Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier.

  • Cazeaux, P. (Pierre), 1808-1862.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    1094/1140 (page 1060)
    excavation, was pushed upwards and to the right by the fingers of the other hand. By operating in this manner for five or six minutes we were fortunate enough to bring down the pelvic extremity, and thus terminate the labor favorably as regards the mother. The lying-in presented nothing unusual. [Decapitation only, is capable of fulfilling all the indications when, in a case of presentation of the body, it is impossible to turn. It has been objected to on account of the difficulty of performing it, and various instruments have been devised with the view of making it easier. A small knife shaped like a pruning-hook, fixed in a long and strong handle, may be used ; or else a special instrument recommended by M. A. Baudelocque. Ramsbotham, Sen., also invented a sort of blunt hook with a concealed blade in its concavity, which, after the instrument is applied to the neck, becomes detached and severs it like a guillotine. Van der Ecken proposed cutting through the neck with a chain-saw. For my own part, I had made by Charrifere a blunt hook, in imitation of Belloc's sound. After the hook is applied, the spring passes through it behind the neck and comes out at the vulva. A cord is then attached to it which will include the neck when the hook and spring are withdrawn. My idea was to use the thread for the pur- pose of drawing through the chain of a linear ecraseur, by which to effect the divi- sion of the neck. The only difficulty would be found in the passing of the spring around the neck, but I am so well satisfied that it would often be impracticable, that I believe the plan could be adopted in a few special cases only. Prof. Pajot devised a blunt hook containing a groove and tipped with a leaden ball, to which is attached a piece of whipcord lying in the groove. The hook being introduced, the cord is loosened and the leaden ball is supposed to drag it by its weight into the vagina, after having passed behind the child. To efi'ect the division, M. Pajot proposes using the cord as a saw by grasping the ends and drawing alternately upon one end and the other with a rapid motion. The thread is passed through a wooden speculum in order to protect the vagina. It must be confessed that it is a rather curious vray of effecting an operation of the kind, yet the possibility of doing it cannot be denied, inasmuch as it has been repeatedly accomplished by M. Pajot on the dead body in the presence of his pupils. The diflSculty, however, does not lie here, but in the passage of the ball, which, I think,- would be found no easier than in the case of the spring just now spoken of. Of all the instruments contrived for the purpose, that of M. Jacquemier is, in my opinion, the best adapted to the object in view, and the most readily applied. It consists of a blunt hook with a wooden handle. The hook is included for its whole extent in a sheath. Hook and handle are constructed with a groove, in which slide a series of connected blades which are put in motion by raising and depressing alternately the little handle to which they are attached through the medium of a rod running the entire length of the hook. M. Jacquemier operates as follows: The hook inserted with its sheath being passed around the neck, he introduces the blades into thte grooves and pushes them on by means of the handle until they project from the concavity of the hook. A to-and-fro motion then being communicated by the little handle, soon divides the soft parts down to the spinal column. The operator now withdraws the blades and substitutes for them a saw of the same size. With it, the bones are cut through without trouble, and it is with- drawn in order to complete the section of the soft parts with the cutting blades, which are again placed in the instrument for the purpose. Both the instrument and its manipulation are, as is seen, somewhat complicated, but it performs well m the dead body, and doubtless would be serviceable in practice.