Further observations on the Caesarean section / by Thomas Radford.

Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Further observations on the Caesarean section / by Thomas Radford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    careful perusal of the case, as detailed by Mr. Wells, ought to convince the most violent and prejudiced anti-Cmsareanist that this operation ought to be recognised and performed with the same confidence of suc- cess as that with which other capital operations are now undertaken. Operation.—Few remarks need be made on this part of the sub- ject. The location of the placenta should, if possible, be ascertained by the stethoscope. In fact, this instrument ought to be carefully em- ployed in all cases in which the abdominal cavity is intended to be laid open, either for the removal of an infant from the uterus, or for the ex- tirpation of an enlarged ovanum. The necessity of observing this rule is most forcibly proved by the results of Case 97. Mr. Wells has kindly informed me that the placenta in his case was situated anteriorly and towards the left side. In the other case (98), the seat of the placenta is not mentioned; but it is presumed that it was on the posterior part of the uterus. Chloroform.—Chloroform was administered in both the cases. For my opinion upon the influence of this anaesthetic on the uterus, the reader is referred to my two former communications. Vomiting oc- curred afterwards in both cases. On the question whether the vomit- ing was a post hoc or a propter hoc, I again refer my reader to observa- tions already made. Mr. Wells, in his letter to me, states: “I don’t think we can judge very well what share chloroform had in the sick- ness.” The incision made in the abdominal parietes was in both cases longitudinal and along the linea alba. Sutures.—Both abdominal and uterine sutures were used in each of the cases. In Case 97, Mr. Wells brought the edges of the uterine wound together by an uninterrupted suture of fine silk, one long end of which was passed into the uterine cavity, and out through the os uteri into the vagina. The edges of the uterine wound were accurately adapted by seven or eight points. The other end of the silk was brought through the abdominal walls along with the three ligatures which were applied to the bleeding arteries : and all the ligatures were tied to the clamp, which embraced the ovarian pedicle. It is worthy of remark, that Mr. Wells burnt off by a hot iron a portion of the omentum; and, as there was free bleeding, he afterwards applied three silk ligatures ; and, after cutting their ends short, he returned the omen- tum into the abdomen. The edges of the abdominal wound were ad- justed by one superficial and six deep silk sutures. In the other case (98), as the uterine incision was somewhat serrated, it was deemed advisable to put in a couple of metallic sutures. Several others were put in the abdominal walls.” In my former observations, I stated that