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The author favors the transverse incision in the lower uterine segment and states numerous reasons for his preference. For anesthesia he employed ether in about one fourth of his cases (sixty), local infiltration in slightly less than one third (seventy-four) and spinal anesthesia in a little less than one half (112). The author's frequent use of spinal anesthesia is surprising in view of his own statement, which he emphasizes by italicizing, that "any obstetrician who sets out to perform a large series of cesarean sections under spinal anesthesia must be prepared to face a possible mortality of not less than 1 per cent due to this cause alone." The author specifies ways of making spinal anesthesia safer in cesarean section but, even if every precaution is taken, spinal anesthesia is nevertheless more dangerous for obstetric patients than any other anesthetic. Throughout the book there is abundant evidence of the author's
Cæsarean Section: Lower Segment Operation. JAMA. 1940;114(4):351. doi:10.1001/jama.1940.02810040061039