Dr. Ross McPherson (_Provid. Med. Jour._) summarizes his views in the
following conclusions: First. Cesarean section is a very useful
operation for removing the child from a pregnant woman at or near term
in cases: (a) where there is a relative disproportion between the birth
canal and the fetus, sufficiently large to make the birth difficult or
impossible; (b) in cases of serious obstruction due to tumors, or
deformities congential or acquired; (c) a certain number of cases of
placenta previa, convulsive toxemia, or occasionally organic disease.
Second. The operation should not be decided upon except by a person
whose training and experience in pelvic and abdominal examination is
sufficiently large to warrant the acceptance of his judgment. Third. The
operation should not be performed by anyone unless he be a skillful
abdominal surgeon, preferably one who has given particular thought and
attention to this subject. Fourth. A long labor, much handling and
manipulation, especially in the presence of ruptured membranes,
predispose the patient to infection of the peritoneal cavity, and fifth,
therefore, intraperitoneal abdominal Cesarean section should not be
undertaken under those conditions, with one exception, namely when the
religious prejudices of the family demand the saving of the child at the
expense of the mother, and then only in the presence of and with the
advice of a consultant and a clergyman, after carefully explaining the
situation to the family and obtaining their written consent to the
procedure. Sixth. If the above demands and conditions are fulfilled the
maternal mortality should be practically nothing, the morbidity
negligible, the end result perfect, and with the exception of those
cases undertaken solely in the interest of the mother, every child
should be born alive.—_Medical Progress._