REPORTS OF OASES. 
385 
catarrhal condition of the vagina it was decided not to operate 
in the usual manner through the vagina, but through the 
flank. Two hours before the operation the rectum was 
emptied by an.enema. 
Only a small number of instruments were selected and 
placed in readiness in an antiseptic solution of phenol, such 
as bistouries, artery forceps, scissors, suture material, sponges 
and a Paquin cautery for cauterizing the bleeding surfaces. 
The subject was placed on the operating table and put 
under the influence of chloroform. The abdominal wall was 
well washed with soap and water and an antiseptic fluid. 
The hair and upper layers of the epidermis were removed 
off a place midway between the last rib, thetransverse pro¬ 
cesses of the lumbar vertebras and the anterior iliac spine. 
A spray was suspended over the field of operation, the 
spray being filled with a solution of lysol, the parts operated 
on were by this method kept continually saturated. An in¬ 
cision was made through the skin and paniculus carnosus, the 
fibres of the abdominal muscles being separated by the fingers 
until an opening was made large enough to admit the hand 
of the operator; the hand was then inserted through the peri¬ 
toneum into the abdominal cavity ; the ovary was grasped 
and brought to the opening, where with the scalpel the peri¬ 
toneum (which was very much thickened) was severed and 
the ovary with a portion of the fallopian tube was removed 
with the ecraseur. Peritoneal toilette was dispensed with as 
very little blood had escaped into the abdominal cavity. 
The peritoneum was then sutured with carbolized catgut, 
the end of the sutures being left long enough to act as a 
drainage tube; the muscles and skin were sutured with silk. 
A dressing composed of hydrargyrum chloridum mitr. 3 ij, 
and acidum boricum §i was dusted on the wound; three 
yards of antiseptic gauze (mussed up) was put over this, and 
over this was placed about a quarter of a pound of absorbent 
cotton, and over all a strong muslin roller wound round the 
abdomen, and secured so it was impossible for it to slip for. 
ward or backward. 
The after treatment consisted of 3 ii doses of extractum 
arnicas radicis fluidum every hour for the first twenty-four 
