Non-operative treatment in gynecology / by George Gellhorn.

  • Gellhorn, George, 1870-1936.
Date:
1931
Catalogue details

Licence: In copyright

Credit: Non-operative treatment in gynecology / by George Gellhorn. Source: Wellcome Collection.

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    axis of the vagina and are then expelled. The Menge pessary overcomes this difficulty (Fig. 40). It consists of a thick, hard rubber ring with a detachable stem which prevents the turning of the support. It is not necessary and is needlessly difficult, first to introduce the ring, as the textbooks advise, and then to fit the stem within the vagina. I always insert the entire appliance Fig. 37. Fig. 38. Fig. 39. Fig. 37.—Hard Rubber Ring Pessary Used in Prolapse (Kny-Scheerer). Fig. 38.—Shell Pessary (Kny-Scheerer). Fig. 39.—Disk Pessary (Kny-Scheerer). with a corkscrewlike motion and select the smallest of the three sizes which will stay in place. The one great disadvantage is the fact that the cervix, resting within, or sucked into, the circumference of the annular part, easily becomes irritated (Fig. 41). For this reason I prefer the Loehlein pessary with its cuplike surface and nondetachable handle (Fig. 42). Constant control of pessaries in prolapse is essential. The patient has to take daily douches with bicarbonate of soda, one table¬ spoonful in a quart of warm water, liquor of aluminum acetate, a tablespoonful in the same amount, peroxid of hydrogen, diluted with five times the quantity of water, or the like. Kelly mixes two grains of menthol in two teaspoonfuls each of bicarbonate of soda and borax and dissolves it in a quart of water. Every four weeks the physician removes and cleanses the ring and inspects the vagina for pressure marks, abrasions, or ulcerations. If such are present, the ring is left out tem¬ porarily, until the irritated parts have healed under cauterization or douches. A tampon, thickly covered with a silver nitrate salve and applied daily by the patient, brings speedy relief. If Argenti nitras. 2.4 (grs. 35) Adeps. Lan. Hyd. (Lanolin) Vasel. alb.aa 60.0 (aa 3 2) Unfortunately the result is often only transitory, because the reinserted pessary quickly irritates the vagina anew.