Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . itis; Gustav Braun, 107 cases with 4 of peritonitis; Kehrer, 86 opera-tions with 4 cases of cellulitis and peritonitis and 1 death; Chrobak, 250cases, with 2 hemorrhages and 2 attacks of cellulitis, up to 1876, sincethen, 50 operations without accident. Thus, among 2,275 collated cases,together with the unnumbered ones of Sims, certainly in all 3,000, we have10 deaths. The cases of severe peritonitis, cellulitis, and
Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . itis; Gustav Braun, 107 cases with 4 of peritonitis; Kehrer, 86 opera-tions with 4 cases of cellulitis and peritonitis and 1 death; Chrobak, 250cases, with 2 hemorrhages and 2 attacks of cellulitis, up to 1876, sincethen, 50 operations without accident. Thus, among 2,275 collated cases,together with the unnumbered ones of Sims, certainly in all 3,000, we have10 deaths. The cases of severe peritonitis, cellulitis, and hemorrhage arenot recorded with sufficient accuracy to be of value, but were certainly ashigh as twenty per cent., all together. One great defect of these statisticsis that it is not mentioned in many of the foreign cases whether only theexternal os, or the internal os also was incised. This may account for CarlBrauns want of accidents, for, of course, the mere division of the externalos is but a trifling matter. The depth of the incision through the internalos depends, in Sims method, greatly upon the dexterity and experience 276 A TREATISE ON 5IINOE SURGICAL Fig. 192.—Lines of incision in flexure of thebody. (Emmet.) of the operator, since only a practised finger can tell how deep and whereto cut. As a rule, it is better to err on the safe side and not cut too deep,and if the operator is not rashly bold, this is generally the case. Only avery practised operator, like Sims himself, will be able to gauge preciselyhow deep he may cut without wounding the circular artery or the perito-neum. If the mechanically working metrotomes are used, the cut may be too small if one does not allow for theelasticity of the tissues, and too largeif the screw is set so as to expandthe blades more widely in anticipa-tion of this elasticity. The knife istherefore thought to be the safestinstrument. With the proper precautions, andcarefully omitting all cases to bementioned under cou
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