Operative obstetrics is an essential part of a physician's education. The process of natural birth is merely an incident, but a birth may become eventful and ultimately tragic. Cases demand action in the order of their occurrence, namely: detention from want of maternal power; due to fetal malposition; arising from deformed fetus; by deformed maternal parts. Nature makes an effort to sacrifice upon these occasions the child for the mother, because her preservation is the conservation of the species—following this guide, accoucheurs strive to do this and more; therefore the highest aim of the art of midwifery is to save both, through the application of therapeutic remedies and other means. More Madden questions if we have an emmenagogue in the special sense in which we use it. Recently I had a letter from a Philadelphia physician, stating that brown sugar was an excellent uterine tonic! Upon this question at present
HAMILTON H. THE VALUE OF SYMPHYSIOTOMY. JAMA. 1895;XXV(8):316–318. doi:10.1001/jama.1895.02430340016001e
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