. The Principles and practice of gynecology : for students and practitioners. RSTON AND RETROFLEXION. 665 also holds tiic attaelud cervix at a proper distaiico from the sacrum,and tlicrchy fullils its indication by sustainin<^ the pelvic floor. TheHodge pessary, or some modification thereof, answers this purpose inordinary cases more satisfactorily than any other. The same general principles—in fact, the same pessaries—whichare applicable to jirolapsc apply also to retroversion and retroflexion,because the first step in the genesis of retro-malpositions is prolapse. Pessaries designed to pr
. The Principles and practice of gynecology : for students and practitioners. RSTON AND RETROFLEXION. 665 also holds tiic attaelud cervix at a proper distaiico from the sacrum,and tlicrchy fullils its indication by sustainin<^ the pelvic floor. TheHodge pessary, or some modification thereof, answers this purpose inordinary cases more satisfactorily than any other. The same general principles—in fact, the same pessaries—whichare applicable to jirolapsc apply also to retroversion and retroflexion,because the first step in the genesis of retro-malpositions is prolapse. Pessaries designed to prop up the body of the uterus by pressureupon the posterior wall for the correction of posterior malpositions, andupon the anterior wall to correct anterior malpositions, are not onlyunnecessary, but they are also very liable to induce metritis and peri-metritis, and therefore are disapproved generally. In certain cases,however, the vaginal walls, especially the posterior, may l)e so relaxedfrom subinvolution and other causes that the instrument, though very Figure Albert Smith pessary in place and uterus maintained in normal position. long, fails to maintain the cervix in its normal place. Under suchconditions an instrument may be required to act directly upon theuterus. The Schultze sleigh pessary, although seldom indicated,represented in Figure 382. fulfils this indication. A long AlbertSmith pessary, with its uterine curve made so extreme as to bring theupper part of the instrument in front of the cervix, instead of behind,may answer the same purpose. Expedients of this kind, however,are always of doubtful value. 41 666 DISPLA CEMENTS. Adjustment of the Pessary. Figure 376 shows a common but faulty manner of introducing thepessary. The vagina is a collapsed tube, the anterior walls of whichrest on the posterior; hence, the long diameter of a cross-section ofthe canal is from side to side, not anteroposterior. The pessaryshould, therefore, be introduced with its lat
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