. A system of medicine, based upon the law of homoeopathy. gated cervix, andthe adaptation of some form of sustaining pessary. Repair of theperinseum and the formation of a new posterior vaginal wall is per-formed in a great variety of ways, every gynaecologist having hisfavorite method. None are perfectly satisfactory, but the following is 414 A SYSTEM OF MEDICINE. simple, requires no special surgical proficiency, and is as useful as anyof the more elaborate methods. An incision is made along the posteriorvaginal wall and ruptured perinseum from A to B, Fig. 4. From B theknife is carried upwa
. A system of medicine, based upon the law of homoeopathy. gated cervix, andthe adaptation of some form of sustaining pessary. Repair of theperinseum and the formation of a new posterior vaginal wall is per-formed in a great variety of ways, every gynaecologist having hisfavorite method. None are perfectly satisfactory, but the following is 414 A SYSTEM OF MEDICINE. simple, requires no special surgical proficiency, and is as useful as anyof the more elaborate methods. An incision is made along the posteriorvaginal wall and ruptured perinseum from A to B, Fig. 4. From B theknife is carried upward on each side along the inner surface of thelabium minor to C. Two triangular flaps are thus formed which aredissected upward until their edges lie as in Fig. 5, where they arejoined by silk sutures, the knots being tied on the vaginal deep sutures are inserted as in Fig. 5, S S, and the raw surfacesleft by the flaps are drawn together. A number of small sutures unitethe skin-edges, and the completed operation is seen at Fig. 6. Fig. 6. ?. Various operations for narrowing the vagina and thus presenting amechanical obstacle to the descent of the uterus have been by Hegar is easily executed and answers the purpose: A triangleon the surface of the posterior vaginal wall is freshened, the apex closeto the os uteri, and extending to the perinseum. Just so much tis-sue is to be removed as will give a rawness. The two edges arebrought together and united by sutures passing deeply into thetissues. The patient must be kept in bed for twenty-one days, andit is better to allow the sutures to suppurate out, as this renders thecicatrix firmer and less likely to break down subsequently. After thisoperation the vagina is rigid and very narrow, connection takes placewith difficulty, and subsequent labors are serious and probably danger-ous. After all this trouble, the vagina may continue to stretch, andthe prolapse recur. The rest in bed, haemorrhage from the wound,
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