Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / by Thomas Radford.

Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / 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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    risk is greatly ciihanced if such mcans have been neglectcd. The blood must be depraved in such subjects, and consequently the secretions and excretions must be unhualthy ; hence the necessity of taking such steps as tend to correct organic or functional de- rangeinent. Conttipation is nearly an invariable attendant on ordi- nary pregnancy ; and, in niany cases, fajoal accuniulations to a great aniount occur. But when distortion of the pelvis exists, this is much more Hkely to liappen, in consequence of the mechanical im- pediment ofFered by the great projection of the proniöntory of the sacrum and lower lumbar vertebrse to the downward passage of the fseces. The cervical and oral portions of the uterus, which are thrown backwards against this osseous mass, tend to compress the inter- vening gut. The same effects, to a greater or less degree, are ])ro- duced when large tumours exist in the pelvis. The iiumerous evils which arise from neglected bowels are not only exi.erienced during pregnancy, but also during the puerperal State. Such are peritoneal inflaunnation, jauerperal Irritation and exhaustion, etc. If, tlien, such serious diseases occur during the puerperal state after ordinary labours, froni causes which ai'e remediable, is it not very probable that the same mischief niight happen after Cfesarean cases, in which these causes do exist in a still higher degree ? Labour, if unduly protracted, is nearly always attended and fol- lowed hy a considerable nuniber of very serious evils. These mischievous effects vary considerably according to the dura- tion of the labour—to the nature of the cause and the degree of the mechanical impediment which obstructs the passage of the child through the pelvis. And, therefore, it is obvious, different measurts must be adopted according to the relative degree of obstruction. We ought, however, always to consider a lengthened duration of labour, from whatever cause it arises, as more or less unfavourable to both the mother and her Infant. In all such cases, we shoiild be extremely watchful, and timely adopt those measures relatively required for the delivery of the womau before any injury is inllicted on, or irreparable mischief is done to, the pelvic tissues or organs. It must be understood, that all the dangers of protraction increase after the rupture of the membranes and the discharge of the li(iuor amnii. It is also a well established fact, that the dangers botli to the mother and to the Infant increase in a ratio proportionate to the duration of labour. I soon learned, from my hospital practice, tliat the rules laid down by systematic writers on midwifery, on the treat- ment of protracted labour, were most mischievous.