CEPHALOTOMY AND EMBRYOTOMY. 529 



tampon; and the cautery, which is easy to apply; will rarely be 

 necessary in such cases. As to the lochia, they escape either from 

 the wound or from the orifice of the uterus, and in these respects the 

 woman requires only such cares as are common after an ordinary 

 parturition. 



SECTION 6. 

 Of Cephalotomy and Embryotomy, 



1163. In England the perforation of the cranium or reduction of 

 the foetus, by removing successive portions of it, even where it is still 

 known to be living, is generally preferred to the cesarean operation. 

 Wigan, combatted by Busch, maintains the same sentiment in Ger- 

 many. In France the operation of cephalotomy is not performed 

 except where the death of the child has been certainly ascertained 

 or at least become very probable, and where the delivery by the 

 natural passages is altogether impossible. When the pelvis has a 

 diameter less than fifteen lines, or the whole hand cannot penetrate 

 into the womb, the cesarean operation is preferred, even though the 

 child be dead. Upon this subject I will remark that our neighbors 

 too rarely have recourse to hysterotomy, and that they are too ready 

 to sacrifice the child, for fear of compromising the life of the mother; 

 that here we fall into an excess of quite an opposite kind, and 

 which, is perhaps, scarcely less blameable. In a case where every 

 circumstance announces that the foetus is still in full vigor, and that 

 it is robust; there is no doubt that, instead of sacrificing it, as is done 

 in Great Britain and at the north, it ought to be extracted without 

 endangering its life, by means of operations which indeed are severe, 

 but not always fatal to the woman; there is also no doubt, in my 

 opinion, that cephalotomy ought to be preferred when there are good 

 reasons for fearing the child's death, or for believing that it cannot 

 continue to live. It would be too cruel, after performing the cesa- 

 rean operation, to be able to present only a corpse, or a feeble, mise- 

 rable being, which must perish in a few minutes or hours, to the 

 unhappy mother as the price of all her sufferings and dangers! But 

 it would be a great mistake also to suppose that embryotomy is wholly 

 unattended with danger to the mother; it is, on the contrary, one of 

 the most redoubtable and revolting operations in tokology, whenever 

 it extends beyond the mere operation of craniotomy. 



1164. To sum up, the operation of cephalotomy is indicated 

 1. When the foetus is dead and the passages are too much con- 



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