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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    In four of the cases, chloroform was administered ; and in one, etherisation was used before and during the operation. In twelve cases, the placenta was cut upon ; in one of which there were twenty to twenty-four ounces of blood lost; in one, fourteen to sixteen ounces; in one, ten to twelve ounces; in two, a con- siderable quantity was lost; and in seven or eight, the quantity was very trifling. In two cases, the epigastric artery was divided; but there was little bleeding, and it was readily stopped. In seven cases, the blood issued from the uterine tissue during the incision. It has been asserted that these accidents (in Csesarean cases) depend on causes which are not very much within obstetric control. This statement is, however, very far from true. In the majority, the sources whence the blood flows are, as has already been men- tioned, the same as those whence it issues in other cases of flooding. The complete contraction of the uterus must, if possible, be ob- tained ; and the placenta must be promptly removed. The latter part of this rule can always be easily and effectually carried out; but there is more difficulty to fulfil the former part of it, as the con- tractihty of the organ is considerably impaired. This is a common effect after protracted labour. In most of the Csesarean cases, the operation was not performed until the power of the uterus was com- pletely worn out; and in many cases its tissue was disorganised. The relative and comparative tolerance of the loss of blood in such cases should be duly considered ; and as far as possible this accident should be guarded against. It is not, however, true that the re- sources of art can effect but little, or to look upon it as a certain contingency upon the operation. The vital powers of most of those women who underwent the Csesarean section were at a very low ebb previously to the commence- ment of labour, and were further seriously exhausted by its duration. Inflammation of the peritoneum is considered as a frequent cause of death after the Csesarean section. This serous membrane is usually more susceptible to morbid disturbance after labour than it is at ordinary times; so that it cannot be wondered at, that this disease is sometimes found in Csesarean cases, especially if the pre- vious management of the labours, and the real condition of the patients at the time of the operation, are duly considered. The dura- tion of the labours of the women who had peritonitis is as follows.