. Diseases of women. A clinical guide to their diagnosis and treatment. from careless treatment with pessaries. Suchthings seldom result from Hodges pessary, but there isno form of pessary with which they are impossible.* * See Neugebauer, Arch, fur Gyn., Bd. xliii. UTERINE DISPLACEMENTS: PROLAPSE. 131 To prevent such accidents while a patient is wearing apessary, the vagina should be daily washed out with cleanwater, to which an astringent may be added if there beleucorrhcea, borax if there be any irritation, permanganate ofpotash if there be foetor. The pessary should be removedand cleansed,
. Diseases of women. A clinical guide to their diagnosis and treatment. from careless treatment with pessaries. Suchthings seldom result from Hodges pessary, but there isno form of pessary with which they are impossible.* * See Neugebauer, Arch, fur Gyn., Bd. xliii. UTERINE DISPLACEMENTS: PROLAPSE. 131 To prevent such accidents while a patient is wearing apessary, the vagina should be daily washed out with cleanwater, to which an astringent may be added if there beleucorrhcea, borax if there be any irritation, permanganate ofpotash if there be foetor. The pessary should be removedand cleansed, and the vagina examined, to see that there areno ill-effects, every three months. With these precautionsa vaginal pessary may be worn without detriment for anindefinite time. Zwanckes pessary.—There is another pessary occasion-ally used: • Zwanckes (Figs. 42, 43, 44). This consists of twowings which can be either folded together or opened outinto a platform, being fixed in this position by a screw orclip. It is put in closed, and opened after introduction. It m. Fig. form of Fig. 43.—Another form of Zwanckes pessary ; Zwanckes pessary : vul- metal screw. The canite screw,dotted outline showsthe pessary closed forintroduction. Fig. 44.—Another form ofZwanckes pessary : fas-tening with clip. (God-sons.) then forms a platform lying across the pelvis, restingon the sides of the ellipse which the levator ani and pelvicfascia form. It prevents the uterus from coming outside,but it does not keep it up as high as the cup and stempessary. It is therefore less efficient. It must be removedeach night, and put in again in the morning. If the patientneglect this, it will cause ulceration. Pessaries with outside straps. —If the vaginal orifice isso large that no vaginal pessary will stay in, the only mechan-ical treatment possible is a pessary supported from are two forms—the cup and stem and Cutters pessary. 132 DISEASES OF WOMEN. The cup and stem pessary
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