142 OF TRUE PREGNANCY. 



place. I think, therefore, with M. Desormeaux, that if recourse 

 Avere had to it early, before the formidable array of inflammatory 

 symptoms have developed themselves, before peritonitis becomes of 

 itself mortal, a considerable number of women might be saved. It 

 has been maintained that in all cases it should not be had recourse 

 to until the seventh month of pregnancy, unless it be certain that the 

 fcEtus is dead, and the cyst opened into the peritoneum; that other- 

 wise, we should, without advantage to the mother, sacrifice the life of 

 a child which we might possibly have conducted to its full term, and 

 rescued alive. This reasoning is good for nothing; the chances of 

 success in the operation are so much the more numerous in propor- 

 tion as the pregnancy is less advanced; in this case there is too lit- 

 tle probability of the future life of the foetus, for it to be balanced 

 against that of the mother. After seven months, when the child is 

 viable,* reason and humanity both dictate its performance without 

 hesitation. Even although the accoucheur should not arrive until 

 after the rupture of the cyst, he should still instantly open the parie- 

 tes of the abdomen; with the operation death is but too probable, 

 but without it, is nearly certain. 



367. In cases where gastrotomy is not applicable, we must be 

 content to prescribe for symptoms, to moderate the violence of in- 

 flammation, to prevent as far as possible the formation of pus, to fa- 

 vor the production of adhesions, so as to circumscribe the eflusion, 

 to sustain, or also to diniinish the strength by means of regimen or 

 blood-letting, according as the appearances of reaction or exhaustion 

 may seem to require; we must asdst in the escape of those portions 

 of the ovum which present themsewes in the vagina, the bladder 

 the rectum; if abscesses form, they mu^t be opened; and we must 

 prevent the stagnation of pus or of any makers in a state of decom- 

 position; in one word, we should put under contribution, one after 

 another, accordingly as they may be indicated, baths, injections, 

 enemata, a severe diet, an analeptic regimen, general or local bleed- 

 ing, and rest or exercise. f 



* I have left this word untranslated: it expresses that state of development in 

 which a child may live, when independent of its connection with the mother. I 

 trust the reader will pardon me for introducing it here, especially as it is getting 

 much into use among the profession in this city. — M. 



t Inasmuch as the diagnosis of extra uterine pregnancy can in no case be ab- 

 solutely clear and undeniable, the question of gastrotomy is one of the most difficult 

 that can be presented to the surgeon. While the woman continues to enjoy even a 

 moderate degree of health, I think few surgeons could be found, bold enough to re- 

 commend or effect the incisions requisite for the extraction of the foetus; the more 

 particularly, since the patient may, as in many examples has been shown, con- 



