. Clinical gyncology, medical and surgical. led to keep the uterus in place with a pessary ;but as this latter occurrence is not so very uncommon, the opportunityis frequently offered to perform this operation. I have thus far, duringthe past ten years, performed it sixty-Jive times, with such success bothas to the immediate and permanent results as to render me more and moreenthusiastic in its favor. I have not only succeeded in lifting up and keep-ing the uterus in its normal position for years after the operation, but Ihave seen probably as many as a dozen of the cases conceive, go to term,
. Clinical gyncology, medical and surgical. led to keep the uterus in place with a pessary ;but as this latter occurrence is not so very uncommon, the opportunityis frequently offered to perform this operation. I have thus far, duringthe past ten years, performed it sixty-Jive times, with such success bothas to the immediate and permanent results as to render me more and moreenthusiastic in its favor. I have not only succeeded in lifting up and keep-ing the uterus in its normal position for years after the operation, but Ihave seen probably as many as a dozen of the cases conceive, go to term,be normally delivered, and the uterus retain the position in which I placedit. In one case I saw the patient in consultation alter her fifth confinementfollowing the operation, and found the uterus in its normal position. Shewas dying of puerperal septicemia, to be sure; but the operation hadnothing to do with that. A few cases have been failures, I must admit;but they were either badly chosen, the uterus being too large and again Fig. Wylies and Dudleys methods of intra-abdominal shortening of the round ligaments. dragging down the shortened ligaments, or the ligaments were too thin andbroke during the operation, and therefore did not give the support whichthey properly should. There are several objections to this operation, and they are : That it isan uncertain one, for one never knows when one will find thick, strong,easily tractable ligaments, or ligaments which are thin, adherent, readilybroken, and can then no longer be recovered. This may be at times the faultof the operator, but also at times of the anatomical structures themselves,and no man can tell before he has opened the inguinal canal and found theligaments whether they will be thick or thin, weak or strong, easily slidingin their sheaths or adherent along the whole track. Resides, the operatorhas to keep his wits about him, or he will easily miss the pubic attachmentof the ligament and then pronounce the ope
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