Caesarean section and symphysiotomy compared, observations being based on: (1) Leopold's results of 160 Cmsarean sections; (2) Pinard's results of 90 symphysiotomies; (3) personal results of both procedures at the Liege Mater nity. With complete asepsis the mor tality of Cmsarean section should not he over 5 per cent. It is a better operation than symphysiotomy on the- ground.. that (1) it is easier to perform, since no special instruments are required, only soft parts are cut through and these are exposed to view, any htemorrhag,e is easy to control, and the operation is quickly finished, while in symphysiotomy much of the cut part is out of sight: after the point is severed there is still the difficult task of delivering the baby, for which purpose obstetrical forceps are generally needed, and serious tears of the soft parts are likely to result: (2) it is safer as regards haemorrhage and injury to adjacent parts, just as safe as far as sepsis is concerned, and it has a less tedi ous convalescence with no fear of a loose pelvis, though there is slight fear of ventral hernia. Charles (L'ObstM.. Nov. 15, '93).
Suprapubic hysterectomy with intra peritoneal treatment of stump advocated in pregnancy at term for obstructed labor. Porro operation preferred to ccelio-hysterotomy. W. M. Polk (Med Rec., Mar. 4, '99).
Cmsarean section is not difficult to one who has had some experience in lap arotomy. It is, however, dangerous if the least detail of antisepsis is omitted, and should never be done in women who have become septic. It is also dangerous
through the possibility of atonic tumor Hinge, which may require ablation of the uterus.
Analysis of 170 opera Lions gives a ma ternal mortality of 0.41 per cent., and a Octal mortality of 5.57 per cent. Bar (L'Obstet., May 15, '99).
Caesarean section personally performed in 14 cases without mortality. The in dications which render it justifiable vary in accordance with whether the mother is, or is not, already infected with sepsis; exhausted by prolonged labor, or by pre vious severe efforts at extraction of the child; or the subject of serious compli cating disease. When her vitality is lowered by any of these causes, the ma ternal death-rate of the Caesarean section is so enormous that is justifiable only for the absolute indication: i.e., when the child cannot he extracted by any other method. In the absence of such unfavor able conditions, and under circumstances which render good operating possible, the Caesarean section is no more dangerous to the mother than any other simple ab dominal operation; it is therefore (a) the operation of choice in cases already at term in which the ordinary intrapelvic operations are inefficient; and (b) may even be chosen in suitable cases in prefer ence to the induction of premature labor, on account of its greater safety to foetal life. Edward Reynolds (Obstetrics, Jan., 1900).