_After-care._—The nurse watches the patient for sighing respiration, rapid pulse, pallor, and other symptoms of hæmorrhage, either external or internal. Artificial heat is supplied. Hæmorrhage from vagina should be looked for. It is normal. Salt solution by hypodermoclysis may be required. Hot water by mouth in small sips or tap water by rectum (drop method) will relieve the thirst. Morphine may be given if pain is extreme. An enema may be given on the second day or calomel may be started in the morning of the second day. Distention from gas, with or without nausea and vomiting, hiccough and rise of temperature are all signs of danger. No milk should ever be given on account of the gas it causes. The child is put to breast as usual after twelve hours. The stitches are to be taken out on the tenth or twelfth day. =Symphyseotomy= is a separation of the pelvis at the pubic joint and is done with a scalpel or a specially devised knife. =Pubiotomy= is the division of the pelvis, three or four centimeters to the right or left of the pubic joint. The division passes through the pubic bone and is usually done with a serrated wire called the Gigli saw. It is introduced subcutaneously by a special instrument called a pubiotomy needle. Both symphyseotomy and pubiotomy are preparatory to delivery. Pubiotomy is the more desirable and successful operation. The ends of the severed bones separate from one and a half to two inches, and the child delivers easily through the enclosed opening. The after-care is usually simple. _Instruments.—_ 1 scalpel. 2 Gigli saws. 1 pubiotomy needle. 6 artery forceps. 3 eight-inch forceps. 1 needle holder. 2 retractors. Suture material and sponges as usual. The hips are strapped in circumference with zinc adhesive plaster to support the bones. The danger of infection of the wound from the lochia is always present. The main difficulty is in moving the patient, who is more than usually helpless. The bony ring of the pelvis is broken and she can not raise her leg. The repair is cartilaginous at first, but solidifies in a few months so that locomotion is not impaired. Especial pains must be taken to avoid bed sores. CHAPTER XIII MINOR OPERATIONS =Aseptic Care.=—Place patient on a clean bed pan. It need not be sterile. Drape with a sheet and arrange it so the fold may be easily raised by nurse’s elbow. Have sterile basin with cotton pledgets to be filled with solution of lysol 1 per cent. Lysol must be put in basin first and the water added. Take to bedside. Nurse scrubs her hands ten minutes with a sterile brush, hot water, and green soap. Use no towel, no gloves. Keep hands wet and clean. Cleanse vulva with wet pledgets from above downward. Apply sterile pad.