American gynaecological and obstetrical journal. . d yet they might haveexpected that I could not speak to a medical society without sayingsomething about hysterectomy. In a recent text-book, published inPhiladelphia, I believe, they say that Eastman was the first Americanto make a total extirpation of a fibroid uterus, and add that he did so * Read before the Tri-State Medical Society, at St. Louis, April 3, 1895. Report of a Case of Hysterectomy. 9 by a very complicated technique. That statement is to me very ob-jectionable, inasmuch as all my efforts have been to simplify the entireoperatio
American gynaecological and obstetrical journal. . d yet they might haveexpected that I could not speak to a medical society without sayingsomething about hysterectomy. In a recent text-book, published inPhiladelphia, I believe, they say that Eastman was the first Americanto make a total extirpation of a fibroid uterus, and add that he did so * Read before the Tri-State Medical Society, at St. Louis, April 3, 1895. Report of a Case of Hysterectomy. 9 by a very complicated technique. That statement is to me very ob-jectionable, inasmuch as all my efforts have been to simplify the entireoperation of both suprapubic and infrapubic hysterectomy. I have here a photograph representing a class of tumors with whichI have come in contact. From conversations with Dr. Bantock, ofLondon, and Dr. Price, of Philadelphia, I believe they find similartumors which could not be dealt with at all by the abdominal fixationmethod. You will see that a fifteen-pound tumor has developed fromthe anterior wall of the cervix, disorganizing the same, and extended. down fully two inches beneath where the lower part of the cervix wasfound. This tumor was removed by a method which I have beentrying to perfect since 1887. It does not make a particle of differ-ence whether we take out the entire cervix or leave a little atom ; mypreference is to take it all out. I left a piece of cervix in my first case,and the result was satisfactory. I do believe, however, that there arebut two methods of hysterectomy now before the world for accept-ance or rejection—abdominal fixation and pelvic fixation—one beingintra-abdominal and the other intrapelvic. The old terms of intra-peritoneal and extraperitoneal must become obsolete, because of thefact that no one now attempts to fix a pedicle within the peritoneal 20 Joseph Eastman, M. D. cavity ; they are all extraperitoneal, though the method I speak of isintrapelvic. I will demonstrate the best I can by means of a pincushion torepresent a fibroid tumor. The b
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