W. A. Freund made the attempt to exert constant traction upon para metric cicatrices by fixing the portio vaginalis with a lever pessary and passing a wire through one lip. C. Chrobak applied elastic traction and invented an apparatus for it.
W. A. Freund has also pulled out very painful parametric bands through an opening made in the fornix vaginae and cut them, without attaining appreciable results.
Laparutomy for the Removal of the Uterine Appendages.—Although this treatment is still under discussion we will mention it because we think that in extreme cases, when tubes and ovaries are considerably diseased, the operation is justified, and because in a large number of cases it has been performed.
We thirst we are correct in assuming that salpingotomy and the removal of the uterine adnexa has gradually developed from castration introduced by A. Hegar and Battey. Salpingotomy was performed by Hegar October 19, 1877, at which time he expressed the opinion that a division between castration and salpingotomy must necessarily be made. In the early reports upon this matter we frequently read that many opera tors intending to perform castration found the tubes or all the uterine appendages diseased and removed them as well. Cases of castration with
out satisfactory results are reported where the operators were sorry that they had not removed the tubes at the time of the operation. Under the heading of " Castration " we also find cases in which only one ovary, which was found diseased, or the uterine appendages on one side were removed, and the healthy ovary left. This makes it evident that the operations were not performed to bring on artificially the climacteric period, but for the removal of the diseased and changed organs. ' For this reason, and especially because it was believed that diseased dropsical tubes are often the cause of chronic and recurrent diseases in women, many specialists, Lawson Tait, Gusserow, Sanger, Hegar, Tauffer and others, extirpated diseased tubes and also all the uterine appendages, with good results in many cases. IL Klotz combined extirpation of the uterine appendages with the stretching of parametric and peritoneal adhesions until the uterus became movable, as he states with good results.