File:The American text-book of obstetrics for practitioners and students (1903) (14591045880).jpg

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Identifier: americantextbook02came (find matches)
Title: The American text-book of obstetrics for practitioners and students
Year: 1903 (1900s)
Authors: Cameron, James C. (James Chalmers) Norris, Richard C. (Richard Cooper), 1863-1937 Dickinson, Robert Latou, 1861-1950
Subjects: Obstetrics
Publisher: Philadelphia : W.B. Saunders & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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divided with the blunt-pointed bistoury, the finger behind the jointserving in place of the director as a guard. Bleeding, which is sometimes OBSTETRIC SURGER ) HI profuse, is controlled by gauze packing. The sickle-shaped knife of <ial-Ki;iii may be substituted for the bistoury. It is passed behind the sym-physis, hooked under the pubic arch, and drawn upward through the joint.Morisani operates by the subcutaneous method through :i small incisionentirely above the symphysis. A.yers, of New York, advocates ;i subcuta-neous operation conducted as follows: The patienl is j► 1.-1<• <• € 1 upon her backupon the operating-table, with the knees drawn up and out. An assistant,standing at the patients left, raises the clitoris and elevates the labia. Theoperator embraces the upper and lower borders of the symphysis with t j i * -thumb and finger of the left hand, then pierces the raucous membrane withan ordinary scalpel just below the clitoris, and pushes the blade, with the
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J0 FIG. 225.—Symphysiotomy: subcutaneous operation . tlie left index-finger within the vagina and behind the symphysis (front view edge against the symphysis, along the face of the joinl to near the top, to make a channel for the bistoury (Figs. 224, 225). With a sound passedinto the bladder the assistant holds the urethra to the left of the medianline, when the operator passes his letr index-finger within the vagina behindthe symphysis. A bistoury is passed through the opening made to the topof tli« symphysis, where it meets the tip of the left index-finger. The knifeis pressed down through the joint to about one-quarter of an inch of theunder herder. It is then taken out and reintroduced with the tip just underthe lower border, and the remainder of the joinl severed from below up.During the division of the joint a second assistant supports the iliac crests.In bringing the severed bones together the sound should be reintroduced. 442 AMERICAN TEXT-BOOK OF OBSTETRICS. and used to ho

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