132 FISTULA AND POLL-EVIL 



the main object — the resection of the hgament. 



In this step we lay the scalpel aside and take 

 up the probe-pointed bistoury. We first pass 

 the index finger of the right hand under the 

 hgament right at the crest and using the finger 

 as a guide pass the bistoury under it, cutting- 

 outward and upward. The ligament through 

 its extreme elasticity will contract backwards 

 as fast as it is cut and tlius reveal itself to the 

 operator. That is, the end will come right out 

 into the foreground after contracting back- 

 ward an inch or more. We then grasp the end 

 with a tumor forcep and dissect it in the back- 

 ward direction as it is drawn upon with the for- 

 cep. Over the region most badly damaged by 

 disease it will be found so fused with the other 

 connective elements that it can not be said to 

 be a distinct structure. We attempt to take 

 away as much of this connective tissue as is 

 thought prudent as the dissection proceeds 

 backward. The dissection is continued along 

 the whole length of the incision or until the 

 sound part of the ligament is reached posteri- 

 orly. We know when the sound part is reached 

 by its elasticity. When the section now held in 

 the forcep is drawn back and forth the liga- 

 ment it seen to stretch easily. Here it is cut 

 off. 



The attention is now directed to the other 



