. A new manual of surgery, civil and military. is nearly, if not wholly, bed-ridden. Upon examination the perineal support of the uterus is found to be greatlyimpaired, the vaginal walls are loose and flabby, the cervix is greatlj thick- 646 SURGERY OF THE FEMALE PELVIS ened and edematous, and in a majority of patients there is a laceration of theleft side. Occasionally there are several other lacerations of the cervix, allfilled with hard, cicatricial tissue. The uterus is found upon bi-manual exami-nation to be considerably hj^pertrophied, sometimes twice or thrice the normalsize—involution
. A new manual of surgery, civil and military. is nearly, if not wholly, bed-ridden. Upon examination the perineal support of the uterus is found to be greatlyimpaired, the vaginal walls are loose and flabby, the cervix is greatlj thick- 646 SURGERY OF THE FEMALE PELVIS ened and edematous, and in a majority of patients there is a laceration of theleft side. Occasionally there are several other lacerations of the cervix, allfilled with hard, cicatricial tissue. The uterus is found upon bi-manual exami-nation to be considerably hj^pertrophied, sometimes twice or thrice the normalsize—involution not having taken place after the confinements and fundus of the uterus may be retroverted or it may be in a nearly normalposition. The entire organ is likely to be somewhat prolapsed and displacedbackward. Preparatory treatment. This should be the same as for any ordinaryoperation, unless the cervix is covered by a septic ulcer. In such instance, itis Avise to place her in bed for a few days before the operation is Amputation of Cervix Uteri for Laceration. (b), (c), (d) and (e) represent the sutures which unite the mucous membrane of thevagina with that of the cervical canal, preventing closure of the latter; (t) (gj and (h) (i)lepresent the sutures on either side which cover the raw surface resulting from the excisionof the cervix. to give large, very hot douches from three to six times a day, and at nightapply some antiseptic, such as compound tincture of iodine, equal parts ofcompound tincture of iodine, glycerine and carbolic acid, or a tampon oftwenty-five per cent, ichthyol in glycerine. During this period of treatmentthe patient should also receive mild laxatives and light diet. Operative technique. The treatment we have found most valuable in thesecases consists in the removal of all of the hardened tissue in the cervix andthen covering the abraded surface with vaginal mucous membrane. A broadvaginal speculum is introduced, as shown in the p
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
