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.

    74/434 (page 56)
    DISEASES OP WOMEN. worll ^r' t+11ian1causiuS a»J ™pture. If the screw works easily, the degree of resistance in the cervix » readily estimated by the finger, and thuii diagnosis as well as treatment is assisted! Other forms of mechanical dilators have been invented by Ellinger and others; in which the blades, two or three in number, are free at the extremity andi are separated by closing the handles. M powerful three-bladed instrument of this hmd, in which the blades are separated by a screw at the handles, on the patteii of that of the cephalotribe, has beem introduced by Dr. Marion Sims. It has been recommended to effect immediate: full dilatation by means of such an in- strument with the aid of an anEesthetij There is some risk, however, of exercising, a dangerous degree of stretching upon* the internal os or cavity of the uterul. and, with the weaker instruments, it is; difficult to estimate exactly the ex- pansion actually produced, on account of the elasticity of the blades. Incision may be performed by Simp- son's single-bladed (Fig. 16), or by any of the numerous two-bladed, metro- tomes, introduced without any speculum. Much caution, however, is required in incising the internal os, since the large vessels which enter the uterus at this; level are not far off, and alarming and even fatal haemorrhage has sometime] occurred. Dr. Greenhalgh's metrotome ■ (Fig. 21) contains an ingenious me- j chanism by which two blades cut out- wards and downwards in a definite adjustment for regulating the width of The incision, however, so produced, even curve, and an the incision.