Treatise on gynæcology : medical and surgical . as possible; but bya lower section I think that there is less risk of secondary hemor- MEDICAL AND SURGICAL TREATMENT OE FIBROMA. 259 rhage, and the stump retracts within the cavity of the uterus and israpidly obliterated. All the measures devised with a view to prevent bleeding shouldbe resolutely abandoned; they have resulted in more victims thancures. Galvano-cautery, ligature, and ecraseur all prolong and com-plicate an operation which, to be safe, should be rapid. Even Dupuy-tren contended against the chimerical fear of hemorrhage, and ad-vi
Treatise on gynæcology : medical and surgical . as possible; but bya lower section I think that there is less risk of secondary hemor- MEDICAL AND SURGICAL TREATMENT OE FIBROMA. 259 rhage, and the stump retracts within the cavity of the uterus and israpidly obliterated. All the measures devised with a view to prevent bleeding shouldbe resolutely abandoned; they have resulted in more victims thancures. Galvano-cautery, ligature, and ecraseur all prolong and com-plicate an operation which, to be safe, should be rapid. Even Dupuy-tren contended against the chimerical fear of hemorrhage, and ad-vised the cutting instrument; it is time to return to his practice. Inthe very rare cases, of which Trelat has cited an example,33 where thepedicle contains large vessels, the condition may be recognized bypalpation, and before operating a pressure forceps should be placedon the part and allowed to remain for several hours. If there ismuch loss of blood, hot injections, ergot, and tamponade with iodo-form gauze will easily check the Fig. 143.—Collins Tumor Forceps. I have rjroposecl34 the name enormous polyps for those which fillthe vagina, do not permit the finger to reach the pedicle and can-not be easily removed through the vulva; these peculiar polyps offerspecial operative indications. The pedicle should not be treated un-til the volume of the tumor has been diminished—a result easily ob-tained by combining certain measures which have been advised at dif-erent times. Simons35 method consists in making a series of trans-verse deep incisions one above another, until the pedicle is reached;Hegar36 attains the same object by a series of spiral incisionson the capsule of the tumor, which is always the most resistant , tbe fragmentary removal of the polyp by a number of conoidalexcisions seems to me the best It is better to attack thetumor at the fourchette and make our incisions at that level, as ad-vised by When the volume of t
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