516 CESAREAN OPERATION. 



1139. The danger attending it cannot, however, be denied. 

 Boerhaave and Boer were doubtless wrong in stating, that scarcely 

 one successful case could be found in fourteen operations; but it 

 is at least certain that it has been performed four times within 

 the last twenty years at the Paris Maternite, and that the wo- 

 men all perished; that out of seventy-three cases cited by Baude- 

 locque, forty-two were followed by death; that of one hundred and 

 six cases reported by Sprengel, forty-five were unsuccessful, and 

 that of the two hundred and thirty-one operations mentioned by 

 Kelly and Hull, one hundred and twenty-three were incompetent to 

 save the lives of the women; let us add that all the successful cases 

 have certainly been published, and that there is a great number of 

 them whose authenticity may justly be called in question; whereas, 

 according to all appearances, the same thing has not happened as to 

 the unsuccessful cases, of which perhaps the greater proportion 

 may have been passed over in silence. It may be stated, there- 

 fore, that, up to the present day, the cesarian operation has proved 

 fatal in at least one out of two cases, and that Tennon was mistaken 

 in asserting that, since the time of Bauhin, it has been performed at 

 the Hotel Dieu on seventy women, who recovered. By the report 

 of J. Burns and S. Cooper it appears that not a single well at- 

 tested case of its successful performance has occurred in Great 

 Britain, although the number of operations amounts to fifteen or 

 twenty. 



I think these details will suffice to exhibit this operation to young 

 practitioners in all its importance, and to prevent them from resorting 

 to it in any case save where the necessity is absolute. 



Nevertheless, it is difficult to conceive a priori that it is of so re- 

 doubtable a character. The wound which it is necessary to make in 

 the abdomen is indeed very large, but the parts divided are not very 

 delicate; there are no arteries, no large nerves, and nothing of any 

 great importance to guard against; the peritoneum is wounded, but 

 the digestive organs may be easily avoided; besides, how often have 

 the largest and most complicated eventrations, and penetrating wounds 

 of all kinds been seen which yet gave rise to no very serious con- 

 sequences, and admitted of the recovery of the patients; is not the 

 serous membrane of the belly laid open every day, without our 

 being alarmed about it, in subjects affected with strangulated hernia? 

 Would the wound of the uterus alone prove dangerous? but every 

 thing in this organ indicates that it possesses but a slight degree 

 of irritability, a slight tendency to take on inflammatory action, and 

 has the most favorable conditions for a sure and prompt cicatrisa- 

 tion. Are there not several cases of women who underwent the 

 cesarian operation successfully, subsequent to rupture of the womb, 



