The student's guide to the diseases of women / by Alfred Lewis Galabin.

  • Galabin, Alfred Lewis, 1843-1913.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to the diseases of women / by Alfred Lewis Galabin. Source: Wellcome Collection.

    146/434 (page 128)
    DISEASES OF WOMEN. surface of the inverted uterus, unless modified by lone/ exposure, is highly injected, velvety, and readily Meei It is also distinguished from a polypus by hems painlul, and sensitive to acupuncture, or the tightenij of a ligature or ecraseur wire. A crucial test is to pass a female sound into the bladder with the point directed backward. If a linger be introduced into the rectum the point of the sound can then, in the case of inversion i be tolt above the os, with only the walls of rectum and, bladder intervening, at the point which would other- wise be occupied by the body of the uterus. In some! cases the funnel-shaped depression formed by the] inversion can be felt from the rectum. Treatment.—In recent cases arising independently of parturition, as well as in those resulting from labour! reduction may be effected by taxis. The patient should be placed under an anesthetic, and the hand passed! into the vagina, so as to compress the tumour, and! make steady and prolonged pressure upwards in the! direction of the pelvic axis, while the other hand makes counter-pressure upon the abdomen. The effort should be to return first the part last inverted, not to indent the fundus, the effect of which would be to double thM thickness of uterine wall to be passed through thej constriction. If the inversion is chronic, there is con- siderable risk of producing laceration by attempting* to reduce it immediately by forcible taxis, and it is preferable to commence by the method of prolonged elastic pressure. If this fail to complete the red ne t urn, taxis may then be tried, and repeated from time tofl time, elastic pressure being continued in the intervals. In easy cases an air-ball pessary in the vagina, supported^ by a perineal bandage, may effect reduction. In a more difficult one a repositor should be used, either straight, or having a compensating perineal, as well as a pelvic, curve, as in the instrument of Dr. Aveling. In the early stage of reduction of a complete or nearly complete inversion, when the uterine axis is likely to lie nearly in the line of the vagina, the straight repositor