Recent improvements in the operative treatment of vesico-vaginal fistula / by J. Clarence Webster.

  • Webster, John Clarence, 1863-1950.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Recent improvements in the operative treatment of vesico-vaginal fistula / by J. Clarence Webster. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Recent Improvements in the Operative Treatment of Yesico-Vaginal Fistula. By J. Clarence Webster, B.A., M.D., F.R.C.P.Ed. For many years the operative methods employed for the closure of vesico-vaginal fistula have been based upon the prin- ciples laid down by Marion Sims, i.e. free paring of the edges of the fistula, and adaptation of the raw surfaces by means of sutures. Sims was not the first to suggest this method. It is certain that it was recommended by Van Roonhuysen1 of Holland, in the seventeenth century, and that Fatio2 of Basel and others employed it successfully in the eighteenth century. In the early part of the present century, Hayward3 of Boston, U.S. A., pointed out the necessity of making a large raw surface, while Mettaner4 of Virginia advocated the use of the silver suture. It is, however, to Marion Sims, and, later, to Simon, that we are mainly indebted for the elaboration of the operation, and for the demonstration of its superiority over the other methods of treatment. They have, indeed, made universal the plastic operation as the only reliable means of treating fistulse. Yet, important as the results of their methods have been, there can be no doubt that better results can be obtained by the employ- ment of certain modifications, both in regard to the manner of preparing the raw surfaces, and of uniting them. Sims and Simon recommended that the edges of the fistula should be rawed by the removal of a strip of tissue, extending from the vaginal to the vesical mucosa. The former pared the edges by a sloping incision, which did not divide the latter, 1 Trans. Philos. Soc. London, vol. xi. p. 621. 2 Pozzi, “Traite d. Gym” Paris, 1890, p. 904. 3 Boston Med. and S. Joum., 1831. 4 Folten, Arch. gen. demed., Paris, 1860, V. Serie, tome xv. p. 459.