One of the greatest triumphs of modern surgery is the performance of this dangerous operation four times successively on the same patient. The first operation was performed in June 1826, the woman being then in her twenty-ninth year, the second in January 1830, the third in March 1832, and the fourth on the 27th June, 1836. The second operation was performed by Wiedemann, of Kiel, and scarcely lasted five minutes; nor does it appear that the patient’s sufferings were very great, for the application of sutures on this occasion elicited more complaint than all the operations put together.[100]
History. Although the early records of the Cæsarean operation are not very distinct, still we possess sufficient data to pronounce it of very considerable antiquity. The earliest mention of it shows that it was at first used merely for the purpose of saving the child by extracting it from the womb of its dead mother, a law having been made by Numa Pompilius, the second king of Rome, forbidding the body of any female far advanced in pregnancy to be buried until the operation had been performed.
The mythology of the ancients refers to two cases of an exceedingly remote period where a living child was taken from the dead body of its mother: these were the birth of Bacchus and Æsculapius; but as these traditions are so enveloped in allegory and mystery, it is difficult to come to any other conclusion than a mere inference of the fact: one circumstance, however, connected with the birth of Bacchus is curious, viz. that his mother Semele died in the seventh month of her pregnancy.
The oldest authentic record is the case of Georgius, a celebrated orator born at Leontium in Sicily, B. C. 508. Scipio Africanus, who lived about 200 years later, is said to have been born in a similar manner. There is no reason to suppose that Julius Cæsar was born by this operation, or still less that it derived its name from him, for at the age of thirty, he speaks of his mother Aurelia as being still alive, which is very improbable if she had undergone such a mode of delivery. We would rather prefer the explanation of Professor Naegelé, viz. that one of the Julian family at Rome had been delivered ex cæso matris utero, and had been named Cæsar from this circumstance, so that the name was derived from the operation, not the operation from the name.
“The earliest account of it in any medical work is that in the Chirurgia Guidonis de Cauliaco, published about the middle of the fourteenth century. Here, however, the practise is only spoken of as proper after the death of the mother.” (Cooper’s Surg. Dict.) Among the Jews, however, it appears to have been performed on the living mother at a very early period; a description of it is given in the Mischnejoth, “which is the oldest book of this people, and supposed to have been published 140 years before the birth of our Saviour, or, according to some, even antecedently to this period. In the Talmud of the Jews, also, their next book in point of antiquity, the Cæsarean operation is mentioned in such terms as to render it extremely probable that it was resorted to before the commencement of the Christian era. In the Mischnejoth there is the following passage, ‘In the case of twins, neither the first child which shall be brought into the world by the cut in the abdomen, nor the second, can receive the rights of primogeniture, either as regards the office of priest or succession to property.’ In a publication called the Nidda, an appendix to the Talmud, there is the following remarkable direction: ‘It is not necessary for women to observe the days of purification after the removal of the child through the parietes of the abdomen.’” (Introduction to the Study and Practice of Midwifery, by W. Campbell, M. D. p. 260.)
The first authentic operation upon a living woman in later times was the celebrated one by Jacob Nufer, upon his own wife, in 1500, after which, owing to its fatal character and the strong feeling against it, it was performed but rarely: still, however, sufficient evidence existed to mark its occasional success and urge its repetition in similar cases; and from what we have already stated, the history of the last twenty years shows that its results have rapidly become more and more favourable, so that in the present day it can be no longer looked upon as an operation of such extreme danger and almost certain fatality, as it was in former times.[101]
CHAPTER IV.
ARTIFICIAL PREMATURE LABOUR.