Volume 2

Applied anatomy : surgical, medical and operative / by John M'Lachlan.

  • M'Lachlan, John.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Applied anatomy : surgical, medical and operative / by John M'Lachlan. 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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    a probe-pointed bistoury is slid, so as to enlarge the incision; the uterus is now exposed. Open the uterus in the centre of the anterior wall; and to allow of this, it may be necessary for the assistant to twist it a little round, so that this point may be opposite the abdominal wound. In this way the large vessels at the sides are avoided. Make a small incision at the upper part, then introduce the left index finger, and enlarge the wound with a probe-pointed bistoury; it is necessary to do this quickly, because of the great haemorrhage. The assistant in the meantime must jam the uterine incision against the abdominal one, especially at the upper and lower angles, to prevent blood passing into the abdominal cavity. Extract the child, taking the liead out first; because, if the legs were taken first, the uterus might contract and imprison the head, wliile the cold, acting on the child's legs and body, might induce inspiratory efforts and suffocate it. Strip off the placenta and membranes artificially, pass a sponge probang of some size through the cervix uteri and out at the vagina, so as to secure a free exit for lochial or other discharges. The peritoneal cavity must then be carefully cleansed, the wound in the uterus stitched with silk separately, or else fixed to the abdominal wound; a glass drainage tube is then passed into the abdominal wound. The dangers of this operation are—(1) Haemorrhage, (2) shock, and (3) peritonitis. L AP ARO - EL YTROTOM Y. (TnoMAa's Operation.) In this operation the cervix is reached by an incision through tlie lower part of the abdominal wall and upper part of the vagina, and through it the foetus is extracted. Its advantages over Caesarian Section are — (1) Tliat the peritoneum is not opened into, and (2) that the uterine wall is not incised, so that one of the chief risks of Caesarian Section— htcmorrhage—is avoided. The cases requiring the operation are those necessitating Caesarian Section, when the mother is alive. It should not bo performed in cases of tumours obstructing the pelvic cavity, carcinoma, noi-