RADFORD, British Record of Obst. Medicine, 1848, p. 84.

The rules of the Catholic Church upon this point have been already referred to. Suffice it to say, further, that while they enjoin the Cæsarean and vaginal sections, in preference to craniotomy and in cases of extra-uterine fœtation, yet turning, the use of forceps, and the induction of premature labor, where such are indicated, are distinctly allowed by them. BARRY, Medico-Christian Embryology, pp. 41, 44, 45, 60.

Guy’s Hosp. Reports, 1856, p. 4.

For a full discussion of the respective merits of the several methods instanced above, see SIMPSON, loc. cit., i. p. 738.

I have lately contrived an instrument very similar to one not long since proposed by Spencer Wells for dilatation of the female urethra, which by a simple combination of the three principles involved, will probably prove of material service in the induction of premature labor. It may be called the uterine dilator, as it possesses many advantages over expansible tents for all cases of uterine disease where dilatation is necessary, either for diagnosis or treatment. A description of the instrument, and of its first application to obstetric practice, is published in the current number of the American Journal of the Medical Sciences.

Bulletin de l’Académie, xvii. p. 364.

British Record, etc., p. 82.

I have elsewhere discussed this subject; American Journal of the Medical Sciences, January, 1859.

Enchiridion Medicum, p. 510.

Question d’Embryologie Médicale, etc.; Revue de l’Amérique et de l’Ouest, 1846.

JOAN. RIOLAN., Anthropographia, lib. vi. cap. vii. p. 589.

CHURCHILL, Dublin Quarterly Journ. of Med. Science, August, 1858, p. 22.

A case in point has been reported by the writer; Amer. Journ. of the Med. Sciences, April, 1859.

Reports to the Suffolk Dist. Med. Society of Massachusetts, 1857, and to the American Medical Association, 1859.

“It would in my opinion,” says Ramsbotham, referring to the nature of fœtal existence, “be much better not to endeavor to explain the secrets of nature, so deeply hidden.”—(Obst. Medicine and Surgery, p. 309.) This belief seems still, in practice, very widely entertained.

CLAY, Obstetric Retrospect, March, 1848, p. 44.

Medical Communications of the Mass. Med. Soc., 1858, p. 77.