The Hahnemannian monthly . he ostium is sur-rounded by a series of concentric wrinkles and there is a peculiarflatness of the crease between the buttocks in front of the anus. Bypassing two fingers into the canal the structures will be found laxand incapable of resistance ; the separated muscles and fascia? can bedetected in one or both sulci. The uterus will be found low down 1894.] Relaxation of the Pelvic Floor. 345 and not infrequently retro-displaced. By retracting the parts withthe two thumbs the posterior vaginal walls presents itself in theform of a rectocele (Fig. 6.). If the patient
The Hahnemannian monthly . he ostium is sur-rounded by a series of concentric wrinkles and there is a peculiarflatness of the crease between the buttocks in front of the anus. Bypassing two fingers into the canal the structures will be found laxand incapable of resistance ; the separated muscles and fascia? can bedetected in one or both sulci. The uterus will be found low down 1894.] Relaxation of the Pelvic Floor. 345 and not infrequently retro-displaced. By retracting the parts withthe two thumbs the posterior vaginal walls presents itself in theform of a rectocele (Fig. 6.). If the patient be now placed in theSims posture the gaping of the ostium will be most marked andfche cervix easily exposed by making a speculum of the finger, orfingers. The perineal body may be entirely uninjured, or it maybe torn down to the sphincter. If uninjured, it falls away from thevagina and the pubic arch, its depth, as already observed, being ac-tually increased. Operative Procedures.—Various operations have been devised for. Superimposed diagrams of Fritschs, Hegars, BischofFs, Simons, and Emmetsoperations. the purpose of overcoming simple relaxation. > Emmet was, I be-lieve, the first to recognize the importance of catching the separatedmuscular fibers in sutures passed through the vagina. In order toaccomplish this end, he utilizes the vaginal sulci, and his oj>erationis considered by many almost, if not quite, perfect. My objectionto it is, primarily, that it does not bring the divided structures to-gether at the median line, which is their normal point of attach-ment, so that the median line of the vaginal axis is left the weakestpoint of the repaired floor. Again, the Emmet operation is a tediousone to perform, involves unnecessary loss of tissue, and does not re- 346 T?te Hahnemannian Monthly. [June, store the perineal body, should this structure be implicated in theinjury. Fritsch, Hegar, Bischoff, and Simon (Fig. 7), as well as manyothers, have devised areas of den
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