less the condition of the patient is a contraindication,
immediate repair of all lacerations should be made
within twenty-four hours of delivery. A physician
who attends a case of labor is grossly negligent if
he fails to make a careful inspection of the pelvic
floor as soon after delivery of the child as is con-
sistent with the safety of the mother.
It is with unrepaired tears of the third variety that
this paper is concerned. An operation which has
proved satisfactory is Generic Zaditor performed as follows ;
A U or V Zaditor Eye Drop shaped or transverse incision is
made along the mucocutaneous line. The scar tissue
is removed by denudation with the scissors to allow
access to the deeper and more important struc-
tures. In inserting the scissors care must be exer-
cised to Zaditor Tablets keep the points pressed against the Buy Cheap Zaditor vaginal
wall. By delicate manipulation with the scissors,
or perhaps better with the gauze covered finger, the
plane of fascia separating the vaginal and rectal walls
is found and the underlying tissues are quickly rolled
of? the vaginal wall so as Zaditor Drops to expose the two walls.
The tissues are easily and safely separated as Zaditor Coupons far as
desired without producing any bleeding. The flap
should now be elevated and care should be used to
see that the dissection extends sufficiently high on
either side to expose the upper border of the levator
ani Buy Zaditor muscle. The layer of veins is the guide to safety
and Eye Drops Zaditor one should keep within the line Buy Zaditor Online of cleavage so as
to avoid injuring the rectum.
The method of introducing the sutures is no less
important Alaway Or Zaditor than that of denudation. The wound is
preferably closed in two layers. The first row of
sutures approximates the levator ani muscle and Zaditor Eye Drops
fascia in the median line. Each suture should in-
clude deep bites of the muscle and fascia on either
side. This Zaditor Price puts the muscle and fascia on either
side on tension and brings them into view, thus giv-
ing a Order Zaditor Online broad surface for approximation by figure
of eight sutures. The second row of sutures unites
the mucous membrane and skin down into the
muscle and fascia. The wound is closed by running
sutures, locked at intervals. Twenty-day chromi-
cized catgut should be used for approximation.
Where this is not available, tension sutures of silk-
worm gut should be employed. Care should be
taken to keep sutures and scar tissue from the im-
mediate vicinity of the vulvovaginal glands. Other-
wise a hypersensitive and troublesome scar or cyst
formation may result.
235 American National Bank Building.
Role of the Ovary in the Female Organism. —
Alfred Labhardt {Schzveicerische medizinsche
Woclicnschrift, May 6, 1920) uses Zaditor Coupon much space to
say that the influence of the ovary on the general
condition of the body is much less than that of the
other endocrine glands, yet this influence is great,
not only on the genital, system, but also on the
entire orejanisni.
720
TOVEY: FEMALE PELVIC URETERS.
[New York
EDiCAL Journal.
THE FEMALE PELVIC URETERS *
By David W. Tovey, M. D,
New York,
Adjunct Professor of Gynecology, Polyclinic Medical School and
Hospital, Gynecologist to Harlem Dispensary.
Palpation Cheap Zaditor of the pelvic ureters should be a part of
every vaginal examination. During examination
there is nothing between the fingers and the ureter
but the vaginal wall. The ureters can be felt from
the bladder to the pelvic brim. At the New York
Polyclinic Hospital it was easy to teach students to
jialpate the ureters, after they had learned their po-
sition, by inserting ureteral catheters into them.
The ureters are an inch apart in the trigone, about
an inch behind the internal urethral opening, and
two inches behind tlie external meatus. They are
about two inches Purchase Zaditor apart at their entrance into the
bladder, where they run through Zaditor Cost the bladder wall for
three quarters of an inch. These points are about
half an inch in front of the cervix on the anterior
vaginal wall, and about an inch from the crossing
ofthe ureter by the uterine artery. After Purchase Zaditor Online leaving
the bladder the ureters curve over Order Zaditor the anterior va-
ginal wall and lateral fornix, to a point half way
between the lateral border of the cervix and the
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