Operative surgery . olon. But the beneficent influ-ence of asepsis in the prevention of peritoneal inflammation, together withthe facts that the posterior incision produced greater traumatism and exposedbroader surfaces to infection, while it offered no good opportunity for intra-abdominal exploration, and placed the artificial opening inconveniently,prompted the substitution of the anterior for the posterior method in themajority of instances. The Linear Guide to the Ojjeration (Fig. 897).—Draw a direct linebetween the anterior and posterior superior spinous processes of the ilium;draw a seco
Operative surgery . olon. But the beneficent influ-ence of asepsis in the prevention of peritoneal inflammation, together withthe facts that the posterior incision produced greater traumatism and exposedbroader surfaces to infection, while it offered no good opportunity for intra-abdominal exploration, and placed the artificial opening inconveniently,prompted the substitution of the anterior for the posterior method in themajority of instances. The Linear Guide to the Ojjeration (Fig. 897).—Draw a direct linebetween the anterior and posterior superior spinous processes of the ilium;draw a second one perpendicular to this, one inch posterior to its center, tomark the line of the colon. Draw a third line with the center correspond-ing to the perpendicular one obliquely downward and outward four inchesin length, parallel with the lower border of the last rib and midway betweenit and the crest of the ilium, to mark the course of the primary incision. OlIMiATlONS ON VIS(KI{A CONNKCIKD WITH IKKIHjNvKUM. 0«3. Fi(i. 897.—Iliac colosloiiiy. a. Colon, b. Veilical lineindicating colon, c. Line of incision in operation. 7/ie MiiscuUir liuidrs to the Oprrittion.—The siiperficiiil niiiscular guideis tlie outer border of the erector spiiui iimscle; the deep one the outer bor-der and anterior surface of the (piadratus luinboruni muscle. Tlie Anatoinical Points.—A mesocolon is })reseut at this situation inthirty-six per cent of the cases (rrcves). If it be not present, tlie posteriorand a greater or lesser ])()r-tion of the lateral surfacesof the colon are uncoveredwith peritonuuni. If thegut be collapsed, it retreatstoward the median line be-hind tlie quadratus luin-boruni, followed by theperitoneal covering, andtherefore exposes the peri-tonaeum to a greater dan-ger of injury than when dis-tended, since it then })ressesthe peritonteum outward,and itself extends beyondthe border of the quadratus lumborum. The intestinal surface not coveredwith peritonaeum is hidden by subs
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