Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D.
- Lawson Tait
- Date:
- 1888
Licence: Public Domain Mark
Credit: Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![the uterus must be the refuge of uncertainty.* But an exploratory incision will clear up all doubt as to the diagnosis, and at the same time it will put the operator on the road to the proper method of treatment. After the diagnosis of a case of extra-uterine pregnancy lias been satisfactorily determined, the question arises, What is to be done with it ? If the child is still alive and near the full term, I believe it to be our duty to operate. If the child is dead, tlie propriety of operating seems to me quite evident, though it has been disputed by so eminent an authority as Mr. Jonathan Hutch- inson. Of course no strict rule can be laid down, and each case must be decided on its own merits ; but the records of surgery are so full of instances of the risks which such cases have to run when suppuration of the sac occurs, as it almost always does some time or other, that I think we are in most instances justified in operating. Moreover, the surgical principles on which the operation is to be conducted are now so well established, and its results are so good, that the opponents of the operation seem to me to be in a very illogical position if they still continue to advocate certain other surgical proceedings, of which tlie results are notoriously bad. Of late years much discussion has turned on various forms of treatment designed to obviate the necessity for surgical operations, and in the arguments used to support them, an altogether new and I venture to think, a very immoral element has been introduced. It is to the effect that if the child is alive the proper thing is to kill it in the belief that the infant's sacrifice is the mother's safety. I am no theologian and this is hardly the place for a discussion on morals, but I am bound to say that this seems a most mysterious kind of belief, and it would put legitimate practitioners of medicine quite on a level with abortion-mongers and reckless craniotomists. Certainly I will have none of it, the more that the men Mdio urge it happen, commonly enough, to be notoriously unfortunate in all their surgical efforts, belonging generally to the hybrid class of obstetric physicians. If the death of the child did bring the mother safety, something might be said for the proceeding, but nature kills the child in the vast majority of instances of ectopic gestation, as we have seen, and safety is thereby brought to a mere fraction of the cases, as Parry * Writers of library papers and otlier inexperienced persons talk so lightly of diagnosis in pelvic and abdominal troubles, and so assuredly of tlie accuracy of tlieir diagnosis, that! am disposed to asli those who are passing through those stages of their ])rofcssional existence to read the following extracts on the subject of tlie diagnosis of ectopic gestation : — Although from the careful perusal of numerous histories of cases of this nature, some degree of facility of distinguishing their presence may be acquired after a certain period o'f tlieir duration, and of deciding even, in occasional instances, on the particular variety of such pregnancies, yet assuredly every practitioner who has attentively studied the subject must admit the distinction to be a task of no ordinary difliculty.—I'arry. ' Telle est robscurite du diagnostic, apres I'exploration du col uterin, que les Baudelocque Ics Osiander, les Dubois, etc, n'ont jamais ose, an milieu des incertitudes qu'il laisse eiitre- prendre, au terme de ncuf mois, I'uxtraclion de I'eufant. Archives Gener, Vol. xxvii p '211 — Lesouef. -i •](https://iiif.wellcomecollection.org/image/b21448048_0074.jp2/full/800%2C/0/default.jpg)
