Treatise on gynæcology : medical and surgical . ajority of operators leave the wound open and introduce one or tworubber tubes. In England glass tubes are more used. Martin em-ploys a rubber tube made in the form of a cross, which has the advan-tage of being easily retained in place, and removes it on the third orfourth day. But in Germany most surgeons close the peritoneal 24 370 CLINICAL AND OPERATIVE GYNAECOLOGY. wound; Kaltenbacli, Mickulicz, Tauffer, v. Teuffel, Schede, etc., de-clare in favor of this method, while Czerny and Fritsch reject thesuture. I think with Demons, Bouilly, Terrier
Treatise on gynæcology : medical and surgical . ajority of operators leave the wound open and introduce one or tworubber tubes. In England glass tubes are more used. Martin em-ploys a rubber tube made in the form of a cross, which has the advan-tage of being easily retained in place, and removes it on the third orfourth day. But in Germany most surgeons close the peritoneal 24 370 CLINICAL AND OPERATIVE GYNAECOLOGY. wound; Kaltenbacli, Mickulicz, Tauffer, v. Teuffel, Schede, etc., de-clare in favor of this method, while Czerny and Fritsch reject thesuture. I think with Demons, Bouilly, Terrier, and almost all Frenchsurgeons that it is more prudent not to close the wound completely,but to diminish it. The discharge of serum and blood which is so fre-quent in the first few hours shows that this is not an unnecessaryprecaution, for in spite of all our care the wound may be infectedwith cancerous material. Decortication of the uterus, the old method of Langenbeck, whooperated thus on a prolapsed uterus in 1813, has been revived by cer-. ?F Fig. 189.—Vaginal Hysterectomy. Forcipressure of the superior border of the broad ligament after inversion of the uterus (Pean). tain authors, among whom are Lane42 and It is only a use-less complication. Operative Accidents.—I have already spoken of hemorrhage andthe means of avoiding it. The ureter may be wounded by the bistoury, a ligature, or thegrasp of a forceps; it is also in great danger from forcipressure. Asit has been included in the forceps of very distinguished operators, itis evidently the method and not the operator which should beblamed;44 when the accident is not mortal, it usually ends in the es-tablishment of a ureteral fistula. To avoid such injury to the ureter we must keep very near to the TREATMENT OF CANCER OF THE CERVIX. 371 cervix, the uterus should not be inverted until it is freed from itsattachments up to the peritoneum, and, lastly, no long forceps shouldbe deeply placed on the broad ligamen
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