The use of nitric acid in the treatment of uterine disease / Lombe Atthill.

  • Lombe Atthill
Date:
[1873?]
Catalogue details

Licence: Public Domain Mark

Credit: The use of nitric acid in the treatment of uterine disease / Lombe Atthill. Source: Wellcome Collection.

    15/18 page 13
    will hold good with respect to all agents applied to the interior of the uterus. I am decidedly of opinion that in all cases the cervical canal should be, if possible, protected, and this no matter whether the cervix have been previously dilated or not , for not only, if this precaution be omitted, will the lower segment of the cervix be most freely cauterized—a part which in the class of cases under consideration is frequently perfectly healthy -—but also much of the caustic will be pressed out by contact with the cervical walls and what remains weakened by admix¬ ture with the cervical discharge. Consequently its action on the interior of the cavity of the uterus will be greatly les¬ sened. In the majority of cases in which I have hitherto deemed it necessary to have recourse to the intra-uterine ap¬ plication of nitric acid, I have in the first instance dilated the cervical canal so fully as to permit a digital examination of the interior of the uterus, because the patients had suffered from repeated attacks of uterine hemorrhage, the cervix being healthy while the body was enlarged, and therefore I could not with certainty pronounce that the bleeding did not proceed from the presence of a polypus or fibrous tumours. When therefore it is decided that nitric acid be applied, after previous dilatation of the cervical canal, my practice is to seize the anterior lip with a vulsellum, and thus draw down and steady the uterus ; then to introduce the blades of my intra-uterine speculum * to the depth of about an inch, and Fig. 1. to expand them slowly to an extent sufficient to per¬ mit a pair of fine forceps, holding a roll of cotton, to be introduced. With the cotton I dry the inner surface of the * This little instrument is made of vulcanite, and is something like an aural speculum expanded by means of a screw worked through a long handle. It was made for me by Messrs. Arnold and Sons, of West Smithfield, London.
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