The Caesarean section. / by Edward William Murphy.

  • Murphy, Edward William.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: The Caesarean section. / by Edward William Murphy. Source: Wellcome Collection.

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

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    he has, I believe, had occasion to use the perforator and crotchet as frequently as any man in the kingdom. In one of these cases, the presentation of the child was preternatural, and, judging it proper to make an attempt to turn the child, he, by great perseverance, succeeded in pressing his hand through the superior aperture of the pelvis, but he met with so much difficulty in effecting this, that he immediately relinquished his design of attempting to bring down the feet of the child, and was satisfied with being able to disengage his hand. As the Ctesarean section was not submitted to in any of these cases, all the ten lives were losf^. Dr. Hull gives, also, the details of three cases that died undelivered, in consequence of the impos- sibility of extracting the child through the pelvis. Jane Kin- nerly was eight days in labour, and died of ruptured uterus. In Sarah Fletcher’s case it is stated:—“Every attempt to accom- plish her delivery proving fruitless, F[Mr. Dunlop] contented myself with giving cordials to support her strength, and ano- dynes to mitigate her pains. She continued to sink rapidly, and was seized witli convulsions about 4 in the afternoon, which soon proved fatal.” Ellen Gyte, after sixty hours’ labour, died of ruptured vagina, after several attempts to deliver by craniotomy had failed'^. To these facts, more, I am persuaded, might be added to prove that there are certain cases in which the degree of con- traction in the pelvis is so great that delivery through it is impossible. If so, it is criminal to make no effort to save the child. It is, therefore, of the utmost importance to determine the kind of case, and the degree of disproportion which would satisfy the practitioner that he is authorized to have recourse to the Caesarean section. In all these cases the cause of the deformity was mollities ossium, and the kind of deformity produced was such that the difficulty of delivery may at once be recognised. The outlet is so contracted that it is impossible to make a satisfactory exa- mination ; the brim of the pelvis can scarcely be reached, and, even then, the space is so small, and the power of moving the fingers so slight, that the os uteri and presentation often cannot be touched. If I were to meet with such a case again, I should at once decide on the Caesarean section, because I hold it to be the solemn duty of the practitioner, who is given two lives in his charge, to use his best efforts to save one, if he cannot preserve both; and in a case where the preservation Hull’s Defence, pp. 221, 222. Hull’s Appendix to Translation of Baudelocque, pp. 152, 159.