A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . an at any subsequent period. The case of chronic laceration of the perineum must bemade to simulate the recent case, by freshening the edges ofthe rent in the vaginal, muscular, and cutaneous tissues,which have become covered by a sort of mucous have made a drawing (Fig. 61), to represent the tissueswhich are lacerated and the position of the sutures to betaken where the laceration includes the recto-vaginal septum. Operation.—First the patient should be in as good a condi-tion as possibl
A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . an at any subsequent period. The case of chronic laceration of the perineum must bemade to simulate the recent case, by freshening the edges ofthe rent in the vaginal, muscular, and cutaneous tissues,which have become covered by a sort of mucous have made a drawing (Fig. 61), to represent the tissueswhich are lacerated and the position of the sutures to betaken where the laceration includes the recto-vaginal septum. Operation.—First the patient should be in as good a condi-tion as possible. If the general health is in bad condition, weare not likely to obtain union of the edges of the laceration. LACERATION OF THE PERINEUM. 635 The bowels should be freely moved previous to the lady should lie upon a conveniently high operatingtable, upon her back, being suitably clothed in woolen drawersand stockings, with the knees flexed upon the abdomen, andwell separated by an assistant upon each side, who shouldalso each hold a vaginal retractor to separate the lateral. Fig. No. 61.—Laceration of the Perineum. walls of the vagina from each other, and bring the entirelaceration into view, after the patient has been given ananaesthetic. We next proceed to denude the lacerated surfaces of themucous membrane developed over them. If the lacerationimplicates the recto-vaginal septum, we make two operations, 636 EA TON ON DISEASES OF WOMEN. the first to cause a healing and closing of the recto-vaginalseptum, and afterwards of the rupture of the perineum;although instances might occur where it would be advisableto perform the whole operation at once. In case we are to make two operations, we only denudethe tissues which are to be approximated to form the recto-vaginal septum. Commence at the lowest portion of thesetissues to be united, and seize the mucous membrane with atenaculum, and incise its lower portion with scissors or smallscalpel; then proceed to lift u
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