When it is necessary to remove both ovaries and tubes an opinion very common now is that it is better to take out the uterus also, because in such cases the uterus and vagina atrophy and this condition later causes trouble. Giles came upon such trouble in 11 per cent. of sixty-two cases. As the uterus is useless after the removal of the ovaries and tubes, there is no reason why it should not be removed. The danger of atrophy is sufficient reason for the mutilation. In operations for pelvic peritonitis it is well to remove also the appendix, because it is nearly always diseased, or it will give trouble from adhesions later and cause a secondary operation. It has no function we know of at present. In conservative surgery of the uterus and adnexa for pelvic inflammatory diseases, the results attained by four skilled surgeons are: Giles cured 90 per cent. of 132 cases; Polak cured 35 per cent. of 300 cases; Robins cured 100 per cent. of 20 cases; Norris cured 73 per cent. of 191 cases. Polak's patients became pregnant after operation much oftener than those of the other operators. Seventeen per cent. of his patients, from whom he removed one ovary and resected the other, became pregnant. Giles found that of his married patients under fifty years of age at the time of the operation 25 per cent. became pregnant and went to term. They bore twenty-five children. Five of these also miscarried. In sixty-eight of Morris's cases seventeen were delivered of living children after the operation; three had two children each, one had three children, and there were seven miscarriages. In one of his cases where he removed one ovary and _both_ tubes, the woman bore a healthy full-term child two years after the operation. Dudley[193] found that about 10 per cent. of 2168 cases of resection became pregnant after operation. Ectopic gestation is likely to occur in a few cases after conservative operations. Giles had seven such cases in his series of 132 operations, Polak one, and Norris two. [193] _Jour. Amer. Med. Assoc._, vol. xli, n. 24. When it is necessary to remove the uterus, the choice between supravaginal hysterectomy, where the cervix is left in after the destruction of its mucosa, and panhysterectomy, where the cervix and the body of the uterus are removed, offers no moral problem except the necessity of deciding upon what will be best for the woman. Rupture of a pus tube is a very dangerous accident--all the patients suffering from such a rupture die if not operated upon, and fifty per cent. die even after operation. A physician may do this damage by ignorant or careless examination, and he may be morally responsible for the death. The accident happens not unfrequently from marital congress, and if the husband has been warned by a physician but does not heed this warning, he is guilty of murder if the woman dies after rupture of the pus tube.