496 TOO SMALL A PELVIS. 



if we may give credit to the assertions of De Boer; and, in all cases, 

 admit of the child's being born alive. Lastly, how many women are 

 there who have been fortunate enough to bring their children into 

 the world without any aid, when in their previous confinements they 

 could be delivered only by symphyseotomy, the cesarian operation, 

 or embryotomy! Here, then, the operator stands in need of all the 

 integrity of a sound judgment, of prudent and sage counsels, of 

 attention to a thousand diversified circumstances, and of proceeding 

 only with extreme caution, if he desires not to compromise the dig- 

 nity of his art, or the safety of those beings who look to him for the 

 conservation of their existence. 



1107. Instead of accommodating itself to the form of the open- 

 ings, the head may be fractured, or the brain mortally compressed. 

 Long continued pressure upon the foetus, and particularly upon the 

 umbilical cord, which most commonly gets down into the excava- 

 tion, rarely permits it to escape with its life; the woman herself 

 soon becomes exhausted; the bladder and other soft parts, against 

 which the head presses with great violence, may inflame, be lacerat- 

 ed or perforated; the womb, violently irritated, by its repeated con- 

 tractions, may be ruptured, and death ensue. The softening and 

 separation of the symphyses often leave behind them a movable 

 state of the articulations, and a degree of lameness which are at least 

 very troublesome, and where the distension is carried to a great ex- 

 tent, are often followed by caries and abscesses, which sooner or 

 later terminate in the death of the patient. There are, therefore, 

 two evils, which it imports to avoid with equal care; there is a just 

 medium we should endeavor to secure. 



1108. Let us suppose that the application of the forceps and 

 turning have been attempted in vain, or that the pelvis is so deformed, 

 that no greater confidence is to be placed in those means than in the 

 efibrts of the woman, one question presents itself; on whom shall we 

 operate — the child or the mother? Where there is a certainty that 

 the pelvis is so contracted as to render the delivery of a mature and full 

 grown child either dangerous or impossible, have we a right to bring 

 on abortion, either at at an early stage of pregnancy, or only between 

 the seventh and eight months. Would it not be possible, by means 

 of regimen, or of a debilitating treatment, to oppose, to a certain ex- 

 tent, the development of the foetus, so that at full term it shall be of 

 a very small size? 



