The Symphyseotomies of the United 
States and of Canada. 
by 
Robert P. Harris, A. M., M. D., 
PHILADELPHIA. 
REPRINTED FROM THE 
American Gynaecological and Obstetrical Journal 
for June, 1895. [Reprinted from the American Gynaecological and Obstetrical Journal 
for June, 1895.] 
THE SYMPHYSEOTOMIES OF THE UNITED STATES AND 
OF CANADA.* 
By Robert P. Harris, A. M., M. D., Philadelphia, 
Honorary Fellow of the American Gynaecological Society. 
It will surprise many to find that symphyseotomy in America dates 
back fifteen years, and that it was performed with entire success in 
Texas in 1880, in which year there were but six operations in the 
world, one third of them proving fatal to the women. Of these six 
cases, only one was operated upon out of Naples, and this was in 
Denison, Texas, under Dr. Joel O. Williams, now a country surgeon 
of William Penn, Washington County, in that State. 
Dr. Williams was at that time in the commencement of his career 
as a physician, and was called upon to deliver a single girl of thirteen, 
the birth of whose child under the circumstances he promised to keep 
a secret. Finding the girl's pelvis small and the foetal head large, and 
failing to deliver with the forceps, it occurred to him that he could gain 
pelvic space by separating the symphysis pubis, which he had seen 
cut through as a matter of curiosity by an associate in a Cincinnati 
dissecting-room. 
Dr. Williams was a student of the Miami College from Kentucky, 
and knew nothing of symphyseotomy, which was not lectured upon ; 
neither did his obstetric text-book mention it as a scheme of delivery 
He had not heard of Sigault or of the revival of his method under Profs. 
Morisani and Novi in Naples. Getting his medical education under 
close economy, he had no advantages other than those afforded by 
the college lectures and the few books he was obliged to purchase. 
His operation, in so far as he was concerned, was an original idea be- 
* Read before the American Gynaecological Society, May 30, 1895 
Copyright, 1895, by J. D. Emmet and A. H. BuckmaSter. 2 
Robert P. Harris, M. D. 
gotten under the necessity of the moment, and was performed with a 
tenotomy knife, which enabled him to deliver a twelve-pound male 
foetus with the forceps under a pubic separation which admitted of his 
forcing in the tissues of the mons veneris with the ends of the fingers. 
As the operator was forced to do his work without assistance, it 
will be of interest to repeat what he wrote in a letter to me more than 
a year ago, in which he described the method adopted. The girl 
being brought under the influence of chloroform and placed partly on 
her left side, " I flexed the right leg strongly upon the thigh, and the 
thigh upon the abdomen, and sat down upon the edge of the bed in 
such a manner as to retain her leg in the above position. My right 
arm and hand were between her two legs ; her right leg was retained 
in a flexed state by my left shoulder and breast, my left arm being 
passed under her right thigh and the hand used to depress the clitoris. 
In my right hand I carried a Tiemann tenotomy knife ; I passed the 
point through the tissue just over the inferior margin of the joint, 
and, directing it upward, carried it in that direction. I then set free 
the clitoris and took hold of the pubic hair, by which I sustained the 
dermal pubic covering from the point of the knife, and after some 
effort discovered that the blade was evidently in the symphysis. I 
then used both hands in directing the knife, so as to prevent any slip 
or awkward cut being made. The bones were separated, and when I 
felt them yield I withdrew the knife and set the legs apart." I think 
the girl may have been conscious when I delivered the child by the 
forceps. 
Dr. Williams is broad shouldered and strongly built, which enabled 
him to hold the girl while he operated ; the women of the household 
absented themselves, being too much frightened to be of any assist- 
ance. It was not intentional that he was without a consultant, as he 
sent for a prominent physician in the night, and the messenger re- 
turned with a report that he was not at home. This was an error, as 
the books of the physician have since shown, and it is now thought 
by Dr. Williams that the messenger gave a false report designedly so 
as to compel him to be alone in the secret. This secret was kept so 
securely for nearly fourteen years that no physician ever heard of the 
case during that period either in Denison or elsewhere. The girl re- 
covered, the boy lived, the mother married and removed, and Dr. 
Williams settled in his present location more than twelve years ago. 
Here in 1884 and in 1889 he performed a second and a third sym- 
physeotomy before any one in America operated. 
I first heard of these operations in February, 1894, and at once The Symphyseotomies of the United States and of Canada. 
3 
took steps to ascertain whether Dr. Williams' statements were to be 
•credited or not. I wrote to physicians in Denison and its vicinity 
and found they knew nothing of his first case, and never having 
heard of it did not hesitate to brand the report as a fabrication and 
its author as entirely unreliable. If I could have furnished them as 
they proposed with the name of the family or the number of their 
house and name of the street, they would no doubt have traced up 
the whole case and the subsequent history of the girl. But this, Dr. 
Williams did not feel in conscience that he had any right to do, so he 
endured their charges rather than fail in his professional obligations 
to his young patient, who he presumed might have married in the 
meantime and become the mother of other children. 
I opened a correspondence with Dr. Williams on February 28, 
1894, which has been kept up to the present time, and on March 2d 
of the same year sent him a blank table for the three cases, which he 
filled up and returned with the points presented at the head of my 
tabular record. 
Finding all of Dr. Williams' statements discredited because of the 
doubts regarding the Denison case, I secured the preparation of affida- 
vits taken before Court, which settled his veracity as to Cases II and 
III, and rendered it highly probable that he had told the truth as to 
the case secretly operated upon in Denison at an earlier period. This 
is the view taken in a letter to me by a prominent physician in Deni- 
son, who expressed his pleasure at finding that the pioneer symphyse- 
otomy of America belonged to the credit of Texas. 
Having proved the performance of operations two and three, the 
next step was to search for and find the subject of the first operation, 
who had not been heard of for several years, although believed to be 
still alive. This search had to be made with much care and tact, so 
as not in any way to make known the early history of the woman. 
After some months, she was traced to a leading city in the far South, 
where she occupied a good social position as a wife and mother. As 
her pelvis had developed with mature years, she was able to give birth 
naturally to several children. The symphyseotomy boy is well grown, 
and was fifteen years old on April 29th ult. 
In the second operation of Dr. Williams, an incision was made at 
' the top of the symphysis, of an inch and a half in length, and the sep- 
aration was effected by carrying a curved probe-pointed bistoury be- 
hind the joint and cutting from within outward. In this case there 
was less pubic separation than in the first, and the foetal head was 
thought somewhat enlarged by hydrocephalus, as shown by the dis- 4 
Robert P. Harris, M. D. 
charge of an extra amount of fluid under perforation. The computa- 
tion of two and three eighth inches for the conju^ata vera must have 
been an error, as the woman delivered herself of a living male foetus 
twenty-six and a half months later. The patient and boy now live in 
northern Georgia, where she gave her affidavit. I have her full-length 
photograph, taken quite recently in Covington, Ga. 
Dr. Williams' third operation was upon a colored woman far ad- 
vanced in Bright's disease, and having a contracted pelvis. The pubic 
bones separated two inches, and the child, strange to say, lived a 
year, although the mother died of uraemia in sixty hours. The 
doctor was assisted by a farmer who had studied medicine a year, 
and then gave it up; he gave an affidavit in Court as to the method 
of delivery. 
It is the height of folly in any one to try to make out Dr. Williams 
a fabricator of his cases. The physicians of Denison doubted his 
veracity ; but after the receipt of numerous letters during fifteen 
months, I have not been able to find the least evidence in vindication 
of their estimate of his character. Certainly the account of his opera- 
tion in their city reads very little like a romance. Dr. Williams lived 
a few years in Denison, where he was not thought a surgeon ; but the 
spirit of surgery was in him, and it has developed to a marked degree 
in the last eight years. He is an original thinker, and has nerve and 
humanity enough for his work : but shows no anxiety for notoriety, 
and has not reported some of his most creditable works. I have not 
been able to find in him the least tendency to departure from the 
truth, or to distortion of facts ; and to question his veracity is an 
insult to his sense of honor. He is ambitious, but it is in the line of 
professional improvement, and had he the means, would put himself 
in a position to perfect his knowledge by observation and study. 
Although Dr. Williams, who bears a good name in his section of 
Texas, was undoubtedly the first to perform a symphyseotomy in 
America, his having done so was not known to others until after it 
had been performed forty times by other men, with a saving of thirty- 
one children and thirty-five women. Thirty-one operators in ten 
States had reported their cases before Dr. Williams felt that he was 
at liberty to reveal the particulars of his own secreted work. He 
therefore had nothing to do with the introduction of the operation* 
and commending it to his medical brethren. The operation was com- 
mended and described to the fellows of this Society on September 20, 
1892, and in seventeen days, as opportunity favored, there were three 
women delivered under it, and this number increased to seven with- The Symphyseotomies of the United States and of Canada. 
5 
out a maternal death in the next three months, although two children 
died within three days after birth. These seven bore fruit in the 
multiplication of cases in 1893, when thirty-one operations took place, 
making the United States the second in point of numbers for that 
year, as compared with the countries of Europe, the lead being that 
of Germany, which had six cases more. These thirty-one symphyse- 
otomies lost five women and eight children, a proportion that was 
somewhat discouraging to its advocates, and gave, an excuse for the 
opposition of others, who were not convinced of its thorough prac- 
ticability. Since the close of 1893 there have been thirty-three 
operations, with a mortality of four women and eight children. The 
operation is still in its infancy in America, and much has yet to be 
learned, and much more care taken, before the mortality can be re- 
duced to the low percentage of Italy for the last nine years. 
General Summary of the Cases in the United States.-We have had 
seventy-four symphyseotomies in fifteen years, and seventy-one in two 
years and seven months. There were ten prior to January 1, 1893 ; 
thirty-one in the year 1893 ; twenty-six in 1894; and seven thus far 
in 1895. The seventy-four operations were the work of forty-four 
operators, and fifteen of them are fellows of this Society. These 
fifteen operated thirty-seven times, and lost four women and nine 
children. Of the seventy-four women ten died, and of the children 
eighteen were lost. The cases were distributed throughout the United 
States as follows: 
States. 
Cases. 
Women 
died. 
Children 
lost. 
Pennsylvania 
24 
24 
9 
3 
2 
4 
2 
6 
New York 
4 
I 
Illinois 
2 
Texas 
I 
I 
California 
I 
Massachusetts 
2 
I 
Washington 
2 
I 
New Jersey 
2 
I 
Louisiana 
Maryland 
I 
1 
I 
Maine 
I 
Ohio 
I 
Oregon 
I 
District of Columbia 
I 
74 
IO 
18 6 
Robert P. Harris, M. D. 
Causes of Death in the Ten Fatal Cases.-The numbers given refer 
to the tabular record, in which the causes are not stated. By asso- 
ciating them together, the causes can be better considered and 
avoided. 
Case III.-Death unavoidable. Subject far advanced in Bright's 
disease, with kidney action suspended. Death from uraemia in sixty 
hours. Child lived a year. 
Case XII.-Woman believed to be beyond hope ; child still alive,, 
and brow presenting. Opening the symphysis permitted version by 
the vertex. Woman and child unskillfully treated before removal to 
the hospital : both died in a few hours. 
Case XVII.-Patient believed to have been infected with sepsis 
through uncleanly obstetric management prior to the operation ; she 
died of septic peritonitis on the eleventh day. 
Case XIX was intemperate, and is believed to have caught cold 
on her way to the Maternity when in labor, and exposed to cold and 
dampness. She died of double pneumonia in seventy-two hours.. 
Two accoucheurs in charge said there were no septic symptoms. 
Case XXIX.-A multipara of forty-two; was three days in labor 
before going to the Maternity. She died of direct sepsis from the 
wound behind the symphysis on the eleventh day. 
Case XXXIX was a multipara of forty-three ; in labor thirty-six 
hours, and in bad condition when she entered the hospital. Her 
vagina was badly torn and oedematous from attempts to deliver before 
going to the hospital. She had a pulse of 140, and temperature of 
1020. Death occurred in twelve hours from shock ; she was also 
septic. 
Case XLIV.-Subject an undeveloped girl of fourteen, living in 
extreme poverty ; was in labor twenty-eight hours, and twenty-two 
of them under the care of a young physician. She died of septic 
peritonitis in five days. Child believed to have died under forceps 
pressure. Hygienic surroundings very bad. 
Case LVI.-Subject was a fat colored multipara believed to weigh 
two hundred and thirty pounds. She was in labor sixty hours ; had a 
small pelvis and a very large foetus. Vigorous and prolonged attempts 
were made to deliver by the forceps before the operation, fractur- 
ing, as was afterward found, the os frontis and os occipitis of the 
foetus. Operation by direct incision through three inches of fat. 
Wound healed by first intention ; but injuries to the vagina by the 
forceps resulted in gangrene, of which the woman died on the fifth 
day. The Symphyseotomies of the United States and of Canada. 
7 
Case LXX was in labor at intervals for a week ; but was in a 
" fairly good condition " when operated on. She died of septic peri- 
tonitis on the fourth day, which was attributed to infection through 
an opening in the anterior vaginal wall. 
Case LXXIV was a primipara of nineteen ; in labor nineteen 
hours, and in good condition when operated upon. She had a rha- 
chitic pelvis, and was delivered by the forceps. Her death was due 
to septic peritonitis and was said to be a radiation " from the pre- 
vesical space." She died on the seventh day. 
Cases XII, XIX, XXIX, XXXIX, LXX, and LXXIV died in 
hospital; and Cases III, XVII, XLIV, and LVI in private practice. 
In Cases III, XII, XXXIX, and LVI the prognosis was very un- 
favorable at the commencement of the operation. In only two cases 
was the condition of the patient a favorable one for symphyseotomy. 
The mortality of the children is one of the drawbacks to sym- 
physeotomy, and with proper care might be much reduced, as it has 
been, by long experience and thoughtful management in Italy. As it 
is a substitute for craniotomy, the life of the foetus should be regarded 
as one of primary importance. The Caesarean operation in our coun- 
try has been very disheartening in its results. It is less fatal to the 
children than symphyseotomy, but far more fatal to the mothers. 
There are Maternities in Europe, like those of Leipsic and Dresden, 
where the Caesarean section has a very low percentage of death-so 
much so that it is preferred by certain obstetric surgeons to sym- 
physeotomy. Operators like Zweifel regard both means of delivery 
with favor, having had good success with each. The danger in sym- 
physeotomy does not lie so much in the pubic section as in injuries 
produced by the forcible delivery of the foetus under forceps of un- 
safe form and adaptation. If the foetus is known to be dead before 
the operation, the case is an exceptional one, where the delivery 
should be by symphyseotomy. Of the eighteen children lost in the 
United States, four were already dead before the operation ; two were 
destroyed by craniotomy in preparation for delivery, having hydro- 
cephalus; four died in delivery, two by version, the head being too 
large for the pelvis, and two by forceps pressure ; six died on the 
first day after delivery, some from forceps injury ; and one died on 
the third day. 
The weight of the American foetus is to be considered in calculating 
the minimum conjugata vera for our operations, and this should not 
be less than seven centimetres, or two and three quarter inches, be- 
cause, by a careful calculation, forty-four male foetuses delivered under 8 
Robert P. Harris, M. D. 
symphyseotomy weighed an average of eight pounds three ounces, and 
twenty-five females eight pounds one ounce. The Italian minimum of 
sixty-seven millimetres is too small for the average American baby's 
head. The biparietal measurements of many that have been deliv- 
ered show this : viz., three and three quarter inches in eleven cases, four 
inches in seven, four and an eighth inches in three, four and a quarter 
inches in four, four and three sixteenths inches in one, and four and 
five sixteenths inches in one. The largest foetus weighed fifteen and a 
half pounds, and was brought through a conjugate of four inches by a 
pubic separation of four inches ; the urethra and bladder were lacera- 
ted and were repaired by suturing. The boy was lost in eight days by 
a diarrhoea produced by improper feeding (see Case XXXII of table). 
The separation of the pubic bones has shown a variation of from one 
inch to as great as five inches, the ordinary measure being about two 
inches. The five-inch separation occurred in Case LV, under the 
care of Prof. Henry J. Garrigues, of New York, who says that it re- 
sulted "by the mere weight of the legs, without manual separation." 
The patient had a soft tumor apparently in the recto-vaginal wall, and 
a foetus of ten and three quarter pounds. Three and a half months 
after the operation, she had a waddling gait, a cystocele, and some- 
times pains in the sacro-iliac and pubic symphyses. The symphysis 
pubis was firm. She was cured by a vaginal hysterectomy and double 
oophorectomy. A separation of two inches, or even three inches, is 
quite compatible with a perfect convalescence and recovery. There 
is no occasion to suture the bones in the Italian method, as they can 
be held securely together by bandages and adhesive strips. The 
dressing for fixation should be unchanged at first, as removing the 
restraint upon the parts favors the production of a mobile union. 
Treat the joint as a fracture, and let it be kept as still as possible 
during the first two weeks. 
The Delivery of the Foetus after Incision.-To permit a woman to 
deliver herself, as was formerly done in Naples in about one case 
out of four, has not been the practice in the United States in head 
presentations, except in two instances. Fifty-four foetuses were deliv- 
ered by the forceps, and in eighteen cases podalic version was em- 
ployed ; one breech case was delivered by the feet. Of thirty-four 
primiparae, twenty-four were delivered by the forceps, nine by version, 
and one by manual aid. Of the children of primiparae, three were 
dead before the operation, two more were destroyed by craniotomy, 
two died under delivery by podalic version, one under the forceps, 
three died on the first day, and one on the third. Of the forty women The Symphyseotomies of the United States and of Canada. 
9 
who had borne previously from one child to eleven, two were deliv- 
ered of children already dead, two children died by forceps injuries, 
one in delivery, one in six hours, and two died shortly after delivery. 
The After-history of Symphyseotomy Cases.-Under the suprapubic 
section of Morisani, where the tissues covering the symphysis are not 
incised, as in the French operation, and where stitching can not be 
employed to keep the bones in apposition, women have, as a rule, 
made good and rapid recoveries under a proper pelvic fixation. This 
has been the experience of Neapolitan operators expressed to me in 
writing, and they have had occasion to operate upon quite a number 
of women for a second time. Two women now living in Philadelphia, 
have been the subjects of two operations each, and their convales- 
cence certainly recommends the operation. The records of symphys- 
eotomy of recent years, have set aside the old objection to it, of 
severe injury done to the sacro-iliac synchondroses. This objection 
was very tenable in the days of Galbiati, of Naples, but the cases of 
this form of injury must be very rare now, in properly conducted 
operations. Opening the symphysis to the extent of three inches has 
been done with impunity in Naples and elsewhere, so far as these 
joints are concerned. But this is not the chief element of danger ; 
neitl er is the claim that the symphysis pubis will not unite firmly, or 
may be a long time in doing so. The danger lies in the effect that is 
produced upon the urethra, vagina, and uterus, in the delivery of the 
foetus by the forceps, and the forcing open of the symphysis by the 
passage of its head under traction. The danger of sepsis lies in the 
torn or injured parts, and these must be at once repaired if it is to be 
prevented. Sepsis originating in the parts behind the symphysis may 
be avoided by packing with a tent of iodoform gauze, if there is 
bleeding, or by a drainage tent simply, if not. There is a very serious 
connection between the length of labor, prior attempts at delivery, 
and the fatal issue of a given case. Sepsis may be already established, 
and the condition of the woman made very critical before the knife is 
used. We admit that the true place for a symphyseotomy is in a 
well-conducted Maternity ; but for success, the woman must enter 
before anything has been done, or better still, before labor. Emer- 
gency cases received in hospital have added three to their quota of 
deaths. Thirty-eight women were operated upon in private practice, 
and thirty-six in hospital, in the United States. Four women died in 
private practice, and six in hospital. Three children were already 
dead in the private cases, and two in the hospital. Six'children 
were lost in the private cases, and seven in the hospital. These are 10 
Robert P. Harris, M. D. 
the facts, but they do not make a fair comparison for the Maternity 
results, especially as regards the deaths of the women. 
The Lameness of Patients following Symphyseotomy.-Objectors to 
this operation make a great deal of capital out of a few cases of ununited 
symphyses. As there are cases of ununited fracture of long bones, so 
there will be exceptional ones of ununited symphyses, and an ambling 
gait, or even an inability to walk. I have not met with a case, but 
have heard of such, through correspondence. Sometimes there has 
formed an abscess, and been an exfoliation of a little piece of bone, 
or of a cartilage. Sometimes the bones have united, so as to admit 
of a perceptible mobility, but without lameness. One such woman 
had an alternate motion upward and downward of three eighths of an 
inch, and gave birth to a second foetus without an operation ; she 
had a confugata vera of three inches. The worst case known to me 
was in a syphilitic woman, and took six months to recover. The pro- 
portion of cases is very small, and may be made still less by a proper 
after-treatment. 
As lacerations of the cervix uteri, the vagina, urethra and peri- 
nseum are some of the consequences of forcible delivery of the foetus 
after pubic section in primiparae, the form of instrument and its mode 
of application are important. The axis-traction forceps as originally 
devised by Tarnier, with its Davis blades, oval fenestrae, and beveled 
edges, was an innocent instrument compared to many of its modifica- 
tions, having the older kite shaped fenestrae. If the Davis blade is 
applied over the parietal protuberances, it will occupy but little 
space, and should not of itself injure either child or mother. If there 
is too great a disproportion between the foetal head and pelvis, the 
soft parts may be injured by the head itself. The capabilities of the 
forceps for doing injury appear to have been demonstrated to such a 
degree in Vienna as to have reacted against symphyseotomy, and in 
favor of the Caesarean section. The form of forceps in use in the 
Krankenhaus must be largely at fault. Our own operators should 
be particularly cautious, in view of the fact that American women 
produce larger foetuses on the average than European women do. 
My paper will hardly be complete without a statement concerning 
the extension and increase of symphyseotomy throughout the world. 
In 1891, the operation was entirely confined to Naples, which in that 
year had twelve cases, saving all the women and ten children. In 
1892, it increased more than seven times, and was performed in twelve 
countries besides Italy. One death in eight and a half cases in 1892, 
and one in eight and two ninths cases in 1893. The Symphyseotomies of the United States and of Canada. 
11 
Symphyseotomies of 1892. 
Symphyseotomies of 1893. 
COUNTRIES. 
Cases. 
Women 
died. 
Children 
lost. 
COUNTRIES. 
Cases. 
Women 
died. 
Children 
lost. 
France 
37 
12 
11 
7 
7 
4 
1 
1 
1 
1 
1 
1 
1 
85 
6 
2 
1 
1 
10 
13 
4 
1 
2 
2 
1 
1 
24 
Germany 
37 
31 
3° 
24 
IO 
5 
2 
2 
1 
1 
1 
1 
1 
1 
1 
148 
I 
5 
7 
4 
1 
18 
to 
SO Ui M 
Germany 
United States.... 
Austria 
France 
Italy 
United States 
Austria 
Russia 
Russia 
Italy 
Holland 
Belgium 
Brazil 
Canada 
Switzerland 
Sweden 
Denmark 
Ireland 
Switzerland 
Roumania 
Canada 
England 
India 
Holland 
13 countries.... 
Brazil 
India 
15 countries. .. 
The record of 1892 is believed to be very complete, as there has 
been time to collect the cases, and five statisticians worked upon it in 
correspondence in different countries. The table of 1893 is mainly 
due to the persevering labors of Dr. Franz Ludwig Neugebauer, of 
Warsaw, the most celebrated of all European statisticians. I have 
extended his list by an addition of American cases. 
The average mortality under symphyseotomy is frequently in- 
quired for, and has been conjecturally stated at ten per cent. ; but 
this is not correct, as these tables will show. Under the operators of 
Naples, Pinard of Paris, and Zweifel of Leipsic, the death-rate has 
been much lower than this. In Italy, from January 1, 1886, to Janu- 
ary 1, 1894, there were fifty-three operations, with a loss of two women 
and eight children. In the clinique Baudelocque, of Paris, there 
have been four women lost out of forty-eight ; and in Germany, in 
1893, the mortality (one in thirty-seven) was but two and three quar- 
ters per cent. These are the possibilities of the operation; but the 
general mortality in all countries, taken collectively, is thirty-four in 
three hundred and three, or over eleven per cent. The record of the 
United States and Canada of ten deaths in seventy-nine is over 
twelve per cent. The record of this country has been taken very 
thoroughly, as the fullness of the points in the table will bear witness ; 12 
Robert P. Harris, M. D. 
and a very large proportion of the cases have been obtained or per- 
fected by correspondence. Records have been secured that would 
never have been published, and the high rate of mortality is in a meas- 
ure due to the search having been made without any desire to show 
other than the exact results, whether favorable or fatal, and a much 
more persevering hunt has been made for those cases which operators 
are not at all anxious to report in journals. After the character of the 
search made for American symphyseotomies, I am a little skeptical as 
to the thoroughness of the reports issued in European countries. 
What is wanted is a persevering local search made by a citizen of 
each country where any given operation is being performed, and then 
an intercommunication of the several parties engaged. This was 
done for the record of 1892. 
Canada is to be commended for her progressive spirit, and con- 
gratulated upon her success ; the operation of Dr. Springle followed, 
as the sixth, after the reading of my paper in Brooklyn. The union 
of the worrfan's symphysis gave him some anxiety, as the new inter- 
vening tissue admitted of a mobility of three eighths of an inch when 
alternately standing on one foot; but did not materially affect her 
locomotion. Such a result is uncommon where the pelvis is well 
secured and the patient obedient to the orders to keep still. The 
first woman operated upon in Philadelphia went back to Germany 
with her baby in two months. Her case was the first one reported in 
the United States, and at the time of the operation was thought to be 
the first in the country. Prof. Hirst has now operated six times with- 
out a maternal death, four of the cases being in two maternities and 
two in private practice ; his first case was reported in twelve days 
after he operated, and had much to do with the introduction of the 
method. Prof. Charles Jewett antedated him in his operation by four 
days, and stood at the head of the American list as a symphyseoto- 
mist until Dr. Williams reported his three cases. Dr. Coggin was also 
a claimant for priority ; but is no longer credited as an operator either 
in Alabama or Georgia, where he has been located. Personal state- 
ments from Athens have decided me to erase his name. This is the 
second report that I have felt obliged to drop from my tabular record 
for want of positive evidence as to credibility ; there is no reason to 
discredit any one of the remaining seventy-four. 
The Present Status of Symphyseotomy.-This mode of delivery is 
unquestionably now an established one in a number of countries, and 
has met with decided favor in some parts of the United States. Its 
chief centers are Paris, Leipsic, New York, and Philadelphia. It was The Symphyseotomies of the United States and of Canada. 
13 
never very largely performed in Naples, ranging from six to twelve 
times a year, and has recently fallen off quite perceptibly. It has 
never become a favorite in Milan or Florence, although pelvic defor- 
mities overcome by craniotomy are quite common, and in former days 
led to many Caesarean sections, particularly in Milan, which were 
almost uniformly fatal. There appears to be a feeling of rivalry 
against the operation that has given so much credit to Morisani and 
in favor of that which bears the name of Porro, of Pavian fame. 
There have been twenty-three symphyseotomies performed in Phila- 
delphia and twenty-one in New York city, with four deaths in the for- 
mer and two in the latter. Five children were lost in Philadelphia 
and three in New York. The surgery of symphyseotomy has much 
less to do with the death of the woman than the obstetrical manipula- 
tions that precede and follow it. This has certainly been the experi- 
ence of our country, as shown by Cases XII, XVII, XXXIX, and 
LVI. 14 
Robert P. Harris, M. D. 
Symphyseotomies 
of the 
d 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age. 
>■ of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
I 
Apr. 
29, 
1880. 
Dr. Joel 
0. Wil- 
liams. 
Denison, 
Tex. 
Private. 
13 
I 
Transversely 
cont. pelvis. 
18 hrs. 
? 
2 
July 
15, 
1884. 
Do. 
William 
Penn, 
Wash. 
County. 
u 
23 
I 
Cont. pelvis. 
18 hrs. 
3 
May 
5, 
1889. 
Do. 
William 
Penn, 
Tex. 
18 
I 
Cont. pelvis 
and uraemic 
convulsions. 
4 days. 
Trans. 
3 in. 
4 
Sept. 
3°, 
1892. 
Prof. 
Chas. 
Jewett. 
Brook- 
lyn. 
« 
22 
I 
Narrow in- 
ferior strait. 
21 
hrs. 
Bis-is- 
chiat. 
' 2% in. 
5 
Oct. 
3, 
1892. 
Prof. 
Barton 
Cooke 
Hirst. 
Philadel- 
phia. 
Mat. of 
Univ, of Pa. 
19 
I 
Cont. pelvis. 
48 
C. V. 
3 in- 
6 
Oct. 
7, 
1892. 
Prof. 
Anna E. 
Broom- 
all. 
« 
Mat. of 
Woman's 
Hosp. 
30 
7 
24 
« 
3'4 in. 
7 
Oct. 
25, 
1892. 
Prof. J. 
Edwin 
Michael. 
Balti- 
more. 
Free Hosp, 
for Women. 
'7 
1 
Narrow in- 
ferior strait- 
rachitic. 
24 
u 
C. D. 
3% in. 
8 
Dec. 
5, 
1892. 
Dr. Chas. 
P. Noble. 
Philadel- 
phia. 
Kensington 
Hosp, for 
Women. 
3° 
5 
Cont. pelvis. 
11 
a 
C. V. 
23/4 in. The Symphyseotomies of the United States and of Canada. 
15 
United States of America. 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
1 Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
R.O. A.| 
Forceps 
R.ecov. 
Lived. 
M. 
12 lb. 
? 
Communicated by the 
operator in 1894. (Wo- 
man and boy alive and 
well in 1895.) 
L. 0. A. 
a 
a 
Dead ; 
crani- 
otomy. 
M. 
? 
? 
Com. by the operator in 
1894. (Woman alive and 
well in 1894.) 
Vertex. 
G 
Died 
in 60 
hours. 
Lived. 
M. 
8 lb. 
3% in. 
Com. by the operator in 
1894. Med. News, Phila., 
Jan. 26, 1895, p. 107. 
a 
Manual. 
Died 
in 24 
hours. 
M. 
37» in- 
N.Y. Jour. Gynaecol, and 
Obstet., Nov., 1892, pp. 
1079-1082. 
u 
Forceps 
a 
Lived. 
F. 
68/IO lb. 
37-in. 
Med. News, Phila., Oct. 
i5, *892, pp. 431-433. 
Trans. Coll, of Phys., 
Phila., 1893, p. 237. 
a 
a 
g 
F. 
6'/t lb. 
33/4 in- 
Am. Jour. Obstet., 1893, 
xxviii, pp. 303-312. 
u 
ll 
a 
Died on 
3d day. 
M 
67, lb 
4 in. 
Maryland Medical Jour- 
nal, January 31, 1893, 
p. 268. Com. of Nov. 5, 
1892. 
u 
Version 
and 
forceps 
G 
Lived. 
M 
87s lb 
3% in 
Medical News, Philadel- 
phia, Feb. 18, 1893, pp. 
176-181. Trans. Coll, 
of Phys., Phila., 1893, 
pp. 56-60. 16 
Robert P. Harris, M. D. 
d 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age- 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
9 
Dec. 
16, 
1892. 
Dr. Har- 
ry Mc- 
Kennan. 
Paris, 
Ill. 
Private. 
31 
3 
Rachitic 
pelvis. 
12 hrs. 
23/4 in. 
IO 
Dec. 
3°' 
1892. 
Prof. 
H. J.Gar- 
rigues. 
New 
York. 
H 
2 | 
2 
Gen. cont. 
pelvis, male 
type. 
38 " 
374 in. 
11 
Jan. 
1893. 
Prof. J. 
Milton 
Duff. 
Pitts- 
burg. 
u 
44 
11 
Exostosis 
from injury 
of pelvis. 
48 11 
3^4 in. 
12 
Jan. 
9> 
1893- 
Prof. 
Wm. T. 
Lusk. 
New 
York. 
Emergency 
Hosp., 
Bellevue. 
■' 
1 
Small pelvis; 
brow present- 
ing ; large 
head. 
25 " 
About 
4 in. 
U 
Jan. 
I3» 
1893. 
Dr. Wol- 
rad Win- 
terberg. 
San 
Fran- 
cisco. 
Private. 
28 
1 
Funnel- 
shaped pelvis. 
24 " 
Trans, 
inf. 
37- in. 
14 
Feb. 
5, 
1893. 
Dr. H'y 
C. Coe. 
New 
York. 
N. Y. Mat. 
Hosp. 
3° 
1 
Simple flat- 
tened pelvis. 
14 " 
C. V. 
3 in. 
15 
Feb. 
11, 
1893. 
Dr. Eg- 
bert H. 
Grandin. 
u 
Infant 
Asylum. 
19 
1 
Gen. cont. 
pelvis. 
14 * 
374 in. 
l6 
Feb. 
20, 
1893- 
Do. 
u 
20 
1 
a 
7 
374 in. 
17 
Mar. 
1, 
1893- 
Dr. Geo. 
N. 
Kreider. 
Spring- 
field, 
Ill. 
Private. 
26 
1 
Small pelvis 
and large 
head. 
16 " 
About 
3 in. 
l8 
Mar. 
3, 
1893 
Dr. Ho- 
ratio R. 
Holmes. 
Port- 
land, 
Ore. 
a 
23 
1 
Cont. pelvis. 
60 w 
3 in. The Symphyseotomies of the United States and of Canada. 
17 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
' Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Left ■ 
arm. 
Version 
and 
forceps. 
Lived. 
F. 
8 lb. 
Aver- 
age. 
Med. News, Phila., Feb. 
4, 1893, p. 130. (Sym- 
physis divided by a. 
metacarpal saw.) 
Vertex. 
Version 
a 
M. 
77* lb. 
4 in. 
Am. Jour. Med. Sci.,, 
Mar., 1893, pp. 286-298; 
April, 1893, pp. 399-417. 
u 
a 
a 
M. 
9 lb. 
3 oz- 
37x in. 
Com. by the operator,. 
Feb., 1893. 
Brow. 
Version 
by vert, 
and 
forceps. 
Died 
in 12 
hours. 
Died 
in 17 
hours. 
M. 
9 lb. 
47s in- 
Com. by the operator,, 
Mar. 3, 1893. Am. Jour, 
of Med. Sci., April, 1893, 
P- 44i- 
L. 0. A. 
Forceps 
Recov. 
Lived. 
M. 
Est. 
9 lb. 
? 
Med. News, Phila., Jan. 
12, 1895, PP- 29-35. 
Com. of the operator. 
Vertex. 
Version 
a 
u 
F. 
8 lb. 
17a OZ. 
474 in. 
Com. by the operator, 
Mar. 27, 1893. N. Y. 
Med. Rec., 1893, xliii,. 
p. 485. 
. u 
Forceps 
a 
u 
M. 
7 lb. 
I OZ. 
3% in- 
Com. by the operator, N. 
Y. Jour. Gynaecol, and 
Obstet., 1893, iii, pp. 
461-465. 
u 
Version 
u 
a 
F- 
5 1b. 
6 oz. 
37s in- 
Op. cit. Am. Jour. Med. 
Sci., May, 1893, pp. 518- 
520. 
u 
Forceps 
Died 
on 
nth 
day. 
Dead 
before 
opera- 
tion. 
M. 
8 lb. 
? 
Com. by the operator, 
Mar. 19, 1893. Trans. 
Ill. Med. Soc., 1893, 
xliii, pp. 267-276. 
u 
u 
Recov 
Lived. 
F. 
77® lb- 
3m in. 
N. Y. Jour. Gynaecol. 
and Obstet., May, 1893, 
pp. 405, 406. Com. of 
June, 1893. 18 
Robert P. Harris, M. D. 
6 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age. 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
, C. V. 
; diame- 
ter. 
*9 
Mar. 
8, 
1893. 
Dr. Ed- 
ward P. 
Davis. 
Philadel- 
phia. 
Mat. of Jef- 
ferson Col- 
lege. 
3° 
4 
Flat, rachitic 
pelvis. 
20 hrs. 
3% in. 
20 
Mar. 
22, 
1893. 
Prof. 
Anna E. 
Broom- 
all. 
a 
West Phila. 
House for 
Women. 
25 
2 
Cont. pelvis. 
50 hrs. 
3% in- 
21 
Mar. 
24, 
1893. 
Dr. J. 
Clifton 
Edgar. 
New 
York. 
Private. 
24 
I 
« « 
48 hrs. 
3?4 in. 
22 
Mar. 
1893. 
Dr. 
Horace 
Packard. 
Boston. 
Mass. Ho- 
moeopathic 
Hosp. 
28 
I 
Small pelvis. 
48 hrs. 
2% in. 
23 
Apr. 
22, 
1893. 
Dr. 
Daniel 
Longa- 
ker. 
Philadel- 
phia. 
Private. 
(1st opera- 
tion). 
3° 
4 
Flat pelvis. 
10 hrs. 
3 in. 
24 
May 
3, 
1893. 
Prof. 
Henry 
Parker 
New- 
man. 
Chicago. 
Private. 
29 
2 
Gen. cont. 
pelvis. 
24 hrs. 
3% in. 
2 5 
May 
4, 
1893. 
Dr. 
Julius 0. 
Cobb. 
Port 
Town- 
send, 
Wash. 
cc 
28 
I 
Equally cont. 
pelvis. 
21 hrs. 
? 
26 
May 
8, 
1893. 
Dr. E. 
Gustav 
Zinke. 
Cincin- 
nati. 
u 
3 2 
6 
Flat pelvis. 
72 hrs. 
33A in. 
27 
June 
i3, 
1893. 
Dr. Rob- 
ert L. 
Dickin- 
son. 
Brook- 
lyn. 
Flatbush 
Hosp. 
26 
2 
Flat and gen. 
cont. pelvis. 
12 hrs 
3^ in. The Symphyseotomies of the United States and of Canada. 
19 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Vertex. 
Forceps 
Died 
in 
72 hrs. 
Lived. 
F. 
7s/. lb. 
3% in. 
N. Y. Med. Rec., May 
i893, PP- 577, 578- 
44 
44 
Recov. 
Dead 
before 
opera- 
tion. 
F. 
87. lb. 
4 in. 
Am. Jour. Obstet., 1893, 
xxviii, pp. 303-312. 
44 
44 
44 
Lived. 
M. 
7 lb. 
3'4 in. 
Com. by the operator. 
N. Y. Medical Journal, 
vol. lix, Mar. 17, 1894, 
P- 343- 
44 
<4 
44 
Dead 
before 
opera- 
tion. 
M. 
9 lb. 
3% in. 
Com. of May 10, 1893. 
Daily Med. Cent., May 
20, 1893, pp. 7, 8. 
Shoul- 
der. 
Version 
by ver- 
tex and 
forceps. 
44 
Lived. 
M. 
7 lb. 
3'4 in. 
Com. by the operator, 
May 3, 1893. Annals of 
Gynaecol, and Paed., 
Phila., 1893-94, vii, p. 
45°- 
Vertex. 
Forceps 
44 
44 
F. 
12 lb. 
4 in. 
/ 
Com. by the operator, 
Jan. 1, 1894. Am. Jour. 
Obstet., Feb., 1894, pp. 
250, 251. 
44 
44 
44 
Died 
soon 
after- 
ward. 
M. 
9'4 lb. 
? 
N. Y. Med. Jour., Aug. 
26, 1893, p. 226. Com. 
of Dr. J. C. House, Nov. 
22, 1893. 
44 
44 
44 
Lived. 
M. 
9 lb. 
37- in. 
Com. by the operator, 
May 29, 1893. Am. 
Jour. Obstet., 1893, 
xxviii, pp. 588, 589. 
4 
44 
44 
44 
M. 
7% lb. 
4 in. 
Com. by the operator, 
June 14, 1893. Med. 
Rec., New York, 1893, 
xliv, pp. 679-681. 20 
Robert P. Harris, M. D. 
d 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age. 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor 
C. V. 
diame- 
ter. 
28 
June 
23, 
1893. 
Prof. 
Robert 
A. 
Murray. 
New 
York. 
N. Y. Mat. 
Hosp. 
36 
4 
Small pelvis, 
with impac- 
tion. 
6 hrs. 
3% in- 
29 
June 
26, 
I^93- 
Prof. 
Anna E. 
Broom- 
all. 
Philadel- 
phia. 
Mat. of 
Woman's 
Hosp. 
42 
I 2 
Flat pelvis. 
3 days. 
3% in. 
30 
June 
27, 
1893. 
Prof. 
Barton 
Cooke 
Hirst. 
a 
Philadel- 
phia Hosp. 
32 
I 
Rachitic 
pelvis; dwarf, 
4 ft. 6 in. 
In- 
duced. 
23/4 in. 
31 
July 
21, 
*893 
Dr. Cae- 
sar A. 
von 
Ram- 
dohr. 
New 
York. 
Private. 
23 
2 
Justo-minor 
pelvis. 
5 
3% in- 
32 
Aug. 
28, 
1893. 
Dr. John 
Wother- 
spoon. 
Seattle, 
Wash. 
4* 
19 
2 
Disproportion 
between size 
of head and 
outlet. 
10 hrs. 
4 in. 
33 
Sept, 
b 
1893. 
Prof. 
Sheldon 
Leavitt. 
Chicago. 
U 
30 
3 
Equally cont. 
pelvis. 
24 hrs. 
3 in. 
34 
Sept. 
8, 
1893. 
Dr. 
James S. 
Brown. 
Mont- 
clair, 
N. J. 
25 
2 
Cont. pelvis. 
20 hrs. 
2'4 in. 
35 
Oct. 
1 2, 
1893. 
Prof. 
Barton 
Cooke 
Hirst. 
Philadel- 
phia. 
Mat. of 
Univ, of Pa. 
22 
1 
Rachitic 
pelvis; dwarf, 
4 ft. 7 in. 
In- 
duced. 
23/l6in. 
36 
Nov. 
8, 
i893- 
Dr. J. 
Clifton 
Edgar. 
New 
York 
Private. 
T9 
1 
Gen. cont. 
pelvis. 
24 hrs. 
3'4 in. The Symphyseotomies of the United States and of Canada. 
21 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Oc.- 
post., 
R. O. P. 
Forceps 
Recov. 
Lived. 
F. 
7 lb. 
9 oz. 
4'4 
in. 
Com. by the operator, 
Nov. i, 1893. 
Vertex. 
u 
Died 
on 
nth 
day. 
u 
M. 
67, lb. 
3'4 
in. 
Am. Jour. Obstet., 1893, 
xxviii, pp. 303-312. 
u 
Version 
Recov. 
a 
M. 
67. lb. 
3% 
in. 
Com. by the operator. 
Med. News, Phila. 
L. 0. A. 
Manual. 
u 
u 
M. 
81/, lb. 
37A 
in. 
Com. by the operator. 
N. Y. Jour. Gyneecol. 
and Obstet., 1893, iii, 
PP- 185-190. 
u 
Forceps 
u 
Lived 
8 days. 
M. 
15'4 lb. 
? 
Com. by the operator. 
Med. News, Phila., 1894, 
Ixiv, p. 501. 
Vertex. 
u 
u 
Lived. 
M 
9 lb. 
3% 
in. 
The Clinique, Chicago, 
Dec. 25, 1893, pp. 544- 
550. Com. of Jan. 10, 
1894. 
a 
G 
u 
u 
M. 
io lb. 
3'4 
in. 
N. Y. Med. Rec., Nov. 
4, 1893. PP- 5^2, 583. 
a 
Version 
Died 
in de- 
livery. 
M. 
? 
3'4 
• 
in. 
Com. by the operator. 
Trans. Coll, of Phys., 
Phila., Dec. 6, 1893, p. 
237- 
41 
u 
u 
Lived. 
M. 
7 lb. 
3'4 
in. 
Com. by the operator 
Nov. 24, 1893. N. Y. 
Medical Journal, vol. 
lix, Mar. 17, 1894, p. 
343- 22 
Robert P. Harris, M. D. 
d 
£ 
4 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
d 
bD 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
37 
Nov. 
r9> 
1893- 
Dr. 
Richard 
C. 
Norris. 
Philadel- 
phia. 
Mat. of 
Univ, of Pa. 
l8 
I 
.... 
Flat pelvis. 
89 hrs. 
2^/16 in. 
38 
Nov. 
24, 
1893. 
Prof. T. 
Byron 
Robin- 
son. 
Chicago. 
Private. 
27 
I 
Transversely 
cont. pelvis. 
16 hrs. 
3% in- 
39 
Dec. 
19, 
1893. 
Dr. 
Thomas 
J. Wat- 
kins. 
<1 
Cook Co. 
Hosp. 
43 
8 
Gen. cont. 
pelvis. 
36 hrs. 
Not 
taken. 
40 
Dec. 
23, 
1893. 
Dr. Ed- 
ward P. 
Davis. 
Philadel- 
phia. 
Mat. of Jef- 
ferson Col- 
lege. 
25 
2 
Justo-minor 
pelvis. 
31 hrs. 
2% in. 
4i 
Dec. 
3°, 
1893. 
Dr. 
Daniel 
Longa- 
ker. 
a 
Private. 
3° 
5 
Flat pelvis. 
24 hrs. 
3 in- 
42 
Jan. 
12, 
1894. 
Dr. J. 
Clifton 
Edgar. 
New 
York. 
u 
25 
2 
Gen. cont. 
pelvis. 
14 hrs. 
3% in- 
43 
Feb. 
i7, 
1894. 
Dr. 
Henry 
Banga. 
Chicago. 
Chicago 
Polyclinic. 
37 
5 
Rachitic 
pelvis. 
16 hrs. 
2% in. 
44 
Feb. 
19, 
1894. 
Dr. Chas. 
W. Co- 
burn. 
Philadel- 
phia. 
Private. 
14 
1 
Undeveloped 
pelvis. 
28 hrs. 
4% in. 
45 
Mar. 
16, 
1894. 
Dr. Ed- 
ward P. 
Davis. 
Mat. of Jef- 
ferson Col- 
lege. 
20 
1 
Justo-minor 
pelvis, threat- 
ening of 
eclampsia. 
In- 
duced. 
33A in- The Symphyseotomies of the United States and of Canada. 
23 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Vertex. 
Version 
Recov. 
Died 
in de- 
livery. 
M. 
8 lb. 
3'4 in- 
Com. by the operator. 
New Eng. Med. Month- 
ly, 1893-94, xiii, July, 
p. 462-464. 
L. 0. A. 
Forceps 
Cl 
Lived. 
F. 
7 lb. 
3'4 in. 
Com. by the operator. 
Vertex. 
U 
Died 
in 
12 hrs. 
a 
M. 
ri lb. 
Crush- 
ed. 
Am. Jour. Obstet., Feb., 
1894, pp. 249, 250. 
u 
a 
Recov. 
a 
M. 
7 lb. 
II oz. 
45Ae in. 
Com. by the operator, 
Jan. 25, 1894. Med. 
News, Phila., Apr. 14, 
1894, p. 401. 
u 
u 
cc . 
cc 
F. 
9% lb. 
3'4 in. 
Com. by the operator, 
Jan. 12, 1894. Annals 
of Gynaecol, and Obs., 
Phila., i893~'94, vii, pp. 
450-457. 
Ci 
Pod. 
version. 
cc 
cc 
F. 
9 lb. 
3m in. 
Com. by the operator, 
Feb. 19, 1894. 
Trans- 
verse. 
Forceps 
a 
cc 
M. 
77^ 
? 
Com. by the operator. 
Am. Jour. Obstet., Dec., 
1894, p. 761. 
Vertex. 
Cl 
Died 
in 
5 days- 
Died 
in de- 
livery. 
M. 
ii lb. 
4% in. 
Com. by the operator, 
May 10, 1895. 
u 
u 
Recov. 
Lived. 
M. 
5"/.6lb. 
3*4 in. 
Com. by the operator. 
Med. News, Phila., Apr. 
14, 1894, p. 402. 24 
Robert P. Harris, M. D. 
o 
Z 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age- 
No. of preg. 
Cause of 
difficulty. 
• 
Time in 
labor. 
C. V. 
diame- 
ter. 
46 
Mar. 
J9> 
1894. 
Dr. Chas. 
P. Noble. 
hiladel- 
phia. 
Kensington 
Hosp, for 
Women. 
32 
6 
Cont. pelvis. 
10 hrs. 
23/4 in. 
47 
Apr. 
3, 
1894. 
Do. 
u 
Private. 
34 
7 
Flat, rachitic 
pelvis. 
38 hrs. 
C. D. 
4 in. 
48 
Apr. 
7, 
1894. 
Dr. Ed- 
ward P. 
Davis. 
a 
Mat. of Jef- 
ferson Col- 
lege. 
33 
1 
Flat, rachitic, 
funnel- 
shaped pelvis. 
30 hrs. 
C. V. 
4 in. 
49 
Apr. 
26, 
1894. 
Prof. 
Barton 
Cooke 
Hirst. 
Private. 
30 
2 
Flat, rachitic 
pelvis. 
8 hrs. 
3% in- 
5° 
May 
i°, 
1894. 
Dr. 
James B. 
O'Neill. 
Portland, 
Me. 
Maine Eye 
and Ear 
Infirmary. 
28 
3 
Gen. cont. 
pelvis. 
26 hrs. 
23/4 in. 
5i 
May 
14, 
1894- 
Dr. Geo. 
Gross. 
San 
Fran- 
cisco. 
Private. 
30 
2 
Head locked 
after delivery 
of breech. 
12 hrs. 
2% in. 
52 
June 
i7, 
1894. 
Dr. 
Henry 
D. Fry. 
Wash- 
ington, 
D. C. 
u 
2 9 
1 
Cont. pelvis. 
48 hrs. 
37s in. 
53 
June 
*9, 
1894. 
Prof. 
Malcolm 
L. Har- 
ris. 
Chicago. 
a 
28 
1 
30 hrs. 
2% tO 
3 in- 
54 
June 
21, 
1894. 
Drs. Col- 
lier and 
Grandin. 
New 
York. 
u 
28 
2 
Flat, rachitic 
pelvis. 
In- 
duced. 
37. in- The Symphyseotomies of the United States and of Canada. 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Vertex. 
Forceps 
Recov. 
Lived. 
F. 
6% lb. 
3% in. 
Com. by the operator. 
(Second operation on 
Case 9.) 
G 
g 
g 
Died 
directly. 
M. 
8 lb. 
Com. by the operator. 
L. 0. A. 
Ci 
G 
Lived. 
F. 
7% lb. 
33A in- 
Com. by the operator. 
Boston Med. and Surg. 
Jour., Aug. 23, 1894. 
R. O. P. 
g 
a 
G 
F. 
97, lb. 
4 in. 
Com. by the operator. 
L. 0. A. 
cc 
G 
G 
F. 
8 lb. 
3% 
Trans. Maine Med. Ass., 
1894, pp. 477-485- 
Breech. 
Manual. 
Dead. 
F. 
Aver- 
age. 
Aver- 
age. 
Com. by the operator. 
Occidental Med. Times, 
Sacramento, 1894, viii, 
P- 538. 
L. 0. A. 
Forceps 
G 
Lived. 
M. 
97. lb. 
33/4 in. 
Com. by the operator. 
R. 0. A. 
ci 
G 
G 
M. 
io lb. 
Long. 
Am. Jour. Obstet., Dec., 
1894, pp. 765, 766. Com. 
of operator, Dec. 21 
1894. 
L. 0. A. 
Version 
G 
G 
M. 
87, lb. 
4% in. 
Com. by the operator. 
25 26 
Robert P. Harris, M. D. 
d 
£ 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age. 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
55 
June 
27, 
1894. 
Prof. 
Henry J. 
Gar- 
rigues. 
New 
York. 
St. Mark's 
Hosp. 
2 9 
2 
Soft tumor in 
recto-vaginal 
wall. 
13 hrs. 
Nor- 
mal. 
5 6 
July 
19, 
1894. 
Dr. T. E. 
Schum- 
pert. 
Shreve- 
port, 
La. 
Private. 
3° 
Slightly cont. 
pelvis and 
large head. 
'62 hrs. 
37A in. 
57 
July 
3b 
1894. 
Dr. Geo. 
W. Jar- 
man. 
New 
York. 
Blackwell's 
Island 
Hosp. 
22 
2 
Justo-minor 
pelvis. 
4 hrs. 
? 
5» 
Aug. 
8, 
1894. 
Dr. Rich- 
ard C. 
Norris. 
Philadel- 
phia. 
Preston 
Retreat. 
30 
3 
Flat rachitic 
pelvis. 
6'4 hrs. 
3*4 in. 
59 
Aug. 
21, 
1894. 
Dr. 
Frank D. 
Gray. 
Jersey 
City. 
Christ 
Hosp. 
27 
3 
Flat pelvis. 
18 hrs. 
? 
60 
Sept. 
5' 
1894. 
Dr. 
Henry C. 
Coe. 
New 
York. 
N. Y. Mat. 
Hosp. 
40 
3 
Cont. pelvis. 
24 hrs. 
3'4 in. 
61 
Sept. 
20, 
1894. 
Prof. 
Malcolm 
L. 
Harris. 
Chicago. 
Private. 
28 
1 
Small oblique 
pelvis. 
16 hrs. 
234 in. 
62 
Sept. 
24, 
1894. 
Dr. J. 
Clifton 
Edgar. 
New 
York. 
u 
35 
4 
Trans, nar- 
rowed pelvis. 
9 hrs. 
4 in. 
63 
Oct. 
IO, 
1894. 
Dr. 
Henry C. 
Coe. 
N. Y. Mat. 
Hosp. 
29 
2 
Flat pelvis. 
7. hr. 
3'4 in. The Symphyseotomies of the United States and of Canada. 
27 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
Vertex. 
Forceps 
Recov. 
Lived. 
F. 
io3/4lb. 
? 
Com. by the operator. 
N. Y. Medical Record, 
Nov. io, 1894, pp. 577- 
580. 
L. 0. A. 
u 
Died 
on 
5 th 
day. 
Dead ; 
de- 
stroyed 
by for- 
ceps. 
M. 
14 lb. 
? 
New Orleans Med. and 
Surg. Jour., May, 1895, 
pp. 788-792. Com. May 
17, 1895. 
L. 0. A. 
Version 
Recov. 
Lived. 
M. 
6% lb. 
3'4 in. 
Com. by the operator. 
L. 0. A. 
Forceps 
u 
Cl 
M. 
7% lb. 
S7» in. 
Com. by the operator. 
L. O. P. 
cc 
u 
Died in 
6 hours, 
fract. os 
occipit. 
M. 
io7Jb. 
? 
N. Y. Med. Record, May 
18, 1895, p. 617. Com. 
by Dr. Joseph M. Rec- 
tor, May 20, 1895. 
L. 0. P. 
Version 
CC 
Died in 
6 days, 
pneu- 
monia. 
M. 
8!/. lb. 
? 
Com. by the operator, 
Oct. 12, 1894. 
L. 0. P. 
Forceps 
Lived. 
F. 
8 lb. 
? 
American Journal of 
Obstetrics, December, 
1894, pp. 766, 767. 
Com. by the operator, 
December 21, 1894. 
Vertex. 
Version 
cc 
F. 
8 lb. 
33A in. 
Com. by the operator, 
April 22, 1895. 
« 
c 
Died in 
% hour. 
M. 
67^ lb. 
? 
Com. by the operator, 
Nov. 10, 1894. 28 
Robert P. Harris, M. D. 
6 
£ 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
Age. 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
64 
Oct. 
23, 
1894. 
Dr. 
Leonard 
Wheeler. 
Worces- 
ter, 
Mass. 
Worcester 
Hosp. Mat. 
28 
7 
Gen. cont. 
pelvis. 
10 hrs. 
3% in. 
65 
Oct. 
26, 
1894. 
Dr. H'y 
McM. 
Painter. 
New 
York. 
Out-patient 
service, 
Lying-in 
Hosp. 
19 
I 
Flat rachitic 
pelvis. 
Right lateral 
obliquity. 
15 hrs. 
3% in. 
66 
Nov. 
6, 
1894. 
Prof. 
Rob't A. 
Murray. 
N. Y. Mat. 
Hosp. 
27 
I 
Gen. cont. 
pelvis. 
14% 
hrs. 
C. D. 
3% in- 
67 
Dec. 
8, 
1894. 
Prof. 
Barton 
Cooke 
Hirst. 
Philadel- 
phia. 
Mat. of 
Univ, of Pa. 
3° 
I 
Moderately 
cont. pelvis 
and slightly 
enlarged h'd. 
20 hrs. 
C. V. 
33A in- 
68 
Tan. 
4, 
1895. 
Dr. 
Thos. R. 
Savage. 
New 
York. 
Private. 
24 
3 
Funnel- 
shaped pelvis. 
24 hrs. 
Labor 
in- 
duced. 
4% in- 
esti- 
mated. 
69 
Jan. 
25, 
1895. 
Dr. J. 
Clifton 
Edgar. 
u 
25 
1 
Funnel- 
shaped pelvis, 
cont. outlet. 
64 hrs. 
? 
7° 
Feb. 
20, 
1895. 
Dr. 
Edw'd P. 
Davis. 
Philadel- 
phia. 
Polyclinic 
Hosp. 
2 7 
1 
Justo-minor 
pelvis. 
At in- 
tervals 
for a 
week. 
3% in. 
7i 
Mar. 
24, 
1895. 
Dr. 
Daniel 
Long- 
aker. 
If 
Private. 
(Case 24, 2d 
operation.) 
32 
5 
Flat pelvis. 
15 hrs. 
3 in. 
72 
Mar. 
28, 
1895. 
Dr. J. 
Richard 
Taylor. 
Sag Har- 
bor, N.Y., 
on Shel- 
ter Isl'd. 
Private. 
27 
1 
Flat pelvis, 
oedema of 
vagina and 
vulva. 
62 hrs. 
3% in- The Symphyseotomies of the United States and of Canada. 
29 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
L. 0. A. 
Forceps 
Recov. 
Lived. 
M. 
8IO/I6lb. 
4 in. 
Boston Med. and Surg. 
Jour., 1894, cxxxi, p. 
637. Com. by the opera- 
tor, Dec. 4, 1894. 
Vertex. 
Version 
u 
M. 
8% lb. 
3% in. 
Com. by the operator, 
Dec. 7, 1894. 
L. 0. A. 
Forceps 
a 
M. 
6% lb. 
474 in. 
Com. by the operator, 
Dec. 14, 1894. 
R. 0. A. 
Crani- 
otomy, 
hydro- 
ceph. 
a 
Dead ; 
crani- 
otomy. 
F. 
9% lb. 
47s in. 
Com. by the operator, 
Jan. 12, 1895. 
L. 0. A. 
Forceps 
u 
Lived. 
F. 
674 lb. 
37= in. 
Com. by the operator, 
May 14, 1895. 
Brow. 
Version 
u 
F. 
8 lb. 
37= in. 
Com. by the operator, 
Mar. 4, 1895. 
Vertex. 
Forceps 
t 
Died 
on 4th 
day. 
u 
M. 
? 
43/i6 in. 
Com. by the operator, 
Apr. 19, 1895. 
R. 0. I. 
u 
Recov. 
u 
M. 
7 lb.+ 
3'7.6 in. 
Com. by the operator, 
Apr. 14, 1895. 
L. 0. A. 
« 
u 
Dead 
before 
opera- 
tion. 
F. 
7%lb. 
374 in. 
Com. by the operator, 
May 13, 1895. 30 
Robert P. Harris, M. D. 
d 
£ 
Date. 
Operator. 
Locality. 
Hospital or 
private. 
•a3v 
No. of preg. 
Cause of 
difficulty. 
Time in 
labor. 
C. V. 
diame- 
ter. 
73 
Mar. 
29, 
1895. 
Prof. 
Barton 
Cooke 
Hirst. 
Philadel- 
phia. 
Private. 
33 
4 
Gen. cont. 
pelvis. 
4 days. 
31/. in. 
74 
Apr. 
16, 
1895. 
Prof. 
Wm. T. 
Lusk. 
New 
York. 
N. Y. Infant 
Asylum. 
19 
1 
Rachitic 
pelvis. 
19 hrs. 
3^4 in. 
Symphyseotomies 
I 
Dec. 
6, 
1892. 
Dr. J. 
Anders'n 
Springle. 
Mont- 
real. 
Private. 
2 5 
1 
Cont. pelvis. 
24 hrs. 
3 in. 
2 
May 
2, 
1893. 
Prof. J. 
Chalmers 
Cam- 
eron. 
Do. 
Montreal 
Mat. 
20 
1 
Rachitic pel- 
vis. Dwarf, 
4 ft. 6% in. 
14 hrs. 
29/i6 in. 
3 
June 
3°, 
1893. 
Dr. J. H. 
Burns 
and Dr. 
A. B. 
Athert'n. 
Toronto. 
Private. 
34 
1 
Small pelvis. 
Dwarf, 4 ft. 
6 in. 
33 hrs. 
3 in. 
4 
July 
26, 
1894. 
Prof. J. 
Chalmers 
Cam- 
eron. 
Mont- 
real. 
Montreal 
Mat. 
23 
1 
Flat rachitic 
pelvis; 
eclampsia; 19 
convulsions. 
U3A 
hrs. 
23/4 in. 
5 
Oct. 
IO, 
1894. 
Dr. C. P. 
Sylves- 
ter. 
Toronto. 
Grace 
Hosp. 
27 
3 
Cont. pelvis. 
Morn- 
ing to 
mid- 
night. 
23/4 in. The Symphyseotomies of the United States and of Canada. 
31 
Part pre- 
senting. 
Aid to 
delivery. 
Result 
to 
woman. 
Result to 
child. 
Sex of child. 
Weight 
of child. 
B. P. di- 
ameter. 
References. 
R. 0. P. 
Forceps 
Recov. 
Lived. 
M. 
7'/. lb. 
33/4 in- 
Com. by the operator, 
Apr. 15, 1895. 
Head. 
<c 
Died 
on 7th 
day. 
a 
F. 
8 lb. 
? 
Com. by the operator, 
May 4, 1895. 
of Canada. 
R.O. A. 
Forceps 
Recov. 
Lived. 
F. 
7?. lb. 
3% in. 
Montreal Med. Jour., 
Jan., 1893. Com. Apr. 
2, 1893, and Dec. 1, 
1894. 
L. 0. A. 
G 
cc 
CC 
F. 
7?. lb. 
35A in. 
Com. May 10, 1893. 
L. 0. A. 
Ct 
cc 
« 
F. 
7 lb. 
9 oz. 
? 
Dominion Med. Month- 
ly, July, 1893, pp. 1,2. 
Com. of Nov. 26, 1894. 
L. 0. A. 
CC 
cc 
M. 
7 lb. 
4 oz. 
3% in. 
Com. Aug. 8 and Dec. 
1, 1894. 
Vertex. 
« 
CC 
cc 
M. 
8 lb. 
37s in. 
Canadian Practitioner, 
Feb., 1895, pp. 92-98. 
329 South Twelfth Street, Philadelphia.