Gynaecology for students and practitioners . Fig. 78. Fergusohs Speculum after Introduction. (From a photograph.) This speculum can conveniently be used in either the dorsal orlateral position, and suffices for most of the purposes for which aspeculum is required in clinical examination, or in the applicationof certain forms of treatment. Simss speculum is shown in Fig. 79 ; it is a double instrument,being held in the middle, and furnished with spoon-shaped ends ofdifferent sizes set transverselyto the handle. According tothe intention of its designer(Marion Sims), the instru-ment should be us
Gynaecology for students and practitioners . Fig. 78. Fergusohs Speculum after Introduction. (From a photograph.) This speculum can conveniently be used in either the dorsal orlateral position, and suffices for most of the purposes for which aspeculum is required in clinical examination, or in the applicationof certain forms of treatment. Simss speculum is shown in Fig. 79 ; it is a double instrument,being held in the middle, and furnished with spoon-shaped ends ofdifferent sizes set transverselyto the handle. According tothe intention of its designer(Marion Sims), the instru-ment should be used in thesemi-prone, or Simss position, the patient lying on herleft side, with the left armcarried behind her back andboth thighs flexed, the right more acutely than the left (Fig. 80). If, in this position, the ostiumvaginae is opened, air enters the vagina and distends it, while theuterus falls forwards and downwards, towards the anterior. Fig. 79. Simss Vaginal Speculum. 126 GYNECOLOGY abdominal wall. The spoon-shaped end of the speculum is thenintroduced along the posterior vaginal wall, and being gently pulledbackwards, the whole of the anterior vaginal wall and the cervixbecome exposed and can be inspected under good the vaginal walls are lax, as in cases of prolapse, the an-terior wall falls into the instrument and obscures the view unlesspressed back with forceps. The speculum is less convenient forgeneral use than the tulbular one, and often necessitates the pre-sence of an assistant to hold it in place. For vaginal operations it
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
