Mechanical appliances in uterine surgery / by William H. Baker.

  • Baker, William H. (William Henry), 1845-1914.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Mechanical appliances in uterine surgery / by William H. Baker. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    11/18 (page 7)
    iodine to tlie fornix of tlie vagina. By these means, at the end of two and one half weeks the tenderness was so far removed tliat attempts were made on alternate days to gradually work the fibroid up out of the excavation of the pelvis, past the promontory of the sacrum, and above the superior strait. This was a rather tedious undertaking; but by the 10th of August, that is, in three weeks from the time we were able to commence these manipulations, we had so far accomplished our object that we were able to introduce a Thomas’s modification of Cut- ter’s pessary with a perineal strap and abdominal belt. The patient’s relief was almost immediate: the backache, bearing-down, and dracro-ino- pains disappeared, the action of the bowels and bladder became natural; and she was able to live in the full enjoyment of the marital relation. The patient, herself having been taught to remove and replace the pessary properly, and then feeling perfectly well and able to walk to and from mv office, a distance of four miles, without any ereat fatiorue. was discharged on the 17th of August. The pessary was subsequently changed for one of the same variety with a larger bulb, there being a tendency of the tumor to work down behind the instrument; but it continued to give the greatest relief. Let it not be supposed that the above happy result can be so readily obtained in every similar case. It is sometimes only after the most long-continued and patient treatment that the hypersesthesia can be removed to such an extent that an instrument can be tolerated. It will be evident that a fibroid of the size of that described, having an attachment to the posterior wall and the fundus of the uterus, would tend to dislocate the uterus backwards; and even if the organ were replaced, unless some mechanical appliance were adjusted to support this increased weight, or to so far antevert the whole mass that its re- turn into its former dislocated position would be prevented, the relief to the patient would be only the most temporary. What, then, except the adjustment of some artificial support, in the above class of cases, can give any permanent relief to the sufferer ? Surgical interference for the removal of the tumor would not be justifiable ; for although the sufferings of the patient were great, yet life was not especially endan- gered, and so grave an operation would be unwarrantable. I am well aware that a large number of additional cases might be given, illustrating this division of the subject; but those already cited sufficiently prove the great advantage often to be derived from the proper adjustment of some form of mechanical a])])liance to the uterus; and the practitioner who entirely discards such appliances sacrifices one of the most efficient means of giving relief to very many of his patients.