DESCRIPTION OF THE OPERATION. 



79 



puncture the whole of the coats of the vagina without injuring any 

 of the abdominal organs or vessels. It is important to ensure 

 incision of all the coats with the knife, as, if an attempt is made 

 to puncture the peritoneal lining with the finger, this covering 

 may recede and give rise to the formation of a pouch with, 

 perhaps, unpleasant sequelae.^ The guard is then replaced 

 and held in position whilst more of the knife is inserted to 

 lengthen the incision. This instrument may then be dispensed 



,/f^. 



\iiii,: i; 



Fig. 31. 

 Two patterns of knife with guarded blade. 



with, and may be either withdrawn altogether (the safer plan) 

 or allowed to fall on the vaginal floor. With the fingers, in- 

 serted one at a time to commence with, then two or three 

 together held wedge-shaped, the opening is made sufficiently 

 large to admit the whole hand. It is better to tear the wound 

 open in this way than to lengthen it with the knife, as there 

 is less danger of severing any of the arteries of the vagina. 



? See Appendix, Case 25. 



