526 CESAREAN OPERATION. 



of any advantage to place in it the tent recommended by Baude- 

 locque, nor the cierge pertuise of Ruleau, nor the tent of Rousset, 

 nor the sound of M. Tarbe, nor any species of canula whatever; 

 these means would not prevent the os uteri from closing, and would 

 augment the irritation to no purpose. The finger introduced from 

 time to time suffices to keep it free enough, should it cease to give 

 issue to the matters, which, after all, nothing can prevent from pass- 

 ing wholly or partly out at the wound. 



1157. The operation being terminated, we must next think of 

 putting a stop to the flow of blood. In the lateral operation, and 

 especially in that of Lauverjat, several arteries may have been 

 divided; they should now be tied, provided they should not have been 

 secured during the progress of the operation. During the operation, 

 the principal orifices of the uterine arteries have been closed by the 

 fingers of the assistants; there never can arise any question about 

 obliterating them with the ligature; but it has been recommended 

 to cauterise them with vitriol, and generally, to trust them to the 

 contractions of the womb, which is to be solicited, provided it be 

 slow in taking place, by irritating the cavity of the organ or the lips 

 of the wound with the fingers, or linen moistened with vinegar and 

 water; after a few minutes the length of the incision in the womb is 

 reduced to from one to two inches, and thenceforth hemorrhage of 

 any kind becomes impossible. 



1158. In England, in Germany, and also in France, the wound 

 in the abdomen is generally closed by the interrupted or twisted 

 suture, because, it is said, that is the only means of keeping the lips 

 in contact, and of preventing hernia of the viscera. Sabatier, how- 

 ever, thinks it ought to be dispensed with, and says that unless the 

 whole thickness of the abdominal parietes be included in each stitch, 

 which would be dangerous, the adhesive strips will do as much as 

 the sutures, without compromitting, in the same manner, the safety 

 of the patient. But notwithstanding the reasons urged by that 

 learned author, it seems to me to be preferable to have recourse to 

 the suture, even where Lauverjat's operation has been adopted. 

 In all cases the lower corner of the wound should be left free to 

 allow the matter to escape. Besides, the sutures do not prevent the 

 application of adhesive strips over their intervals, nor the favorable 

 action of the uniting bandage, and a proper position. 



The wound is then covered with a piece of linen, perforated, or 

 with strips spread with cerate; two long and broad compresses are 

 placed on the sides; some pledgets of soft lint, common compresses, 

 and a body-bandage well applied, will complete the dressing. 



Previously to leaving the woman, the linens soiled during the 



