By which a fœtus is extracted from the uterus of the mother through a wound, made for that purpose, in the abdomen. The term Cæsarean, according to some authors, is derived from the operation “cæso matris utero,” while others have supposed that it owes its origin to the fact, recorded by Suidas, of Julius Cæsar having been cut from the womb of his dead mother in the ninth month. Although Hippocrates, Celsus, Paulus, Ægineta, and Albucasis, all treat upon the subject of instrumental labours, not the slightest allusion is made to the cæsarean section. The Chirurgia Guidonis Cauliaci is the first work in which any mention is made of the operation; and this was published about the middle of the fourteenth century, but the author only describes it as a resource to save the child after the death of the mother, as, says he, happened at the birth of Julius Cæsar. Parè also considered the operation as one that ought never to be attempted on the living subject; Rousset, however, his cotemporary, published a work[[454]] in its favour, which becoming popular, was, through the medium of a latin translation by Caspar Bauhine in 1601, quickly circulated throughout Europe; from this period, the cæsarean section acquired a certain degree of vogue, and began to be performed in cases of extreme difficulty, particularly on the continent, where it has not unfrequently proved successful. In this country the operation has been generally fatal: a very extraordinary case[[455]] is, however, stated to have occurred in Ireland, and however incredible the story may appear, says Dr. Merriman,[[456]] there seems no reason to doubt its truth; it is related by Mr. Duncan Stewart, surgeon, in Dungannon, who saw the patient some days after the operation; and the account is confirmed by Dr. Gabriel King of Armagh, who says, that he drew out the needles, which the midwife had left to keep the lips of the wound together. The patient’s name was Alice O’Neil, and the operator was an illiterate midwife, one Mary Dunally; the instrument used was a razor, with which she first cut through the containing parts of the abdomen, and then the uterus. “She held the lips of the wound together with her hand, till some one went a mile and returned with silk and the common needles which tailors use; with these she joined the lips in the manner of the stitch employed ordinarily for the hare-lip, and dressed the wound with whites of eggs.” The woman recovered in twenty-seven days. It has often been an object of inquiry, why this operation[[457]] should have been more successful upon the continent than in this country? the answer to this question is obvious and satisfactory. In this country we have only had recourse to it as an operation of necessity, where we can neither accomplish the delivery by diminishing the bulk of the child, nor by any of the other resources already explained; whereas the practitioners of France, and the other states on the continent of Europe, perform it not only as an operation of necessity, but as one of election, in cases where the mother may confessedly be delivered with safety, by sacrificing the life of the fœtus; it would also appear that in general they have recourse to the operation, before the patient has suffered very much from the continuance of labour. How greatly this circumstance is capable of influencing the success of a surgical operation, we have a satisfactory demonstration in the history of that for Hernia, and in which Mr. Bell[[458]] informs us, the French were formerly more fortunate, because they proceeded more early to the operation than the surgeons of almost any other nation. It deserves notice that the religious tenets of different countries appear to have influenced the popularity of the cæsarean section; it is easy to suppose that in those catholic nations where, a belief exists of the necessity of baptism to secure the eternal happiness of the infant, the mother would become a willing sacrifice to make her offspring a christian.[[459]].
In delivering our opinion upon the propriety of performing the cæsarean section in this kingdom, we should say that there are cases in which it is the bounden duty of the accoucheur to proceed without delay, and such appears to have been that described by Dr. Merriman, of which the pelvis in the museum of Mr. Charles Bell is a sufficient proof; for so extreme is the distortion, that a marble measuring less than one inch in diameter, cannot be made to pass through it in any direction; in this case, and some others of a similar nature, the Cæsarean section was the only means of preserving the child. We are of opinion, however, that the operation ought never to be performed where by Embryulcia the child can be extricated; and although circumstances of inheritance should induce the husband to entertain a feeling like that which animated Henry VIII, the practitioner has but one broad line of duty to observe, to save if possible the mother and child, but where this is impossible, to feel no hesitation in sacrificing the life of the latter. In the event of a woman, near the full time of pregnancy, dying undelivered, the Cæsarean operation ought always to be performed with as little loss of time as possible; since by this measure a chance of preserving the child will be afforded, and Dr. Merriman states that several cases of such an operation, after the death of the mother, have been recorded, with the desired effect of saving the infant.[[460]] Numa Pompilius prohibited the burial of a pregnant woman until the fœtus shall have been extracted.[[461]] We have already stated, upon the authority of Suidas, that to such an interposition Rome owed the life of Julius Cæsar; and it has been maintained that Edward VI was thus taken from his mother after death, while others have endeavoured to render it probable, that the cæsarean operation was performed while she was yet living. How long after the death of the mother the child may survive in utero, is a question which cannot be readily answered; some authors[[462]] mention twenty-four or even forty-eight hours; and in relating this fact, Dr. Merriman adds an accompaniment which we also feel a great inclination to adopt—a note of admiration! In the late Dr. S. H. Jackson’s Cautions to Women (1798) mention is made of a child extracted by the forceps, which was restored to life, though the mother had been dead full half an hour before it was taken from the womb.
It must be admitted, that a child taken from the womb of its mother by the cæsarean section, cannot in philological strictness be said to have been born. The ingenious purpose to which Shakspeare has applied this quibble has no doubt suggested itself to the reader.
App. Macbeth! Macbeth! Macbeth!
* * * * * * *
Be bloody, bold, and resolute: laugh to scorn
The power of man; for none of woman born
Shall harm Macbeth.
Act iv, sc. 1
Macd. * * Despair thy charm;