BIBLIOGRAPHICAL NOTICES.
JI Theoretical and Practical Treatise on Midwifery, including the
Diseases of Pregnancy and Parturition. By P. Cazeaux, Adjunct
Professor in the Faculty of Medicine of Paris, etc. etc., (adopt-
ed by the Royal Council of Public Instruction.) Translated
from the second French edition, with occasional notes and a
copious Index, by Robert P. Thomas, M. D., Member of the
Philadelphia County Medical Society, late Demonstrator of
Anatomy in the Franklin Medical College, etc., with one hun-
dred and seventeen illustrations. 8vo. pp. 765. Philadelphia,
Lindsay and Blakiston, 1850.
Considering the numerous excellent and comprehensive systems
of Midwifery which have appeared in this country within a very
short period, there would seem to be but little necessity for add-
ing another to their number, and yet, the treatise before us comes
to us with recommendations of so high a character as to warrant
the translator and publisher in placing it within the reach of the
great body of the American Medical Profession. Its adoption by
the Royal Council of Public Instruction—the position and charac-
ter of its author as a teacher of obstetrics—his opportunities for
clinical experience, and the fact of the early demand in France
for a second edition, present strong extrinsic recommendations of
the work, which are fully sustained by its intrinsic merits.
Written expressly for “ the use of students of medicine, and
those of midwifery especially,” its teachings are plain and explicit,
presenting “ a condensed summary of the leading principles
established by the masters of the obstetric art,” and such clear
practical directions for the management of the pregnant, partu-
rient, and puerperal states, as have been sanctioned by the most
authoritative practitioners, and confirmed by the author’s own ex-
perience. Collecting his materials from the writings of the entire
body of antecedent writers, carefully testing their correctness and
value by his own daily experience, and rejecting all such as were
falsified by the numerous cases brought under his own immediate
observation, he has formed out of them a body of doctrine, and a
system of practical rules, which he illustrates and enforces in the
clearest and most simple manner possible.
The first two parts of the Treatise present a very full and excel-
lent account of the anatomy of the female organs of generation—
the physiology of generation—the anatomical changes which
occur during the progress of gestation—the diagnosis of pregnancy
—the history of the foetus, and the pathology of gestation. The
reader will find in the second part a very accurate account of the
modern doctrines of ovulation, and an excellent and intelligible
history of the changes which the human ovum undergoes from the
period of fecundation to the termination of utero-gestation. The
changes that take place in the ovary and ovulum, both before and
after fecundation, are illustrated by numerous engravings, ex-
hibiting the successive stages the ovum passes through, from
its primary appearance as a microscopic point, to the forma-
tion of the corpus luteum in the non-fecundated state, and to
the development of the allantois, in that of conception. Every
particular, in fact, connected with the maturation and perfection
of the human ovum, upon which there is a general agreement
among the leading physiologists of the day, has been very clearly
described and pictured by M. Cazeaux.
Part the third is devoted to the history of labor in general, its
causes and phenomena ; the several presentations and positions ;
the management of the parturient and puerperal states, and the atten-
lions required by the mother and child immediately after the termina-
tion of labor. The mechanism of labor is very ably defined; we agree
with the translator, that the doctrines inculcated on this all import-
ant subject by M. Cazeaux are founded in truth. “'The author has
adopted the simple and beautiful classification of M. Naegele, by
which the description of the whole process of delivery is wonderfully
simplified, its comprehension is rendered more intelligible, and the
indications for manual or instrumental aid, in cases of difficulty or
deformity, become more clear and determinate.”
The positions and presentations of the foetus, and the several
stages of labor in each, are illustrated by very excellent wood cuts,
without which the young student would scarcely be able to under-
stand the verbal exposition, however clearly and explicitly given.
The fourth part of the Treatise treats of Dystocia, or preternatural
and painful labors. It consists of two divisions, in the first of which
are considered the causes of dystocia, or the circumstances that
require the intervention of art. The author distributes all difficult
labors into three groups : 1, where they are rendered difficult,
impossible, or dangerous by a deficiency or an excess of action in
the expulsive forces; 2, where any obstacle whatever exists which
might oppose the easy expulsion of the foetus; and 3, where the
labor is complicated by any accident, sufficiently grave to
compromise the health or life of either the mother or child.
The second division of part four treats of obstetrical operations.
An attentive study of this portion of the work is not only recom-
mended to the student of midwifery, but we are persuaded that the
practitioner will derive from it practical precepts of a most valua-
ble character. To know when manual interference is absolutely
necessary, and to resort to it promptly when this decision has been
formed, and to wait patiently in all cases in which there is good reason
for believing that delivery will be safely effected by the powers of
nature, without the necessity of manual or instrumental aid, is the cha-
racteristic of the ’well instructed and judicious obstetrician, and the
rules and precautions laid down by M. Cazeaux, are well calculat-
ed to form this characteristic. While he points out the mischievous
tendency of an unnecessary resort to manual and instrumental
means for terminating the labor, he, at the same time, inculcates
the importance of the early use of those means whenever abso-
lutely required to ensure the safety of the mother or child.
The chapter on the induction of premature labor is deserving of
an attentive perusal.
Part the fifth and last, treats of the delivery of the after-birth.
The principles and practice laid down by the author, are sound
and judicious. They differ, however, in nothing from those adopt-
ed and practiced by every experienced accoucheur.
No notice is taken in the work before us of the use of the re-
cently introduced anaesthetic agents in labor. This is much to be
regretted. It is a subject upon which it is all important that the
student of midwifery should be correctly instructed. Of the
advantages and dangers of the production of anaesthesia in the par-
turient female, he should be clearly informed, as well as of the
results of experience, and the judgment formed of the practice by
the authoritative masters of the obstetric art. We feel somewhat
surprised that the translator has not supplied the omission of the
author in a note or additional chapter.
The translation of Dr. Thomas, so far as we can judge, without
having carefully compared it with the original, is tolerably well
executed; it is occasionally, perhaps, too literal. The style is
plain, and in general, sufficiently clear, though marred by occa-
sional Gallicisms. The notes added by the translator, are few and
unimportant.
In the present notice of the treatise of M. Cazeaux we have
aimed at nothing further than a general expression of our views
of the leading character of the work. In a more minute and criti-
cal examination of its several parts, we should unquestionably be
obliged to dissent occasionally from the author; but not, we admit,
from any leading principle or rule of practice laid down by him.
In the correctness of all the more important of his teachings, we
fully acquiesce, and can very conscientiously recommend the work to
the medical student, as one that will prove to him a safe and valua-
ble guide to a knowledge of obstetrics.
d. f. c.