194 EVISCERATION 



the shaft of the ilium. During the entire work the opera- 

 tion is carried out subcutaneously or rather intra-fetally 

 and the maternal parts are amply guarded against injury. 

 The size of the fetal trunk may be further reduced if de- 

 sirable, by evisceration, (60), and followed still further by 

 the introduction of the chisel guided by the hand and the 

 ribs, on one or both sides, severed one after another until 

 the chest can completely collapse. Or the ribs may be yet 

 more conveniently severed by introducing the sector in the 

 body cavity, pushing it forward until the first rib is reached, 

 catching the spherical end over the rib and drawing back- 

 ward, severing each rib in turn. If need be, some of these 

 may be removed and one of the anterior limbs caught by a 

 cord around the scapula and the fore leg extracted intra- 

 fetally. The remnant of the fetus is to be extracted by 

 means of a cord fastened about the lumbar region of the 

 spine. 



59. EVISCERATION 



Evisceration of the fetus is frequently desirable in ob- 

 stetric practice and has a variety of uses. It decreases the 

 size of the fetal trunk greatly and permits its more ready 

 passage through the genital canal, as in the anterior presen- 

 tation ; it renders the fetal trunk flaccid through the re- 

 moval of the viscera supporting the body walls, and 

 permits the body remnant to be bent or moved more read- 

 ily for the correction of any mal-presentation like that of 

 the lateral deviation of the head ; it permits freedom of iu- 

 tra-fetal operations directed against other parts, as for de- 

 truncation, or for the destruction of the pelvic girdle in 

 the anterior presentation ; and when a fetus is emphysema- 

 tous, evisceration permits the gases of decomposition to 

 pass into the fetal body cavity and thence externally. The 

 escape of gases is very greatly favored further by the 

 cutting of the ribs. 



