530 CEPHALOTOMY AND EMBRYOTOMY. 



tracted to permit its extraction with the forceps or by turning; 

 2. When it is very probable that the child is dead, or at the point 

 of death, and when it cannot be got away whole without the per- 

 formance of the operation of hysterotomy; 3. When the head alone 

 remains in the pelvis and cannot be extracted by the hand, the for- 

 ceps, or crotchet. It would be useless, dangerous, and ought to be 

 proscribed even in case the foetus were dead, provided the small dia- 

 meter of the inferior strait were less than eighteen or twenty lines 

 in extent. 



1165. Embryotomy, that is to say, that operation which consists 

 in introducing a cutting instrument within the cavity of the womb, 

 for the purpose of lessening the size of the child, dividing, and re- 

 ducing it to small pieces, so as to be afterwards able to extract it 

 piece-meal, was frequently employed by the ancients, who had no 

 other resource, and did not confide enough in the powers of the sys- 

 tem; but at the the present day the forceps, the lever, turning, sym- 

 physeotomy, and the cesarean operation, properly appreciated as to 

 their respective value, render it almost wholly useless; it is therefore 

 no longer performed at the present day, except by certain country 

 medicasters, who are as ignorant of the art of midwifery, which they 

 disgrace, as they are of the plainest principles of the other branches 

 of medicine. 



1166. Even the operation of craniotomy must very rarely be ne- 

 cessary or indispensable, since out of a total of more than twenty 

 thousand labors Madame Lachapelle has indicated only three instances 

 of it.* In performing it, Avicenna and Mauriceau made use of sharp 

 extractors in the shape of a crotchet; Levret, Denys, Fried, and 

 Ould, made use of sheathed perforators; Simson boasted of a ring- 

 scalpel; spear-pointed perforators have been recommended and modi- 

 fied in an infinite variety of ways; but at present a simple bistoury 

 is employed, or the scissors of De la Motte, improved by Smellie 

 and by Walbaum, are made use of when it is necessary to penetrate 

 to a great depth within the organs, and to exert a certain degree of 

 force to perforate the bones. 



1167. The woman should be placed as for the application of the 

 forceps; the bistoury, wrapped with a small linen roller to within a 

 few lines of its point, which Baudelocque guarded with a small ball 

 of wax, is directed along the palmar surface of one or two fingers 

 of either hand, previously introduced into the vagina, and so on to 



* Dr. Collins, of Dublin, states that 79 cases of delivery by lessening- of the 

 head, occurred out of the whole number of cases during his mastership of the 

 Lying-in Hospital. — The whole number is 16,414 cases, or one in about 206 la- 

 bors.— M. 



