Licence: Public Domain Mark
Credit: Lectures on the diseases of women / by Charles West. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![that the womb is perforated by the probe, but this misadventure can scarcely occur without the cognizance of the practitioner if he is careful. A softened uterus is said to be easily perforated; but while there is no proof of this, it may even be the case that a softened uterus is tougher than a normal one; besides, experiments have shown me that in some, and probably in all, cases, it is the peritoneum that offers most resistance to the perforation of the uterus by a probe. Having recently left Edin- burgh, I have not access to my notes of these laboratory experi- ments, but I remember that a force at the perforating point of the probe of about six pounds was required to pierce the uterus. This force, used in even a rough examination, implies a degree of violence which the practitioner must recognise. The force required in most cases to pass the instrument along a tube far into the peritoneal cavity is scarcely appreciable. It is of interest to remark that the uterine probe which I use, and which is sold in the shops, has, as applied in uterine diagnosis, strength enough in its shaft to bear a pressure producing six pounds of force at the point, but no more, or little more. In this way the very instru- ment, as ordinarily made, is, by its little strength, a protection against the misadventure of puncturing the womb. It must be added that even the passage along a tube into the peritoneum is a proceeding not to be lightly considered, although I have not been so unfortunate as to see any bad result from it. Generally it causes no pain.] The idea of adopting some contrivance by which the condition of the uterus might be examined by the eye was not altogether unknown to the ancients, though for the most part those instru- ments, of which drawings may be seen in old works on midwifery, and which received the name of Speculum Matricis, were used for dilating the mouth of the womb during labour, rather than for examining its condition in disease* An instrument similar in kind, however, appears to have been sometimes employed for the investigation of diseases of the uterus and vagina, though it never came into anything like general use. The introduction of the speculum into modern practice as a means of facilitating the investigation of uterine disease does not date further back than * See some remarks and quotations referring to the early history of the specu- lum, in Balbirnie, Organic Diseases of the Womb, pp, 41-45. 8vo, London. 1836.](https://iiif.wellcomecollection.org/image/b21923796_0034.jp2/full/800%2C/0/default.jpg)
