. The Principles and practice of gynecology : for students and practitioners. way as toobscure the field of operation. To obviate this difficulty one may use DIAGNOSIS. 71 a smaller though similar retractor which acts in the opposite direc-tion, like the anterior blade of the bivalve spccnlnni, and, itnecessary,lateral ileprcssors on either side. All of these instruments are moreor less in the oj)erators way ; besides, the introduction of the sound,curette, or other instrunu^nts to the int<rior of the uterus is more dif-ficult in the dorsal than in the Sims position ; moreover, if the organ
. The Principles and practice of gynecology : for students and practitioners. way as toobscure the field of operation. To obviate this difficulty one may use DIAGNOSIS. 71 a smaller though similar retractor which acts in the opposite direc-tion, like the anterior blade of the bivalve spccnlnni, and, itnecessary,lateral ileprcssors on either side. All of these instruments are moreor less in the oj)erators way ; besides, the introduction of the sound,curette, or other instrunu^nts to the int<rior of the uterus is more dif-ficult in the dorsal than in the Sims position ; moreover, if the organis anteverted or anteflexed, the instrinnent is especially liable to bearrested at some point on the posterior wall of the cervix or at theinternal os, and refuse to pass further. Simons speculum is heldless easily, and re(juires more assistants, more attachments anddepressors, than Sims; it gives less light and space, and for generaldiagnostic and surgical use, therefore, should seldom have the pref-erence over the Sims instrument. On the other hand, the Simon Figure Sounds of Simpson and Sims compared: sections of full size. The upper sound is Sims: the lower Simpsons. instrument is preferable for vaginal hysterectomy and many otheroperations involving vaginal section. The Probe and Sound have been mentioned in connection withconjoined palpation as a means of diagnosis in tumors. In somecases the sound, and especially the probe, may be difficult or impossibleto pass in the dorsal position, but may readily be passed wdth the aidof Sims speculum in the lateral position. To Pass the Probe or Sound, the Patient being in the Dorsal Posi-tion, without a speculum, first introduce the left index-finger to the osexternum, then, on the finger as a guide, introduce the instrument intothe OS and let it find its own way, judiciously aided by slight force,to the fundus. To Pass the Sound or Probe through the Specvlum, first bring thecervix into view, seize it with a uterine tenaculum
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