File:The practice of medicine and surgery, applied to the diseases and accidents incident to women (1881) (14579205537).jpg

Identifier: practiceofme00byfo (find matches)
Title: The practice of medicine and surgery, applied to the diseases and accidents incident to women
Year: 1881 (1880s)
Authors: Byford, William Heath, 1817-1890. (from old catalog)
Subjects: Women
Publisher: Philadelphia, Lindsay & Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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tion for vesico-vaginal fistula is, in many respects, different fromthat above detailed. 96 AFFECTIONS OF THE VAGINA He places his patient on her back with the breech very much ele-vated. In cases where the fistula is near the orifice of the vagina,the limbs are placed in the position usual in lithotomy. If thefistula is deep, however, the limbs are brought up and extended overthe sides of the abdomen and breast, as shown in Fig. 27. If theuterus is sufficiently mobile, Simon draws it down to the external Fir 9q
Text Appearing After Image:
organs of generation, and thus places the fistula immediately underthe hand of the operator. In order to ascertain the mobility of theorgan, he seizes the cervix with Museuxs forceps, and draws upon ituntil the vagina is inverted, or until it is evident that the forcibletraction required will do violence to some of the tissues. When thecervix is drawn down sufficiently, two strong threads are passedthrough it by which it is held in place. Fig. 28 represents this stage of procedure; the sides of the vulvabeing held out of the way by levers made for the purpose. URINARY FISTULA, 97 When the uterus cannot be thus drawn down, Simon uses twospecula, and the levers in the sides of the vulva, if necessary. Thismethod of exposure is very pkiinly illustrated by Fig. 29. Onelarge speculum draws back the perina?um, and another, somewhatdifferently constructed, is placed under the symphysis pubis. Fig. 30.

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