On the diagnosis and treatment of retroversion of the unimpregnated uterus / by J.Y. Simpson.

  • James Young Simpson
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: On the diagnosis and treatment of retroversion of the unimpregnated uterus / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    remaining form which I most frequently employ is free from these disadvantages. The two first forms are, when used, altogether concealed within the genital passages. In this third form a portion of the instrument is placed externally, and an- other internally. Third Form of Pessary.—It is made up of two parts:—1. An internal part (fig. 2), provided, like the two preceding pessa- ries, with a stem (f), to pass into the uterine cavity; a bulb or ball (e), for the cervix to rest upon; and, in addition, a vaginal portion, or curvilinear tube (d). 2. An external part (fig. 1), consisting of a wire frame-work (a, c, s), to maintain and hold the internal portion in situ. This external part, or wire frame, is about five inches long; at its lowest or vaginal portion it is about ^ an inch broad; and towards its upper, or pubic por- tion, it suddenly swells out to 3 inches in breadth. From the vaginal extremity of this frame projects, at nearly right angles to it, a flat tubular portion (s) 2^ inches long, closed at its further extremity, like the point of a female catheter, and fitted to slide into and fix in the corresponding open tube (a) attached to the bulb of the internal half of the instrument(6). In the Plate the uterine stem of the instrument is repre- sented as placed in the cavity (h) of the uterus, a section of the organ (f) being outlined around it. In introducing the instru- ment, the internal portion, fig. 2, is first passed into the uterus and vagina, in the same way as the uterine bougie is passed (a) I have a patient at present wearing one of these pessaries with a stem three and a half inches long. The retroverted uterus is enlarged and elon- gated by fibrous tumours in its walls, and one of the ordinary pessaries did not suffice to hold it replaced. (i) The different parts of the pessaries in figures 1, 2, and 3, are repre- sented as somewhat below their actual size, in order to suit the size of the plate. The bulb or ball is, in general, made an inch and half long, one mch broad, and about half an inch thick. I have sometimes used a larger bulb. When smaller it is apt to produce dilatation of the os uteri, and even to pass partially into it. [The accompanying plates were kindly furnished by Dr. Simpson Ed.]