On the contrary, if I had had time to finish, I would have said that after I go away from my cases, I insist that the nurse shall leave them alone-keep out of that domain. I permit none of these antiseptic washings that we have here recommended in the journals and elsewhere, to be carried out every day or twice a day. On the country, I believe that if we do not have trained nurses, we had better keep the nurse away from that domain. Let us make the vagina as aseptic as possible. Let us be as cleanly as possible. These are my views on this subject, and I was glad that this paper camp up after the other one, because I felt that I was misunderstood.
H.E. BEEBE, M.D.: The measures recommended are all very good, but I think it is quite well proven that of later years laceration of the perinaeum is more frequent when the shoulders are passed than when the head is passed.
SHELDON LEAVITT, M.D., in closing the discussion, said: I have nothing of importance to add, though I might say a few words with regard to the use of the forceps as mentioned, more especially by Dr. Ripley. These short forceps-these very short forceps-are a convenience, to say the least. The use of emollients, as mentioned by Dr. Ripley, is an excellent practice; but we must give what Graves demanded-the tincture of time, in which the perinaeum may accommodate itself to the size of the foetal head.
But the cases of which I spoke, in which episiotomy is desirable, are those in which we have given the time, and the vulvar opening is hard and unyielding, and the head out of proportion to it. Under these circumstances, where laceration is received, from the experience which we have had, we may introduce the scissors and make the incision to which I have alluded.
