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September 10, 1910


JAMA. 1910;55(11):918-921. doi:10.1001/jama.1910.04330110018006

As the members of this Section know, this is not the first time that I have addressed it on the subject chosen. I seek this opportunity because, I confess in advance, I am greatly disappointed in the results obtained by surgeons in various parts of the country. Patients come to me from widely scattered localities, having been operated on by surgeons of repute and of ability beyond question. Of course, it should be borne in mind that the cases thus seen are exceptional. If the experiences teach anything, the criticism applies to the method, rather than the operator.

REPORTS OF CASES  In illustration of this I shall cite three recent cases in young, healthy women.

Case 1.—  Mrs. B., aged 29, underwent instrumental delivery of a large child. An extensive laceration of the perineum, not involving the rectum, resulted. Six weeks after the delivery she was operated on by two

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