416 DYSTOCIA. 



size. But again, the observations of Plenck, Smellie, &c. demon- 

 strate that monsters of a much smaller size have, on more than one 

 occasion, rendered delivery very distressing, both to the mother and 

 the accoucheur, particularly where there was a great desire to have 

 them born alive. 



947. When there are two heads to a single trunk, provided the 

 one that is in front succeeds in engaging first, the second may fol- 

 low without any extreme difficulty, and being forced downwards, 

 they will clear the vulva, almost as easily as if there had been but 

 one. When such a monster presents by the feet, the posterior head 

 ought to descend first into the excavation, whilst the other remains 

 above the pubis; the woman may exhaust herself in vain efibrts, 

 and the intervention of the accoucheur may become indispensable. 

 But, previously to operating, several questions present themselves 

 to the practitioner; is the monster dead, or is it living? In the lat- 

 ter case, are we to act upon the woman, or upon the foetus! I 

 know that a double child, or one that is simply bi-cephalous, may 

 live and grow after birth; that several have lived for seventeen, or 

 twenty years, and even to a very advanced age; that a fostus seen 

 by Everard Home that was born in the East Indies, and which died 

 at three years of age of the bite of a serpent, grew as regularly as 

 the best formed child, though it had two heads united together at the 

 vertex. Who is unacquainted with the history of the monster 

 noticed in China, and of which an account was laid before the 

 Academie des Sciences last year? I do not wish therefore to 

 maintain that such beings are of necessity unlikely to live; but is it 

 true that they have the same rights as any other foetuses to our care 

 and solicitude? Is their life so valuable, that with the view, and 

 under the few chances of preserving and raising them, we are bound 

 to perform on the mother a most dangerous and too commonly 

 fatal operation? I am aware that by the cesarian operation we 

 may save the child, and not cause the mother to perish; but is it 

 not well known that one half of the women who submit to it lose 

 their lives, and that almost all the fostuses soon undergo the same 

 fate? I do not hesitate to say, and I believe in conformity to the 

 sacred laws of humanity, that if I were obliged to choose between 

 hysterotomy and the murder (meurtre) of a monster, I should not 

 vacillate a moment, I would sacrifice the fcetus. Happily, the skil- 

 ful acooHcheur can scarcely ever be subjected to this distressing 

 alternative; manoeuvres well arranged, and performed either with 

 the hand, the forceps, or the lever, almost always succeed in disem- 

 barrassing the woman through the natural passages, without injuring 

 the child. 



