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ON

THE SCIENCE AND PRACTICE

OF

MIDWIFERY.

BY

W. S. PLAYFAIR, M.D., LL.D., F.R.C.P.,

PHYSICIAN-ACCOUCHEUR TO H, I, AND R. H. THE DUCHESS OF EDINBURGH; PROFESSOR OF OBSTETRIC
MEDICINE IN KING'S COLLEGE; PHYSICIAN FOR THE DISEASES OF WOMEN AND CHILDREN TO
KING'S COLLEGE HOSPITAL; CONSULTING PHYSICIAN TO THE GENERAL LYING-IN
HOSPITAL, AND TO THE EVELIXA HOSPITAL FOR CHILDREN ; LATE PRESIDENT
OF THE OBSTETRICAL SOCIETY OF LONDON ; EXAMINER IN MIDWIFERY
TO THE UNIVERSITIES OF CAMBRIDGE AND LONDON AND TO

THE ROYAL COLLEGE OF PHYSICIANS.

SIXTH AMERICAN FROM THE EIGHTH ENGLISH EDITION.

WITH NOTES AND ADDITIONS

BY ROBERT P. HARRIS, A.M., M.D.,

HONORARY FELLOW OF THE AMERICAN GYNÆCOLOGICAL SOCIETY, AND OF THE PHILADELPHIA OBSTETRICAL SOCIETY; CORRESPONDING MEMBER OF THE OBSTETRICAL SOCIETY OF LEIPZIG,

AND OF THE ROYAL MEDICO-CHIRURGICAL ACADEMY, OF NAPLES, ETC.

WITH FIVE PLATES AND TWO HUNDRED AND SEVENTEEN ILLUSTRATIONS.

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Entered according to the Act of Congress, in the year 1993, by

LEA BROTHERS & CO., In the Office of the Librarian of Congress, at Washington. All rights reserved.

DORNAN, PRINTER,

PHILADELPHIA.

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DURING the intervening four years since the last American edition was issued, very decided advances have been made in the field of obstetric surgery, particularly in the adoption of methods that have resulted in the saving of human life. The conservative Cæsarean operation in the most carefully managed European maternities, and even in the general practice in our own country, may be honestly claimed to save 90 per cent. of the women-16 having died out of 160 cases in certain European hospitals, and 2 out of the last 20 in the United States. The Porro-Cæsarean record of all countries now shows a mortality which has been reduced to 14 per cent., as proven by the record of 1890–1891 ; and the sub-peritoneal, replacing the fatal intra-peritoneal method, has saved 22 women out of 25. The introduction of symphyseotomy into our country a year ago, has required us to give a special notice to this operation, now

, so largely performed in Europe, and attracting a growing attention here, because of its possibilities of success. The term laparotomy, and the prefix laparo-, as applied to abdominal surgery, and not to flank-incisions, have been abandoned throughout the volume, and the term coeliotomy, and the prefix cælio-, substituted for them. Craniotomy having fallen in the estimation of American obstetricians, and some of the younger thinkers of Great Britain, because of the diminishing dangers of Cæsarean and symphyseotomic deliveries, the American editor has striven to do away with the leaning of the English author toward a preference for the infantile destructive method, begotten of opinions based upon comparative results which were prevalent, and thought to be well founded, forty years ago. Notes and additions of the American editor are enclosed in brackets [ ]

329 SOUTH TWELFTH STREET, PHILADELPHIA.

September, 1893.

(iii)

59990

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