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.

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    wall, and, at the same time, high up, and sheltered behind the pubes. In Dr. Greenhalgh's pessary, 2 order to fulfil this end, the lower limb is made of sol rubber tubing, the whole instrument beincr 0f some! what elastic wire, covered with india-rubber, so thafal it can be prassed together during its introduction! It has, therefore, a disadvantage in point of cleanlil ness, and, the india-rubber becoming very soft in the* vagina, the unsupported corners are apt to presd injuriously. I have met with several instances inE which they had ulcerated very deeply into the vaginal Avails. ° i In some instances, when there is considerable hyperl amua, sweUing, and tenderness of the fundus, as is thel case more frequently in retroflexion than in retro-f version, it is desirable, before attempting to use al pessary, to treat these conditions by rest for a few* days in bed, Avith saline aperients and sedatives, ani sometimes local depletion. Eecourse should always be had to the same plan when a pessary has been trie! but cannot be tolerated on account of the pressure] which it exerts upon the fundus. Before a pessary is inserted, the uterus should hi replaced, if possible, by the finger. This may be donej in the lateral or, what is better, the semi-prone position.-] By one or two fingers, the perineum is retracted, aid alloAved to enter the vagina, the fundus pushed upwards;] and the cervix, if it looks too much forward, is after- Avards drawn backward. Sometimes the external hand above the pubes may assist in bringing the fundus completely forward. For this, the patient is placed in' the dorsal position; the fingers in the vagina first raisd the fundus as far as possible, then push the cervi very far back, while the external hand, pressed deep] in a little below the umbilicus, endeavours to get behin the fundus and bring it forward into anteversion. Th. introduction of a Hodge's pessary itself Avill often effect or complete the restoration of the uterus. For its adii justment, the patient is placed in the left lateral or semi- IX ply id le