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Show .1213 EXIIRPAIION 0F POLYPUS FROM THE "70MB; EXTIRPATION 0F POLYPUS FROM THE \‘VOMB. some elasticity; so that being run along the cord which ties the tumour, it may direct it deep, and slip 011‘ from it when necessary. Placing the patient on her side, or on her back, we take a small firm cord, and without making a noose upon it, we spread the doubling of it upon the extremities of the fingers : insinuating the fingers conically into the es exter= num, w hen they touch the lower part of the tumour, expand them, and as it were grasp the tumour, carrying the cord round it at the same time upon the points of the fingers ; then pushing the fingers as deep as possible, leave the ligature and withdraw the hand. ' *' .-.',4urv77i401 \ ‘x a":"fi"!%"l‘" - W" "1-an --v-' -" 7"‘3‘? "‘"" " '_ i" 7 7 _ 3-5," p.43.-. «fin-7‘4 "0..."... / .. . . ‘ ‘ ' f - But the ligature may still be far from being home to the. neck of the tumour, we have now to take one of these curved instruments, having a. ring in the end, and carry it along the ligature, and direct it to the very base of the tumour within the uterus: then with the other ringed instrument enr brace both ends of the ligature, and run it home along them, until the instrument is brought up close to that first introduo ed, which is new withdrawn. We may now tie the cord in "the common methid, holding one of the ends (put throug h the ring, and the in5trument pushed beyond the knot to be tied). Or it may he more easily done in this way ;« I g 1' \-: ‘ ‘ i A, the tumour ; B, the ligature round the neck of the tu mour ; C, the instrument, being a piece ot'steel, with a ring at each end-the one is put on both ends of the ligature, and pushed up to the neck of the tumour, so as to tighten the cord B ; then the ligature is put through the nearer ring, and tied. firmly at D. This is simple and effectual. , _ \MfiJCh 1 The ligature ought to be drawn only so tight as to stop the circulation. If too slightly drawn, by only strangulating the veins, it will produce or inCrease the hremorrhagy, if the surface has been injured ; but when it is sufficiently tightly drawn, the bleeding will cease; on the next day the cord will be drawn a very little tighter; and each succeeding day the tightness should be increased ; and between the third and sixth day, the ligature comes away, having cut through the neck of the tumour. If, during this Operation, much pain and sickness follow, we must be particularly cautious ; and if in the course of it there arises pain and tension of the belly, we immediately desist, and by fermentation and bleeding, allay this rising inflammation. ‘ i , ' .- _ . - "H |
