A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge.

  • Dührssen, Jacob Alfred, 1862-1933.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    belongs. TJiese obstructions may be as a rule avoided by a suitable alteration in the technique). 6. Prolapse with rigid long cervix. 7. Cancer and myoma of the cei-vix. In new growths of the cervix it is easy to combine vaginal Cesarean section with enucleation of the new growth. With cancer of the cervix, after scraping it away, the^ cervix can be separated from the vagina and the bases of the parametria and amputated above the growth; then the uterus is split back and front and the child extracted Avith ease. . If the peritoneum is opened in doing this it is of small concern, since after emptying the uterus the splitting is continued* upward until the uterus can be drawn out, when the ligaments are either ligatured or clamped from above down. Even when the clamjDS are used it is pos- sible, as Diihrssen has shown, to close the peritoneal cavity by sutures behind the clamp. The author has ex- perienced the facility of vaginal extirpation of the uterus immediately after labour in a case successfully operated upon in this way for rupture of the uterus. When myomata obstruct the parturient canal a similar procedure is used. The cervix is incised round about, the exposed anterior and posterior uterine walls are divided as high as possible back and front, the myomata are cut up and enucleated, the uterine incision is enlarged sufficiently to admit of the delivery of the child. The uterus is emptied. The uterine incisions are sutured, and so are those of the peritoneum, if opened, and' the vagina. If there are several myomata these may be enucleated, or the myomatous uterus may be extirpated after removal of the child. This operation of vaginal Cassarean section can only be carried out by a specialist who possesses