DISEASES OE THE GENERATIVE ORGANS. 



205 



through the transparent lining membrane of the abdomen (perito- 

 neum), letting the point of the knife lie in the groove between the first 

 'two fingers of the left hand as they are slid down inside the membrane 

 and with their back to the intestines. Ah assistant, whose hands, like 

 those of the operator, have been dipped in the sublimate solution, 

 may press his hands on the wound behind the knife to prevent the 

 protrusion of the intestines. The operator now feels for and brings 

 up to the wound the gravid womb, allowing it to bulge, well through 

 the abdominal wound, so as to keep back the bowels and prevent any 

 escape of water into the abdomen. This is seconded by two assistants, 

 who press the lips of the wound against the womb. Then an incision 

 12 inches long is made into the womb at its most prominent point, 

 deep enough to penetrate its walls, but not so as to cut into the water 

 bags. In cutting, carefully avoid the cotyledons, which may be felt 

 as hard masses inside. By pressure the water bags may be made to 

 bulge out as in natural parturition, and this projecting portion may 

 be torn or cut so as to let the liquid flow down outside of the belly. 

 The operator now plunges his hand into the womb, seizes the fore or 

 hind limbs, and quickly extracts the calf and gives it to an attendant 

 to convey to a safe place. The womb may be drawn out, but not until 

 all the liquid has flowed out, and the fetal membranes must be sepa- 

 rated from the natural cotyledons, one by one, and the membranes 

 removed. The womb is now emptied with a sponge, which has been 

 boiled or squeezed out of a sublimate solution, and if any liquid has 

 fallen into the abdomen it may be removed in the same way. A few 

 stitches are now placed in the wound in the womb, using carbolized 

 catgut. They need not be very close together, as the wound will 

 diminish greatly when the womb contracts. Should the womb not 

 contract at once it may have applied against it a sponge squeezed out 

 of a cold sublimate solution, or it may be drawn out of the abdominal 

 wound and exposed to the cold air until it contracts. Its contraction 

 is necessary to prevent bleeding from its enormous network of veins. 

 When contracted the womb is returned into the abdomen and the 

 abdominal wound sewed up. One set of stitches, to be placed at 

 intervals of 2 inches, is passed through the entire thickness of skin 

 and muscles and tied around two quills or little rollers resting on the 

 skin. (PL XXVIII, fig. 7. ) These should be of silver, and may be 

 cut at one end and pulled out after the wound has healed. The super- 

 ficial stitches are put in every half inch and passed through the skin 

 only. They, too, may be of silver; or pins may be inserted through 

 the lips and a fine cord twisted round their ends like a figure 8. (PL 

 XXVIII, fig. 9.) The points of the pins may be snipped off with 

 pliers. The edges may be still further held together by the applica- 

 tion of Venice turpentine, melted so as to become firmly adherent, and 

 covered with a layer of sterilized cotton wool. Then the whole should 

 be supported by a bandage fixed around the loins and abdomen. 



