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September 27, 1947


Author Affiliations


JAMA. 1947;135(4):245. doi:10.1001/jama.1947.02890040047022

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To the Editor:—  In the article on Rectal Complications of Episiotomy on page 1174 of The Journal, August 2, Marbury and Goldman do not state the type of episiotomy which was performed, but I judge that it was the old median episiotomy. It is only right to call the attention of the profession to the fact that a mediolateral episiotomy, or perineotomy, will avoid the dangers and complications which are portrayed in this article, since the incision avoids the close neighborhood of the rectum. Over many years I have never seen this type of perineotomy give any subsequent trouble. Instead of the incision being in the line between the posterior fourchette and the anus, it is made from the point a little to the right or left of the posterior fourchette and runs obliquely outward. While the occasional operator may find it advantageous to have his index finger in the

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