. Gaillard's medical journal . by abuse of the operation thereis a tendency to underrate and misjudge the work of those who applythe operation in its proper sphere by conscientious and skillful dis-crimination in diagnosis. Morever, there are many practitioners whodo not operate at all, and who would by a constant plea of conserva-tism justify an expectant course of medication in a class of caseswhere operative interference furnishes the only hope of the of purulent salpingitis are treated as pelvic cellulitis without im-provement, and with the danger of rupture and general perit
. Gaillard's medical journal . by abuse of the operation thereis a tendency to underrate and misjudge the work of those who applythe operation in its proper sphere by conscientious and skillful dis-crimination in diagnosis. Morever, there are many practitioners whodo not operate at all, and who would by a constant plea of conserva-tism justify an expectant course of medication in a class of caseswhere operative interference furnishes the only hope of the of purulent salpingitis are treated as pelvic cellulitis without im-provement, and with the danger of rupture and general peritonitis inwaiting. In order to show some of the characteristic lesions of dis-ease of the Fallopian tubes, I have had a photograph made of thespecimens removed in one of the cases of double pyo-salpinx. Thefollowing cut is a faithful reproduction of the photograph. The rightFallopian tube had ruptured and discharged at least four ounces of pusinto the peritoneum. The left tube was filled with pus when the pho-tograph was Fig. i. Fallopian Tubes, from a Case of Pyo-Salpinx. The same condition is illustrated in the following figure, with theadditional lesion of ovarian abscess. (Fig. 2.) From the writingsof those so severely criticising the operation of removal of the ap-pendages it is apparent that many are altogether unacquainted withthese diseases of the Fallopian tubes and ovaries. The one fatal case (No. 18) was in an extreme and wretchedcondition when abdominal section was done. The left tube and ovary TWENTY CASES OF ABDOMINAL SECTION 139 were destroyed by suppuration, and had formed an immense abscess,filling the left side of the pelvis. She was septic and emaciated, withpigmented skin. An early operation would doubtless have savedher. These cases were formerly classified and treated as pelvic cellu-litis. Thirty years ago Bernutz and Gonpil described their true na-gaillardsmedical5018unse
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