De Soyre divides pelves into two classes: 1. Those having at least 2.34, and not under 1.56 inches. 2. Those under 1.56 inches.
In the first, the pelvis being at least 1.56 and the fcetal head at 6i months having a bi-parietal diameter of 2.93 inches, reducible by at least .78 of an inch, miscarriage should be induced between 4. and 5i months, that is, we wait as long as is possible.
In the second category, when the pelvis is 1.56 or less inches, the head admitting only .78 inches reduction, premature miscarriage should be induced all the more quickly, as the pelvis falls under 1.56 inches.
We may say then: In pelves of 1.56 inches miscarriage need not be induced until 5 months; of 1.17 inches 4 to 44- months; of .98 inches 3i to 4 months.
Under .98 inches, if the patient is not seen till after the third month and a half, the CEesarean section is the only recourse.
As for the operative methods, they are identical with those described in the previous chapter. Our preference, seeing that we take no account of the fcetus, is for rupture of the membranes. The only precaution we must take is not to wound the uterus.
THE CiESAREAN SECTION.
the name, Ccesarean section, sectio Camarea, partus aesareus, we understand an operation which consists in opening the abdomen and the uterus of the gravida, in order to deliver thus artificially the foetus, which cannot be born by the natural passages.
History and Statistics. —Pliny tells us that this operation owes its name to the fact that the first of the Caesars was thus brought into the world, but according to others, its name is derived from the operation itself, ems° niatris ?item It is practised not only on the living, but on women dead during pregnancy and labor.
Made lawful by the royal laws of Numa Pornpilius, adopted by the Christian church, counselled by the Talmud and the Koran, it was prac tised for the first time in 1500, on the living woman, by Jacques Nufer, a swine herdsman, on his own wife, with success; but it was not till 1581 that the first treatise on the subject was written by Rousset. Opposed by Ambroise Par6, Guillemeau, Mauriceau, Viardel, Pen, Dionis, Amand; it was again successfully performed by Ru lean. Then appeared the mono graphs of Simon and of Levret. About the middle of the last century occurred the celebrated quarrel between the Symphysiotomists and the Cresarianists, but, notwithstanding the intense advocacy of Saccombe and his anti-Caesarean school, cases multiplied. Although all the successful cases were published, it was far otherwise with the others, and thus it is very difficult to give exact figures in regard to frequency and results; and it is only since the middle of the last century that we have been able to weigh the operation at all from the standpoint of its results for mother and for child.
Harris gives the data of 120 cases in the United States, and one fact is striking—the difference in the results obtained in the city and in the country: