During the year ending December, 1S9G, 95 patients, who had some pelvic abnormality, were confined in the Bau delocque Clinic. Fourteen cases were treated by symphysiotomy. In 7 in stances the operation was done upon primipare, and in 7 upon multiparm. All of the patients had rachitic pelves, and one had, in addition, luxation of the hip-joint. After the operation, 13 of the children were extracted by forceps and 1 by version. Results were: in 14 cases 12 mothers and 10 children recovered; 2 women and 4 children perished. Of the fatal cases among the mothers, 1 died of pneumonia, the other of strepto coccic infection. The infant-mortality was largely due to aspiration - pneu monia. Finard (Annales de Gynee., No. 47, '97).
At clinic at Leipzig, 31 otomies personally performed; all of the mothers recovered without incon venience or injury: 27 of the children survived and left the hospital in good condition. Referring to cases reported in which patients could not walk with out difficulty, this is considered to be due to the excessive stretching of the pelvis and especially to injury of the sacroiliac joint. The operation should he limited to cases in which the con jugata Vera is not less than fi centi metres, and best results are obtained when the limit is placed as high as S or S '/, centimetres. Zweifel (Monats. f. Gehurts. u. Gyniik.; Brit. Gyn. Jour., Nov., '98).
Case in which symphysiotomy was per formed without subsequent immobilizing measures and a perfectly satisfactory re sult obtained. The operation was per
formed in six minutes. Tarnier's forceps being used. The interpubic dilatation waF, seven centimetres. On the sixteenth day the patient was up and no pelvic trouble ensued. M. Fieux %az. lIebdom. de 3,1(1.. etc., Apr. 26. 1900).
Symphysiotomy is a useful operation within a limited range of pelvic contrac tion. It is suited to conditions in which only very little additional space is re quired for delivery. It is a valuable re source. therefore, in eases in which forceps unexpectedly prove inadequate. Axis-traetion forceps with the aid of posture should always be tried before resorting to symphysiotomy. Its re sults would be much improved by re stricting it to pelves with a conjugate of not less than 7.5 centimetres (3 inches) in simple flattening, or 9 centi metres inches) in general contrac tion. Under equally favorable condi tions its total mortality should be no greater than that of Coe-sarean section. When the pelvic space permits, it should replace the Cresarean operation in the presence of exhaustion. It may be elected primarily as an alternative of Cesarean section when the operator can he assured that the degree of obstruc tion is well within its safe limit. Here the choice of operation is a matter of individual preference. Within its proper field symphysiotomy is better than C-fesarean section for au operator of little experience in surgery. Jewett (Amer. Medicine. Sept.. 28. 1901).