Technic. Introduce one hand, armed with the embryotomy
knife, through the maternal passages until the perineum of
the fetus is reached, make a free incision through that
region, involving the anus in the male fetus and the anus
and vulva in the female, and enlarge the incision sufficiently
to admit the operator’s fingers into the fetal pelvis. Locate
the great sciatic ligament and with the knife or chisel
divide it from end to end, thus enlarging the pelvic
cavity and giving ample operating room. When this has
been severed and sufficient operating room attained, carry
the chisel with the hand, place it against the shaft of
the ilium as shown between I’ I’ in Fig. 73, as nearly per-
pendicular to the long axis of the iliac shaft as possible and
keeping the hand in touch with the chisel blade, have an
assistant drive it through the bone until it and its periosteum
are completely severed. Revolve the chisel on its long axis
and force the cut ends of the bone apart. Disengage the
chisel and place it against the symphysis pubis or against
the ischium opposite the obturator foramen and drive it


UWAOYS SI [ISI IT,
wWoljEyHasaid Yose1g


“TANI [B1@J 9YI JO Yes ay} Ysno1y} suissed
"rnumoy yey “yy Sstqnd ‘gq {mimiost jeuseyeur ‘J | wnt! [eqaj ‘/T/J * minty peursyeyy ‘J


‘pourejzar Apayo[d moo sda] pury ay} YW uoryezUaseid s011ajsod ay} UL AMIOJOATQUIT
sanmienXxg 1011ajSs0g ay) Jo uoNEndury s1Ajad-e Uy
SL Old


192 INTRA-PELVIC AMPUTATION OF POSTERIOR LIMBS


through the ischium and pubis at this point. Revolve the
chisel upon its long axis and separate the isolated portion of
the pelvis as completely as practicable from the surrounding
tissues. Separate the muscles with the fingers from the
detached pelvic bone for a short distance from the severed
ends on either side. ‘The most important point of resistance
is the attachment posteriorly of the skin, vulva and anus to
the sciatic ligament and the ischium and anteriorly, chiefly on
the median line, the prepubic tendon to the pubic brim ;
these are to be cut, if necessary, with the chisel or knife.
