DEEP INCISIONS OF THE OS CERVICIS. —Deep incisions into the os uteri after the disappearance of the cervix are some times indicated in cases demanding rapid delivery. Four incisions are made, reaching from the cervico-vaginal june tion downward in such a manner as com pletely to dilate the os by the bloody method, as does Nature by her own un aided efforts. Since no important ves sels are cut, primary suture is not neces sary. The field for this operation is ex tremely small, and limited to those cases in which instant delivery is indicated: rapidly deepening coma from eclampsia, embolus of the lung, severe accidental hwmorrhage, impossibility to dilate by other means, a spastic or cicatricial os. The presence of the cervix is a contra indication to its performance, since, with this, we get a persistence of the internal i ring. Its effacement can be effected by dilating the cervix by the rubber bags or the finger, until the cervix has merged into the lower uterine zone.
In the Prague maternity school, in 3855 labors (1892-95), incision was prac ticed 24 times, namely: one incision in 1 case, two incisions in 8 cases, three in 9, and four in 6. In 11 cases the in cisions were sutured after labor, 7 unit ing down to the edge of the external os by first intention. Indications for in cisions were: prolapse of cord, 3 cases; eclampsia, 3; dangers threatening fetus, 17; cancer of the patio, 1. Delivery was completed by symphysiotorny and forceps in 3 cases, by the forceps alone in 14, by turning and extraction in 5, and by perforation and cranioclasty in 2. The puerperium was normal in 17 of the patients; in 3 there was a slight rise of temperature; in 2 parametritis; in I mastitis; and in l endometritis, salpingitis, peritonitis, and fatal sepsis. This patient was mentally afflicted and very uncleanly. Barkman (Cearalb. f. Gyntik., No. 32, '97).