. Annual of the universal medical sciences. iusss^^ Fig. 2.—Repair of the Perineum. the Cavity of the Wound, Flap beinq Drawn Forward by Tenaculum. (Cincinnati Lancet-Clinic.) with its apex to the posterior cul-de-sac and having its base at thefourchette. The flap is thick and firm and is not removed. It isseized at the centre of its base with a sharp hook, and then (Uuwn Perineum. ] DISEASES OF VAGINA AND EXTERNAL GENITALS. H-33 forward, forming a tetrahedronal cavity, the apices of which uniteat the vaginal extremity, with the bases toward the vulva. Twoof the triangles (a and b) are
. Annual of the universal medical sciences. iusss^^ Fig. 2.—Repair of the Perineum. the Cavity of the Wound, Flap beinq Drawn Forward by Tenaculum. (Cincinnati Lancet-Clinic.) with its apex to the posterior cul-de-sac and having its base at thefourchette. The flap is thick and firm and is not removed. It isseized at the centre of its base with a sharp hook, and then (Uuwn Perineum. ] DISEASES OF VAGINA AND EXTERNAL GENITALS. H-33 forward, forming a tetrahedronal cavity, the apices of which uniteat the vaginal extremity, with the bases toward the vulva. Twoof the triangles (a and b) are formed by the flap, and the othertwo (c and d) by the surfaces, which will form the perineal surfaces are now brought into apposition with a continuouscatgut suture, so that a lies on b and c on d. Neio Instrume7its.—Jenks, of Detroit, j„f/i6has devised a flexibledouble-edged knife and slightly-curved overlapping scissors, withboth inner and outer edges equally sharp, for submucous dissectionsin his flap-splitting X COLPOPERINEOKRHAPHY KNIFB AND SCISSORS. (Journal American Medical Association.) Rectocele.—Ozenne mI^ » regards vaginal rectocele as much lessfrequent than is usually believed, the rectum usually remaining insitu,, while the posterior vaginal wall is prolapsed. As to the in-fluence of age upon the development of the aftection, he believesthat it is more common in the middle period of life, from the thirty-fifth to the forty-fifth year. Ozenne prefers the procedure ofcolpoperineoplasty by gJissement,de\ised by Doleris, for the reasonthat it attains the double end of re-inforcing the pelvic floor and ofdrawing the vaginal wall against the rectum, thus overcoming thetendency to a vulvar hernia of that organ. Tliis operation is doneas follows:— The vaginal wall is carefully separated from the rectum anda suflficient quantity removed. Three Jil-de-Florence sutures arethen inserted witli a curved needle, the first suture being themost centr
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