. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. atment.—The uterus should be returned to its nor-mal position and held there (usually by a pessary).There are several methods of reduction. The simplestand best way is to place the patient in Sims position onthe left side, with the clothing around the waist madeloose. In this position there is a tendency for the pelviccontents to gravitate forward toward the table, while airis sucked in, distending the vagina when the perineumis retracted. The operator stands beh
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. atment.—The uterus should be returned to its nor-mal position and held there (usually by a pessary).There are several methods of reduction. The simplestand best way is to place the patient in Sims position onthe left side, with the clothing around the waist madeloose. In this position there is a tendency for the pelviccontents to gravitate forward toward the table, while airis sucked in, distending the vagina when the perineumis retracted. The operator stands behind the patient,facing her, and introduces the first two fingers of theright hand into the vagina, with the palmar surfacetoward the rectum ; he then pushes his finger-tips high Mundes cuts are introduced to show the various stagesof this method. They are drawn to represent the patienton the back, but the operation is really done on the leftside. The plates are, however, here turned upside down,to give a better idea of the way in which gravity and at-mospheric pressure act. The uterus can also usually be replaced by bimanual. Fig. 4314.—Same ; third step, ^unde.) manipulation with the patient on the back. By thismethod the uterus is lifted up with the fingers of theleft hand in the vagina, until it can be caught above thepromontory of the sacrum with the right hand, fromthe outside, and pulled forward under the pubes. Theretroverted or retroflexed uterus can usually be easilyreduced by either of the above methods, but not infre-quently the fundus is swollen and impacted in the hol-low of the sacrum, or caught by the folds of Douglas insuch a way as to make reduction very difficult. If thesemethods do not succeed, the patient should be put in theknee-chest position (Fig. 4315), because in that positiongravity and atmospheric pressure act as in the Sims po-sition, and even more forcibly. Dr. Campbell, of Augusta, Ga., has systematized thisprinciple as a practical methodof red
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
