Aseptic surgical technique, with especial reference to gynæcological operations . de aftera hemorrhage from the uterus has taken place, with noapparent reason to account for it, will sometimes givea clue to the cause of the bleeding, which has, perhaps,been unsuspected not only by the physician, but alsoby the patient. The appearance of the villi when seenis sufficiently characteristic, but, as in some cases theyare not numerous, careful search should be madethrough different sections, when an abortion is sus-pected, before deciding that they are not present.(Fig. 42.) The surgeon is, however,
Aseptic surgical technique, with especial reference to gynæcological operations . de aftera hemorrhage from the uterus has taken place, with noapparent reason to account for it, will sometimes givea clue to the cause of the bleeding, which has, perhaps,been unsuspected not only by the physician, but alsoby the patient. The appearance of the villi when seenis sufficiently characteristic, but, as in some cases theyare not numerous, careful search should be madethrough different sections, when an abortion is sus-pected, before deciding that they are not present.(Fig. 42.) The surgeon is, however, most frequently called uponto decide from his examination of pieces removed fromthe uterus whether or not malignant disease of theorgan exists. Cases not infrequently occur in whichthe first section will reveal the presence of an un-doubted carcinoma or sarcoma at a time when theclinical phenomena are insufficient to determine the 246 ASEPTIC SURGICAL TECHNIQUE. diagnosis, and at other times even when they are suchas apparently to justify the conclusion that the dis- Fig. Section through a blood-elot from the uterus after abortion, showing transverseand longitudinal sections of chorionic villi. (After Orth.) ease is benign. Often, however, in cases in which theclinical indications are doubtful, the results of a micro-scopical examination are also not positive, and in suchcases the course of procedure should be determinedupon only after all the phenomena concerned, bothclinical and pathological, have received due consider-ation. Many unfortunate errors in diagnosis have resultedfrom the tendency of pathologists to rely too much onisolated signs in the sections and to base a diagnosis EXAMINATION OF SPECIMENS. 247 of malignant disease on a single abnormality, such, forinstance, as atypical gland-tubes, variations in the sizeof the epithelial cells in the same tubule, the occur-rence of solid columns of epithelial cells, the irregular Fig. 43.
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