Treatise on gynæcology : medical and surgical . is necessary (as in cancer ofthe body, sloughing fibroma, etc.), or I em-ploy it as a haemostatic after enucleationof fibromata. d. Sweeping with a Tampon and Scrap-ing. — Many gynaecologists content them-selves with dilating the cervix and cleansingthe uterine cavity by means of a pledget ofabsorbent cotton rolled on a handle. This isvery simple, and the cotton will be securelyheld on the handle if the end of it is a littleirregular; Fritsch, Tenneson, Meniere, Sims,and Munde10 have invented special applica-tors ; but a sound with no terminal en
Treatise on gynæcology : medical and surgical . is necessary (as in cancer ofthe body, sloughing fibroma, etc.), or I em-ploy it as a haemostatic after enucleationof fibromata. d. Sweeping with a Tampon and Scrap-ing. — Many gynaecologists content them-selves with dilating the cervix and cleansingthe uterine cavity by means of a pledget ofabsorbent cotton rolled on a handle. This isvery simple, and the cotton will be securelyheld on the handle if the end of it is a littleirregular; Fritsch, Tenneson, Meniere, Sims,and Munde10 have invented special applica-tors ; but a sound with no terminal enlarge-ment is all that is required (Fig. 116). It•is easy to make pledgets of tapering form,so that they can be passed into a cervix but little dilated. It iswell to soak these in a 1:1,000 solution of bichloride, or carbolic1: 50, to gently squeeze the excess out before introducing them, andthen to turn them about within the uterine cavity so that the wallsof the organ shall be thoroughly wiped clean. The last tampon maycarry the Fig. 116.—Sims Slide Applicator. TREATMENT OF METRITIS. 191 Doleris n prefers to this simple means the employment of a scraperlike that used in cleaning bottles (Fig. 117); the instrument, designedto brush the interior of the uterine cavity, is rendered aseptic by im-mersion in 1: 100 sublimate solution, and then introduced by aspiral motion, which is kept up in different directions until it is re-moved. Both the scraper and the tampon may be charged with vari-ous medicating solutions. Doleris thinks that by using scraperswith harder or softer bristles, he can effect both a cleansing and ascraping of the mucous membrane, with destruction of it if this is an illusion will be clear to all those who are accustomedto use the blunt curette, and know the amount of force necessaryto remove the membrane with a dull instrument; it seems to me im-possible by simple friction of the mucous membrane with a brushto destroy its elemen
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