VAGliVAL HYSTEROTOMY. 551 



With regard to the consequences of vaginal hysterotomy, it must be 

 admitted that it is not without danger, and that death not unfrequently 

 results. We have no reliable statistics to guide us in estimating the 

 amount of success or non-success following its performance, as not all — 

 or perhaps not many — of the cases are published. Saint-Cyr has col- 

 lected thirty-four cases — all those published in France and Belgium since 

 the commencement of the century, an analysis of these gives the follow- 

 ing results : 



Mother and progeny saved in 14 instances. 



Mother saved — fate of the progeny not mentioned — in - 9 " 

 Mother alone saved in ------5 " 



Progeny saved, mother died, in - - - - - 6 " 



Mother succumbed — fate of progeny not mentioned — in 5 " 

 Mother and progeny perished in - - - - - i " 



So that of 40 Cows operated upon, 28 survived, and 12 — or 30 per 

 cent. — succumbed; while, with regard to the progeny, 14 calves were de- 

 livered alive and continued to live, and 6 were dead ; nothing is said as 

 to the other 14. 



In other words, of 80 lives more or less compromised, 18 at least — or 

 22^ per cent. — were not saved by the operation. 



And Saint-Cyr is inclined to think that if all the successful cases have 

 been published, there is reason to believe that all the unsuccessful ones 

 have not ; and he is apparently confirmed in this view by Bugniet {lie- 

 cueil de Med. Veterinaire, 1873), who writes: "Distinguished veterina- 

 rians have published very interesting observations on this important 

 question in obstetrics^ but I am bound to say that these experienced 

 practitioners have been more fortunate than myself, for I have had noth- 

 ing but misfortune, and in the interest of science I do not hesitate to say 

 so." Bugniet, after describing three cases in which he operated, and in 

 which death of the mother followed, as evidence that his procedure was 

 not at fault, remarks : '• Nevertheless, I acted with extreme prudence ; 

 when the incisions were made, I proceeded to complete delivery with 

 great care and deliberation. Incision, dilatation, birth, removal of the 

 placenta — all conducted with knowledge and circumspection; and yet 

 this did not prevent a fatal issue." But in opposition to this experience, 

 we have that of other practitioners who have had a fair — indeed, a large 

 — share of success. Donnarieix, for instance {Ibid., 1874, p. 511), com- 

 menting on Bugniet's report, blames the latter for adopting expectant in- 

 stead of active treatment, and asserts that he has taken the exception for 

 the rule. From his own experience, extending over thirty years, during 

 which he had performed vaginal hysterotomy in sixty cases with only 

 one death (the cause of which was not apparent), he concludes (i) that 

 incision of the cervix uteri is generally curable, and (2) that palliative 

 measures are more injurious than beneficial, when their uselessness is 

 demonstrated. 



Many instances of successful treatment by incision might be given, in 

 addition to those already enumerated, but a few will suffice. 



I. Of several cases given by Donnarieix {Op.cit., 1874, pp. 512, 514) we will select two. 

 In one case, atresia was so complete that the index-finger could not be introduced into 

 the OS. and it was impossible to discover if there was a calf. The vagina was prolapsed 

 beyond the vulva, and formed a tumor as large as a man's head. After evacuating the 



