A manual of operative surgery / By Lewis A. Stimson.

  • Stimson, Lewis Atterbury, 1844-1917.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / By Lewis A. Stimson. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    upon, the opening enlarged with the fingers, and the sound withdrawn. 4. The cervix is drawn up into the iliac fossa by an assistant with a blunt hook, the fundus of the uterus de- pressed in the opposite direction, and the operator pas-ses his right hand into the open cervix and delivers the child, turning it if the head presents, extracting it if the breech presents. 5. The iliac fossa should be cleaned with a stream of tepid water introduced through the abdominal wound and escaping through the vagina, ligatures applied to bleeding vessels, or, if that is impossible, a metallic vaginal speculum introduced through the abdominal wound, and the actual cauterv care- fully applied. If liemoiThage should continue after the abdominal wound has been closed by suture, the uterus should be excited to firm contraction, and a sponge, wet with a solution of persulphate of iron introduce<l through the vagina, and placed in contact with the bleeding point, or the vagina tamponed. 6. Should no hemorrhacre occur, the vacjina should be sponged out eveiy twelve hours with a weak solution of carbolic acid. REMOVAL OF THE FALLOPIAN TUBES AND OVARIES. *'TAIT*S OPERATION. A small incision is made in the median line midway be- tween the umbilicus and pubes, and carried down to the peritoneum. All bleeding is arrested, and then the peri- toneum carefully opened upon a director. The index and middle fingers are passed to the fundus of the uterus, and thence along the back of each broad ligament to explore the tubes and ovaries. If the tube is found greatly distended it should now be emptied with the aspirator. If the ovary is deeply covered in by the broad ligament it can be readily exposed by unrolling the ligament from behind forward.^ If there are adhesions they must be gently separated, or tied and cut; it will perhaps be necessary to enlarge the abdom- inal incision for this purpose. » Wylie, Dis. of the Fallopian Tubes, p. 20.