Vaginal Ovariotomy in the Marc 265 



plication of 1:1000 aqueous sublimate solution to the exter- 

 nal parts and for a short distance inside the vulvar lips and 

 to the clitoris. Do not introduce irritant disinfectants into 

 the healthy vagina nor deeply into the vulva, as they may 

 cause severe straining during and subsequent to the opera- 

 tion and, by injuring the vulvo-vaginal mucosa, favor subse- 

 quent infection of the vaginal wound. The vagina may 

 with benefit be flushed out mechanically with 0.6 per cent, 

 salt or soda solution. 



Wash away the sublimate solution with a tepid 0.6 per 

 cent, soda bicarbonate solution, and fill the vulvo-vaginal 

 canal with the same. After thorough disinfection of the 

 hands and arms, remove the disinfectants by washing in 

 sterile soda solution, which at the same time renders the 



Fig. 76 — Colin's scalpel. 



hand unctuous and readily introduced through the vulva. 

 Armed with the guarded sterilized scalpel, Fig. 76, intro- 

 duce the hand into the vagina promptly and when the organ 

 is well "ballooned," unsheath the knife. Place it just above 

 the OS uteri, parallel to the long axis of the uterus, a few 

 mm. to the right or left of the median line in order to avoid 

 a loose fold of mucous membrane generally existing there. 

 Hold the blade vertical — that is, with the cutting surface 

 parallel to the longitudinal muscular fibers of the vagina — 

 and, guarding the possible extent of its introduction with 

 the thumb and fingers, push it directly forward with a 

 quick thrust through the vaginal mucosa, the muscular walls, 

 and the peritoneum, until the disappearance of resistance 

 indicates that the latter has been penetrated. This is the 

 most critical step in the operation. 



If the hand is introduced into the vagina immediately 

 after the injection of the sterile saline solution, the vagina 



