Treatise on gynæcology : medical and surgical . in old cases of catarrhal metritis. Mucous polypi may be removed by seizing them with a flat forcepsand twisting off their pedicle. If numerous and sessile, the cuttingcurette of Sims or Simon should be used and the bleeding surface 200 CLINICAL AND OPEKATIVE GYNAECOLOGY. touched with perchloride of iron or the actual cautery. If the cervixis very much altered, if there is follicular hypertrophy, we have re-course to the operation of Schroeder described below. Cervical ulcerations are only a new growth of glands, more or lesshypertrophied, and ar
Treatise on gynæcology : medical and surgical . in old cases of catarrhal metritis. Mucous polypi may be removed by seizing them with a flat forcepsand twisting off their pedicle. If numerous and sessile, the cuttingcurette of Sims or Simon should be used and the bleeding surface 200 CLINICAL AND OPEKATIVE GYNAECOLOGY. touched with perchloride of iron or the actual cautery. If the cervixis very much altered, if there is follicular hypertrophy, we have re-course to the operation of Schroeder described below. Cervical ulcerations are only a new growth of glands, more or lesshypertrophied, and are found only with deep inflammation of themucous membrane of the body of the uterus, as was shown a long-time ago by Gosselin in the reaction from the narrow doctrine whichdissociated the two. Usually, to cure the ulcers it is enough to cure*the endometritis. After curetting we see the ulcers disappear as doesthe coating from the tongue after vomiting, but this is true only ofcases taken at the start. Later on, the glandular proliferation be-. Fig. 121.—Uterine Dressing Forceps, Straight and Elbowed, for Removal of Polypi. comes a settled lesion and requires for its cure topical modificationor removal by the bistoury. As the first treatment of the ulceration, we must employ thecurette; in the second place come applications of nitrate of silver ortincture of iodine, practised every second day. In America, weaknitric acid (not fuming) has been much used, applied with a verysmall tampon of cotton on the end of a handle; this caustic ispreferred to chromic acid which has caused intoxication; but allsuch energetic caustics may produce contraction of the cervix, and Iavoid them. The good effects of chloride of zinc have also beenmuch praised. Rheinstadter advises the hastening of the action ofthis caustic in deep ulceration by making small punctures in the cer-vix. Hofmeier28 strongly advocates acetic or pyroligneous acid. Heincloses the cervix in a Fergussons cylindrical speculum
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