P A R T U 
traced to allow of it, the delay of another fortnight 
will give a greater chance to the child of furviving the 
birth. The utmoft care (hould be taken to guard againft 
an attack of (hivering and fever, which feeins to be no 
umifual conl'equence of this attempt to induce uterine 
action, and has often proved deftrudfive to the child, as 
well as alarming with regard to the mother. The pecu¬ 
liar circumftances under which the operation is per¬ 
formed, and the habit of body of the patient, will de¬ 
termine the accoucheur either to adopt a ftridlly anti- 
phlogiftic plan, or to exhibit opiates, or antifpafmodics 
and tonics. In order to give every poffible chance for 
preferving the life of the child, it will be prudent to 
have a wet nurfe in readinefs, that the child may have 
a plentiful fupply of breaft-milk from the very hour of 
its birth. 
We (hall fubjoin a very-fuecefsful cafe, which was 
communicated by Mr. Marfhall, of Half-moon-ltreet, to 
the London Medical Journal forAtiguft 1814. We (hall 
give this cafe at full length, with Mr. Marftiall’s expla¬ 
natory introduction. 
“Before entering upon a dfefcription of the fuccefsful 
termination of this cafe, I think it expedient to give the 
heads of two dreadful labours that preceded, the more 
iatisfadlorily to prove the relief obtained by adopting this 
mode of practice. 
“Mrs. H. H. D-was taken in labour of her firft 
child on Tuefday morning, feven o’clock, on the 5th of 
May, 1809, and was not delivered until the Friday morn¬ 
ing following, about two o’clock ; the child was ftill- 
born, and at the commencement of the labour was felt 
to move diftincSHy, and with confiderable vigour. 
“On the 13th of September, 1810, (he was taken in 
labour of her fecond child, on Saturday night at eleven 
o’clock, and was not delivered until the Friday after, at 
feven in the morning, of a ftill-born child, which feemed 
to have but very recently died. After each of thefe 
labours, (lie was fo much weakened, that her voice was 
loft for ten weeks, and (lie was incapable of walking 
for nearly four months. 
“On the 8th of October, 1811, I firft vifited this lady; 
and, hearing attentively her defcription of the former 
labours, I propofed to examine the pelvis, after explain¬ 
ing my reafons, and my fufpicions of the date of the parts 
concerned in parturition. On examining, I found, by 
meafuring the pelvis, a confiderable contraction of the 
pubis at the fymphylis, fo as to allow only the middle 
finger to fill the curve; the capacity of the pelvis at the 
brim formed a long triangle, caufing a preternatural dis¬ 
tance from the fymphylis pubis to the facrum : this mal- 
verfation of the pelvis immediately fatisfied me of the 
great difficulty a full grown foetus muft have to pafs, and 
the total impracticability of my patient’s ever completing 
the full period of geftation without a refult fimilar to 
what (lie before experienced. I calculated, as near as 
poffible, the period (he had then completed ; and pro¬ 
pofed to punCture the membranes of the womb on or 
about the 19th of November following, which would 
bring the time to feven months and rather more than a 
fortnight, with a view to be nearer the eighth than the 
Seventh month, to give the child a better chance of 
being reared, and to favour the probability of a head- 
prefentation. 
“On the 19th of November, about twelve at noon, I 
punCtured the membranes of the womb, by means of a 
probe half ?s long again as the ufual fize, and (footer in 
proportion, conducting (he point with my left hand along 
the middle finger of the right hand ; the liquor amnii 
began immediately to run off, and was caught in confi¬ 
derable quantity in an earthen veil'd before I left the 
room: and, upon the patient’s moving, continued to 
come away in larger or finaller quantities until the be¬ 
ginning of her pains, which commenced the next day, 
twenty-fix hours after the operation of punCturing, i. e. 
at two o’clock in the afternoon. The pains were very 
Vol. XVIII, No. 1275, 
R I T I O N, 693 
feeble, and occurred about every half hour; but at a 
quarter before eight in the evening the real ftrong pains 
of labour began, and continued equally ftrong and fre¬ 
quent until the birth of the child, which took place at a 
quarter paft eleven that night, making the (hort fpace of 
three hours and a half. The head prefented ; and, as 
foon as it efcaped the contracted part of the pubis, it re¬ 
quired only two or three pains to be delivered. My pa¬ 
tient was fully able to fuckle her child ; and four days 
after delivery, to life her own words, (lie felt as well as 
if nothing had happened. 
I obferved during the progreftive ftate of labour, that 
a confiderable quantity of a mucilaginous fluid was given 
oft' from the glands fituate in the neck of the womb, 
which appeared to make up for the deficiency of the liquor 
amnii, and to facilitate the paflage of the foetus. This 
circumftance I have noticed in every cafe wherein I have 
performed the operation. The child is now living, and 
remarkably ftrong and healthy.” 
3. The Sigaultian operation. —Monf. Sigault, a furgeon 
at Paris, fubmitted, in the year 1768, to the Academy 
of Surgery, a propofal to divide theJ't/mphyJis pubis during 
labour, as a mode of facilitating delivery; and in the 
year 1777, aflifted by M. Alphonl'e Le Roy, he performed 
the operation 011 a woman named Souchet, who had borne 
four children before, but not one alive. On this occa- 
fion, however, the life of the child was prel'erved ; but 
the woman was placed in a ftate of great danger, and 
the urethra and biadder were ferioufly injured by the 
operation. 
Perhaps there never was a furgical operation more en- 
thufiaftically received and commended than this. The 
operator was immediately honoured with a penfion from 
the French government, and a medal was (truck to 
commemorate the invention. So eager were many ac¬ 
coucheurs to adopt this operation, that in a comparatively 
(hort (pace of time, it was performed on a great number 
of women. But the admirers of this new method foon 
difcovered, that they had been too hafty in forming their 
opinion. Forty-four women had undergone this ope¬ 
ration in different countries ; fifteen only of the children 
were preferred, and thirty of the mothers ; and of thefe, 
many remained infirm, or fullered from want of power 
to retain their urine, orother grievous complaints, during 
the remainder of their lives. 
At length the ill fuccefs of this practice occafioned it 
to fink into complete difuetude ; and therefore we pro¬ 
ceed to defcribe the operation of 
Embryotomy. —When it is determined to have re- 
courle to the operation of embryotomy, the inftruments 
required are— the perforator, which, as its name implies, 
opens the head and breaks down its contents; and the 
crotchet, or (harp-pointed hook, to extract the cranium; 
or, as a fubftitute for the crotchet, the craniotomy forceps. 
Of the craniotomy forceps, as the competitor of the 
crotchet, Dr. Conqueft (peaks as follows-: “The vene¬ 
rable lecturer on midwifery at Guy’s Hofpital (Dr. 
Haighton) has for many years been in the habit of exhi¬ 
biting a pair of lithotomy-forceps, a little altered, and 
which he reprefents as a very valuable fubftitute for the 
crotchet, in fome cafes of difficulty in parturition, ari- 
fing from the impaction of the cranium at the fuperior 
aperture of the pelvis, after the operation of cephalatomia 
had been performed. Fourteen years back it forcibly 
ftruck me, that thefe forceps, (bmewhat modified, pol- 
fefl'ed all .the advantages of the crotchet, without having- 
appended to them any of thole flagrant defects which 
fully juftify the exclulion of that vile and dangerous in- 
ftrument from obftetric practice, in all thofe cafes which 
require the application of confiderable extracting force 
to bring down the perforated’cranium. Midwifery is 
indebted to feveral continental writers for very fimilar 
fuggeftions ; and gentlemen who have attended the lec¬ 
tures of Dr. Hamilton, of Edinburgh, muft be familiar 
with Dr. Lyon's forceps, which are l'o ltrongly recom- 
8 O mended 
