CEASAREAN OPERATION. 523 



to the distrust of the author's notions, derived, a priori, from 

 reasoning. 



1152. Method of Dr. Physic. Another mode of operating, which 

 is somewhat like that of Professor Ritgen, and also is not very diffe- 

 rent from that of M. Baudelocque, appears to have been proposed, 

 almost at the same time, by Dr. Physic. After having remarked that 

 in pregnant women, the peritoneum is easy to separate from the 

 bladder and parts about the os uteri, this surgeon conceived that by 

 making a horizontal incision immediately above the pubis, the os 

 uteri might be reached and opened without interesting the peritoneum: 

 but notwithstanding what Dr. Horner may say concerning it, this 

 operation is but little worthy of its inventor, and does not deserve 

 the trouble of being discussed. 



1153. Previously to commencing the operation, it is proper to 

 soothe the mind of the patient by inspiring her with the greatest 

 possible confidence; a good condition of the general strength, and 

 of the womb in particular; an obtuse, rather than a lively sensibility; 

 a great degree of resignation such as are pretty often observed in 

 country-people, is most of all to be desired; if the child is incur- 

 ring any risks we should make haste; otherwise, bleeding, baths, 

 purgatives or any other proper means may be sometimes made use 

 of; and lastly, the conduct here in relation to the preparations, is the 

 same as in all the great operations. 



Jf the bag of waters is not ruptured, ought it to be torn, as Plan- 

 chon advises, previously to making the incision into the womb, or 

 must it be let alone, as most other authors advise? By empty- 

 ing the membranes the escape of the liquor amnii into the perito- 

 neum is prevented, and there is less reason for fear as regards he- 

 morrhage and inertia of the womb. But these are not the most to 

 be dreaded of all the occurrences that may take place during the 

 operation; we are much more frequently embarrassed by the con- 

 traction of the womb than by its inertia. When the ovum is whole, 

 the child can be much more easily extracted; the wound in the 

 uterus, at first more extensive, is however reduced at last to much 

 smaller dimensions; lastly, there is less irritation excited in the 

 womb, and upon a careful consideration of all the circumstances, I 

 believe, in common with M. Desormeaux, that it is better to preserve 

 the membranes whole. 



We should never omit to empty the rectum and bladder, especially 

 if it be intended to follow the method of Mauriceau. The appa- 

 ratus consists of a convex bistoury, a straight probe-pointed bistoury, 

 pincers, scissors, suture-needles, thread, quill-barrels, adhesive strips, 

 lint in rolls and in pledgets, of pieces of linen spread with cerate, of 



