Mutilating  Operations. — The  many  mutilating  operations  with
which  the  anteflexed  uterus  has  been  attacked  is  a  sad  chapter  in
surgical  gynecology,  and  much  mischief  has  likewise  resulted
from  the  use  of  the  so-called  intra-uterine  stems.  Were  it  not- for
the  recent  revival  of  this  pernicious  method  of  treatment  the
subject  might  be  dismissed  without  further  comment;  but  so  much
malpractice  has  been  perpetrated  by  this  contrivance  in  the  hands
of  those  apparently  ignorant  of  the  first  principles  of  gynecological
pathology  that  I  trust  some  good  may  be  done  by  quoting  the
views  held  by  Emmet  on  this  subject.  More  than  thirty-five  years
age  he  wrote  as  follows :

"Unfortunately,  members  of  the  profession  are  frequently
advocating  the  use  of  the  stem  pessary,  regardless  of  the  experi-
ence of  those  who  have  gone  before  them,  until  they,  in  turn,-
learn  that  they  have  not  been  wiser  in  their  day.  As  soon  as  the
true  condition  comes  to  be  appreciated,  the  use  of  the  intra-uterine
stem  will  be  abandoned  as  a  most  irrational  instrument.  Experi-
ence will  at  last  teach  every  one  that  no  permanent  benefit  is  ever
derived;  and  that  sooner  or  later,  in  almost  every  case,  mischief
will  result  from  the  use  of  the  instrument."

Cases  bearing  out  the  truth  of  what  Emmet  wrote  so  long  ago
are  coming  to  our  attention  again,  so  that  it  is  now  no  unusual
experience  to  meet  with  the  pathetic  case  of  the  young  woman
in  whom  the  use  of  the  stem  pessary  has  resulted  in  an  infection
involving  the  uterus  and  tubes.  This  may  have  even  necessitated
a  pan-hysterectomy.  At  the  best  she  has  been  deprived  of  all
hope  of  maternity,  which  was  her  heart's  desire,  and  with  intelli-
gence enough  to  understand  the  situation  can  hardly  be  blamed
for  her  feelings  of  bitter  resentment  at  the  way  she  has  been
maltreated.
