. The diagnosis and treatment of diseases of women. Fig. 599. Bringing the Fundus Uteri forward andpushing the Cervix backward and upward. (Kelly—Operative Gynecology.) forward. This brings the fundusuteri out from the promontory andpermits it to fall forward into itsproper position. The cervix is thenpushed well backward into the hol-low of the sacrum, and a pessary orpacking is put in to hold it there. The method of replacement bysound or repositor I mention onlyto condemn. The sound or intra-uterine repositor used in this way isdangerous. A uterus that is notadherent can usually be brought
. The diagnosis and treatment of diseases of women. Fig. 599. Bringing the Fundus Uteri forward andpushing the Cervix backward and upward. (Kelly—Operative Gynecology.) forward. This brings the fundusuteri out from the promontory andpermits it to fall forward into itsproper position. The cervix is thenpushed well backward into the hol-low of the sacrum, and a pessary orpacking is put in to hold it there. The method of replacement bysound or repositor I mention onlyto condemn. The sound or intra-uterine repositor used in this way isdangerous. A uterus that is notadherent can usually be brought for-ward by one of the two methodsalready mentioned. A uterus thatis adherent could not be broughtforward by the sound or repositor,and its use in such a case is liable tolead to inflammation or perforationof the uterus. In some cases the uterus and ad-jacent tissues are too tender to per-mit the manipulations necessary forreplacement. In such a case, hot. Fig. 600. The Uterus brought forward into shows also tlie method of taking the backwardflexion out of the uterus, by bending it firmly forward overthe vaginal fingers. (Kelly—Operative Gynecology.) THE PESSARY IN RETRODISPLACEMENT 605 vagiiical douches, purgatives and the knee-chest posture morning and evening fora few days, may diminish tlie tenderness very muclr. In such a case, after theknee-chest posture has been taken morning and evening for a few days, theuterus may he found forward at the next examination. Vaginal tamponade with the patient in the knee-chest posture or in the Simsposture, with gauze or cotton, every second or third day, helps to restore tlie uterusto its normal position. Also, in cases where no pessary is at hand, the uterus,after replacement, may be held in place temporarily by packing the vagina withgauze or cotton in such a way that the cervix is held well back in the pelvis. Again,when a pessary has to be removed temporarily for any cause, t
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