Anomalies and Curiosities of MedicineGould, George M. (George Milbrey)
Science
Anomalies and Curiosities of Medicine
Gould, George M. (George Milbrey)
Abnormalities, Human; Medicine -- Anecdotes
Symphysiotomy is an operation consisting of division of the pubic
symphysis in order to facilitate delivery in narrow pelves. This
operation has undergone a most remarkable revival during the past two
years. It originated in a suggestion by Pineau in his work on surgery
in 1598, and in 1665 was first performed by La Courvee upon a dead body
in order to save the child, and afterward by Plenk, in 1766, for the
same purpose. In 1777 Sigault first proposed the operation on the
living, and Ferrara was the one to carry out, practically, the
proposition,--although Sigault is generally considered to be the first
symphysiotormist, and the procedure is very generally known as the
"Sigaultean operation." From Ferrara's time to 1858, when the operation
had practically died out, it had been performed 85 times, with a
recorded mortality of 33 per cent. In 1866 the Italians, under the
leadership of Morisani of Naples, revived the operation, and in twenty
years had performed it 70 times with a mortality of 24 per cent. Owing
to rigid antiseptic technic, the last 38 of these operations (1886 to
1891) showed a mortality of only 50 per cent, while the
infant-mortality was only 10 2/3 per cent. The modern history of this
operation is quite interesting, and is very completely reviewed by
Hirst and Dorland.
In November, 1893, Hirst reported 212 operations since 1887, with a
maternal mortality of 12.73 per cent and a fetal mortality of 28 per
cent. In his later statistics Morisani gives 55 cases with 2 maternal
deaths and 1 infantile death, while Zweifel reports 14 cases from the
Leipzig clinic with no maternal death and 2 fetal deaths, 1 from
asphyxia and 1 from pneumonia, two days after birth. All the modern
statistics are correspondingly encouraging.
Irwin reports a case in which the firm attachment of the fetal head to
the uterine parietes rendered delivery without artificial aid
impossible, and it was necessary to perform craniotomy. The right
temporal region of the child adhered to the internal surface of the
neck of the uterus, being connected by membranes. The woman was
forty-four years old, and the child was her fourth.
Public-domain text, read in full here on John Shaqi.
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