Interstate medical journal . ter operation made a diagnosis of thrombosis in the internalcapsule. Locally, in spite of the bladder plastic, there were no signs ofperitonitis or urine leakage. The patient sat up out of bed for a shorttime on the tenth and eleventh day, but on the twelfth day incontinenceof feces and urine of central origin developed and on the fourteenth dayshe rather suddenly died. No general autopsy was allowed but locallyin the pelvis the ureter and bladder were found well healed with noevidence of suppuration. The death, therefore, was caused solely by thecerebral complicat


Interstate medical journal . ter operation made a diagnosis of thrombosis in the internalcapsule. Locally, in spite of the bladder plastic, there were no signs ofperitonitis or urine leakage. The patient sat up out of bed for a shorttime on the tenth and eleventh day, but on the twelfth day incontinenceof feces and urine of central origin developed and on the fourteenth dayshe rather suddenly died. No general autopsy was allowed but locallyin the pelvis the ureter and bladder were found well healed with noevidence of suppuration. The death, therefore, was caused solely by thecerebral complications. The three factors, prolonged narcosis, Trendelen-burg posture, and unusual obesity, contributed to the occurrence of thisextremely rare complication. To my knowledge no other such hemiplegiafollowing this form of panhysterectomy has been reported. Of late I have preferred not to expose the ureter as the first step inthe operation but only after tying off both ovarian arteries, and cutting 112 INTERSTATE MEDICAL JOURNAL. Figure 1.— (Private Case.) Early cancer of the cervix showing extensive re-moval of cellular tissue, especially on the right side (left side of picture).The ureter in this case lay in the groove between the uterine vein (short) anduterine artery (long). Diagnosis could be made positively only by the micro-scope. Operation Dec. 16, 1908. Recovery.


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