Transactions of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons for the year ... . 3 tion. Mrs. E., aged fifty-six years, was referred January 3, 1914, bya Pittsburgh friend and a gynecologist of high standing. She hadchanged her domicile temporarily from that city to one in the writersneighborhood. She had suffered much with cardioYascular diseaseand a cystocele that gave her great annoyance. She was a heavy,stout woman, who soon grew cyanotic on the examining table. Hersystolic blood pressure was 220, though her urine was fairly nor-mal. An operation was out
Transactions of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons for the year ... . 3 tion. Mrs. E., aged fifty-six years, was referred January 3, 1914, bya Pittsburgh friend and a gynecologist of high standing. She hadchanged her domicile temporarily from that city to one in the writersneighborhood. She had suffered much with cardioYascular diseaseand a cystocele that gave her great annoyance. She was a heavy,stout woman, who soon grew cyanotic on the examining table. Hersystolic blood pressure was 220, though her urine was fairly nor-mal. An operation was out of question, and this my Pittsburghfriend had already decided for me. We introduced a well fitting Geh-rung pessary in her case, which not only gave her great relief, but madeexercise so bearable, that it improved her general health. Of coursethe instrument was carefully looked after, as all pessaries should be. In due time she returned to Pittsburgh to find that her doctor couldnot replace the instrument after he had removed it. He had never seensuch an instrument. And well might a man be puzzled with it. The. Fig. 1.—Showing position of the Gehrung pessary in relation to the uterus (A and B).S, Symphyseal end; L, left; R, right arm. woman returned to Newark to have the instrument replaced. Later herfamily moved to Virginia, near Washington, but to my dismay she againreturned to Newark because no one could be found to replace the instru-ment properly. It is not the writers intention to read to you his views as to the inter-position operation of Watkins; suffice it to say that nothing has givenhim greater satisfaction, and to his patients greater relief, unless itbe the operation for vesicovaginal fistula or the repair of a completeperineal laceration. You will understand, therefore, that this form ofpessary is purely for those cases where an operation is not advisable. The pessary consists of the Hodge instrument bent on itself so as toform a double horseshoe, one lever bein
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