File:The practice of medicine and surgery, applied to the diseases and accidents incident to women (1881) (14763314104).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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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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The margin of the fistula is prepared by cutting away all the cica-tricial tissue, and the paring is done almost perpendicular to the sur-face of the vaginal mucous membrane. There is some slight inclina-tion or declivity in the cut edges, but they are very much less bevelledthan in Dr. Simss operation. Fig. 30 will give a correct idea of 98 AFFECTIONS OF THE VAGINA. this part of the operation. A comparison with Fig. 30 will give thereader an idea of the liberality with which Dr. Simon considers itnecessary to pare away the tissue. The wound is closed with fine white silk, about the size of a largehorsehair. Each stitch is placed a little more than a line distant Fig. 31.

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