SYMPHYSEOTOMY. 513 



ticularly the two spoken of by Madame Lachapelle, and who were 

 operated on at the Maternite; that in some of thera the operation 

 was not indispensably necessary, since, as we find in Baudelocque's 

 work, that they were afterwards delivered without assistance or 

 difficulty; that most frequently the child has not been saved, and 

 that, in fact, it must in a majority of cases perish under the opera- 

 tion of turning or the forceps, which we are almost always obliged 

 to try; lastly, as observed by Lauverjat, that in eighteen operations, 

 twenty-one individuals, mothers or children, perished; that in two 

 cases it was found necessary to have recourse to the cesarean opera- 

 tion; that five were followed by incontinence of urine, and one by 

 claudication; that in the thirty-four cases mentioned by Baudelocque, 

 only eleven children were saved; when we consider, I say, all these 

 dangers, and compare them with the advantages derived from it in 

 the most successful cases, it is difficulty not to concur with M. De- 

 sormeux in regarding the section of the symphyses as being in fact 

 scarcely less serious than the cesarean operation, and that its em- 

 ployment ought to be restricted within pretty narrow limits. 



1135. Catolica's operation. If I understand correctly what was 

 told me by Professor Vulpes, it would appear that Dr. Catolica of 

 Naples has substituted another operation for that of symphyseotomy, 

 which, properly speaking, is but a modification of the one already 

 proposed by M. Desgranges of Lyons. Instead of dividing the car- 

 tilage, he proposes that the body and ramus of the pubes on each side 

 should be divided between the two oval foramina, as was recom- 

 mended by Aitken. In this way, the sacro-iliac symphyses remain 

 uninj ured; no risk of wounding the bladder or urethra is incurred; 

 the cellular tissue of the pelvis is scarcely stretched, and the conso- 

 lidation is easily obtained; there is no fear of abscess, caries, fistulas, 

 claudication nor peritonitis, and a considerable ampliation of the 

 sacro-pubic diameter is obtained. I am not sufficiently acquainted 

 with the reasons of the author to enable me to combat or approve 

 the operation, and until I shall have become more fully informed, 

 shall content me with the little I have now said concerninsf it. 



SECTION 4. 



Of the Cesarean Operation, [Hysterotomy, Hysterotomotocia, 

 Cesarean Delivery, Gastro-Hysterotomy). 



The denomination of cesarean section is given to an opening 

 made into the belly and womb for the purpose of extracting the 

 foetus when it cannot be delivered through the natural passages; since 



