A manual of obstetrics . radical ope-ration of craniotomy and thereby save the fetal life. Otherindications are persistent mentoposterior positions when thechild is living, occasionally in occipitoposterior positionsand in the presence of small pelvic tumors. Methods ofOperating.—There are two well-recognized methods of per-forming symphysiotomy, known respectively as the Italian,or subcutaneous, and the German, or open, methods. Thelatter consists in making an incision directly over the sym-physis pubis and continuing it down through the line ofcartilaginous union. There are two well-founded
A manual of obstetrics . radical ope-ration of craniotomy and thereby save the fetal life. Otherindications are persistent mentoposterior positions when thechild is living, occasionally in occipitoposterior positionsand in the presence of small pelvic tumors. Methods ofOperating.—There are two well-recognized methods of per-forming symphysiotomy, known respectively as the Italian,or subcutaneous, and the German, or open, methods. Thelatter consists in making an incision directly over the sym-physis pubis and continuing it down through the line ofcartilaginous union. There are two well-founded objectionsto this plan of procedure : in the first place, the great vesselsthat are situated at this point are more exposed to injuryduring the operation; in the second place, the divided jointis exposed directly to contact with the atmosphere and isliable to be soiled with the lochia, thereby favoring thedevelopment of sepsis. By far the better method is thatadopted by the Italians, the steps of which will now be de-. FiG. 150.—Galbiali knife. scribed. Instruments Required.—The Galbiati or Morisaniknife (Fig. 150) (a falcate or sickel-shaped knife especiallydevised for the operation) or a blunt-pointed bistoury; asimple scalpel; two or more hemostatic forceps; a chain-saw(in case osseous union be found); a needle-holder and nee- 558 A MANUAL OF OBSTETRICS. dies; an obstetric forceps ; a metallic catheter; strips of iodo-form-gauze; strips of adhesive plaster; Chinese silk forligatures; antiseptic cotton ; and a strong abdominal Stips of the Operation.— i. The woman is placed in thelithotomy position at the edge of the bed or table. asepsis of the abdominal surface, the pubes, thegenitalia, and the perineum ; the mons veneris must beshaved. The parts should first be scrubbed with soap andwater, and then bathed in boiling water, then in benzine toremove the fat, and, finally, in a i : looo mercuric-chloridsolution. The bladder and bowels must be emp
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
