. The science and art of surgery, embracing minor and operative surgery. Comp. from standard allopathic authorities, and adapted to homoeopathic therapeutics, with a general history of surgery from the earliest periods to the present time .. . ith anordinary Simss speculum, held by an assistant, but may be more Fig. 404. conveniently effected by means of h ^MZSZ^^z^ Emmets modification of that instru- ment, if the semi-prone position ischosen, or by a similar modificationdescribed by Wells, if the patientbe placed either on her back or in theposition here recommended. Thesemodifications of Sim
. The science and art of surgery, embracing minor and operative surgery. Comp. from standard allopathic authorities, and adapted to homoeopathic therapeutics, with a general history of surgery from the earliest periods to the present time .. . ith anordinary Simss speculum, held by an assistant, but may be more Fig. 404. conveniently effected by means of h ^MZSZ^^z^ Emmets modification of that instru- ment, if the semi-prone position ischosen, or by a similar modificationdescribed by Wells, if the patientbe placed either on her back or in theposition here recommended. Thesemodifications of Simss speculumconsist in the adaptation of a fenes-trated blade, which fits over the buttock or sacrum of the patient,and thus keeps the instrument in place without the aid of anassistant. A bright light is necessary for the operation, thebest illumination being afforded by placing the operating tablenear a high window ; if this cannot be obtained, an Argand lampand reflector may be substituted. 3. Paring the Edges.—This may be done with either knivesor scissors, according to the fancy of the operator ; a convenientform of knife is one with a double-edged blade, bent at an anglewith the shaft. The sides of the fistula may be steadied by. OPERATIONS ON THE FEMALE GENERATIVE ORGANS. 711 means of suitable forceps, or one or more hooks with long han-dles, while the paring is effected by transfixing the part with theknife, and cutting first in one, and then in the opposite direction,so that a complete ring is denuded. In doing this, some surgeonscut perpendicularly to the plane of the vesico-vaginal septum,while others bevel the edges by cutting in an oblique direction,so as to spare the mucous membrane of the bladder. Langen-beck again, and, more recently, Collis, of Dublin, have advisedthat the edges of the fistula should be split, so as to obtain abroad raw surface without cutting away any tissue that a broad surface is obtained for adhesion, it prob-ably makes l
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