Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

    16/50 (page 14)
    c* the amnion and chorion 4^ inches long, by 3 inches broad. This tumour was slightly lobular, its lobules being closely adherent to each other; some of a dirty white, others of a pale rose tint, and of a very various texture. It was traversed by large branches of the umbilical vessels, some of which entered it, but many of these vessels were blocked up with coagula. Another smaller tumour was near it, and the placenta was so much enlarged by these bodies, as to render its extraction difficult. [The cases are interesting, but the evidence of these bodies being organized is far from satisfactory.] Operative midivifery. Symphyseotomy. Dr. David Smith* advocates this operation on theoretical grounds, and by reasoning which presents nothing novel, as a substitute for craniotomy in cases of contraction of the outlet of the pelvis too considerable for delivery to be effected by the forceps, and yet where a comparatively slight increase of room would allow of the passage of the child. [The arguments by which it has been attempted to support this opera¬ tion, are most ably refuted by Michell, De Synchondromonia Pubis, 8vo, Amstelod, I7S33 see also the remarks of Kilian in his Operationslehre, Bd. ii, p. 867 ; and the statistics of the operation as given in Churchill's Operative Midwifery, p. 247 ; all of which furnish unanswerable objections to its perform¬ ance under any circumstances.] The Ccesarean section. References are given below to seven casesf in which this operation was performed with complete success ; the life both of mother and child having been preserved. In Dr. Mestenhauer’s ease, the operation had already been performed once before in consequence of the presence of a large bony tumour in the pelvis. M. Aubinais} relates a case in which the life of the mother, and Dr. Etlinger§ another, in which the life of the child was preserved. Six cases are related in which both mother and child were lost.|| [The first of these cases is a remarkable instance of that unhappy pro¬ crastination to which it is in great measure owing that the results of the Cae¬ sarean section in this country are so almost invariably fatal. The statistics of the operation, including the cases collected by Kayser in his valuable disserta¬ tion which contains none but well-authenticated cases are as follows : The operation has been performed 364 times ; in 139 the women recovered, in 225 they died; or the recoveries were in the proportion of 38 per cent.; or as 1 to 2*6. The fate of the child is stated in 304 instances 3 in 209 it was saved, in 95 it died, or 2 out of 3 children were saved.] Premature labour. Professor Hoffman^ has published a very elaborate and learned defence of this operation 3 which will possess greater interest on the continent than in our own country where the operation has so long been ap¬ proved of, and practised. Dr. Simpson** advocates the induction of premature labour in cases where the death of the fetus has been found to occur frequently during the latter months of utero-gestation. [This practice is propounded by him as if it were novel, but it apparently had escaped his memory that Denman has practised and recommended it under the same circumstances.] Three casesff are recorded of attempts to induce premature labour, by the use of the * Northern Journal of Medicine, Jan. 1845. t Dr. Ziehl, Bull. Gen. de Therap. Fdvrier 1844; Dr. Luzzani, II Filiatre Sebezio, Sept. 1843; Dr. Mestenhauer, Oesterr. Med. Wochenschr. April 27, 1844; M. v. Thibault, Archives Gdn. de Med. June 1844 ; Dr. Bresciani di Borsa, Ibid. June 1845; Dr. Jehn, Casper’s Wochenschr. April 12, 1845 ; Lebleu, Gnz. de Med. Mai 10, 1845, p. 298. t Gaz. Mdd. Mai 10, 1845, p. 297. § Observationes Obstetrica?, etc. 4to; Bonnas, 1844. II Cox, Prov. Med. and Surg. Journal, Sept. 18, 1844; v. Thibault, Arch. Gen. de Medecine, June 1844 ; Etlinger, Op. cit. p. 49; Coley, a case of Cassarean Operation, &c. Bridgnorth, 8vo ; Lohr, ex¬ tracted in London and Edinb. Monthly Journal, April 1845, p. 323; E. von Siebold, Neue Zeitschr. f. Geburtsk. Bd. xviii, 1 Heft, p. 45. Ibid. Bd. xv. Heft 3, and Bd. xvi, Heft 1. ** Lond. and Edinb. Monthly Journal, Feb. 1345. ft By Drs. von Haselberg, Feldmann, and Naegele of Dortmund, in Preuss. Med. Zeitung, Jan. 10, April 10, Dec. 4, 1844.