Essentials of gynecology : arranged in the form of questions and answers prepared especially for students of medicine.

  • Cragin, Edwin B.
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Essentials of gynecology : arranged in the form of questions and answers prepared especially for students of medicine. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    187/258 (page 189)
    metrorrhagia, a thoroiigli curettage of the uterus, followed at inter- vals b} astringent applications to the endometrium, will often give marked relief A curettage, however, is fi-equently, if not usualh^ impossible. In some cases it will start a sloughing of the growth. (c) Diminution of Blood-supply.—Ligation of the uterine arteries from the vagina has been ouployed, but has now given place to more reliable methods. Tait's operation of removal of the ovaries and tubes has in many cases been not only palliative but curative, but its present interest is only historical. Curative Treatment.—This consists of either myomectomy or hjs- terectomy. Describe the operation of myomectomy. Myomectomy consists in exposing the tumor in the uterus, either from the abdomen or vagina, incising the capsule, enucleating the tumor, and closing its bed with catgut sutures. This operation is indicated where the tumor can be easily removed without serious mutilation of the uterus. The operation is gaining in favor and may be employed even when the tumors are multiple. H^^sterectomy is easier and less shock often than the removal of many tumors by myomectom}'; hence, if patient is near the meno- pause, if children are not desired and a sound ovary can be left, hj'^sterectomy is to be preferred in the presence of many tumors. What are the varieties of hysterectomy ? Hysterectomy, removal of the uterus, may be performed: (a) Through the vagina—vaginal hysterectomy., indicated when the uterus and tumor are small. [h] Through the abdomen—ahdominal hystei^ectomy^ indicated when the uterus and tumor are large. Describe the operation of vaginal hysterectomy for fibro- myoma uteri. This differs from the operation described under carcinoma uteri only in the fact that in cases where fibro-myomata are large enough to cause symptoms the uterus with its tumors is often too large to come through the vagina without removing it piecemeal, i. e. by morcellation. After thorough disinfection of vulva and vagina, the uterus is curetted and irrigated with a sterile solution; the cervix