Cæsarean Operation (cædo, 'I cut'—cæsus) has from very ancient times been the popular name for Hysterotomy (hystera, 'uterus,' tomē, 'section'). Pliny distinctly alludes to it in his Natural History (lib. vii. cap. ix.), saying that Cæsar was so called from being taken by excision out of the womb of his mother, and that such persons were called Cæsones. In the case of Julius Cæsar, however, the statement must be regarded, to say the least, as extremely doubtful.
The risk to the child's life, if it be alive when the operation is begun, is slight; but to the mother's, very great indeed. Still, many cases are on record where not only the child but the mother was saved. Some women, indeed, seem to have accepted it as their usual method of delivery, having several children, each requiring to be removed through an abdominal incision; one woman submitted to it seven times. It has also been successfully performed in most unfavourable circumstances. An illiterate Irish midwife operated with a razor on a poor farmer's wife in 1738, removing a dead child, and her patient completely recovered; and cases are known in which women have operated on themselves with perfect success. The operation has been less often and less successfully resorted to in Great Britain than on the continent of Europe and in America.
Since about 1870, two procedures have been introduced with the view of diminishing the risk to the mother when delivery is impossible by the natural channel. Porro's operation, first performed by him in 1876, consists in the removal of the uterus after the child has been delivered. In Thomas's operation (1870), the skin incision is made in the groin, and the genital canal is opened into below the uterus, which is left intact. Both these operations have hitherto given promise of more favourable results as regards the life of the mother than the old procedure, in which the first incision was made in the middle line of the body.
Practitioners are not quite agreed as to the circumstances which justify the performance of such a severe operation on the living female, but all are unanimous as to the propriety of at once removing by it the child of a recently dead woman. Tradition ascribes to Numa Pompilius a decree that every pregnant woman who died should be opened; and the senate of Venice in 1608 decreed that practitioners should perform, under heavy penalties, the Cæsarean operation on pregnant women supposed to be dead. In 1749 the king of the Two Sicilies decreed the punishment of death to medical men who omitted to perform it on women dying when advanced in pregnancy. Of course, to be of any use, it must be performed immediately.