. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. the use of this new anteversion pessary, I had, with considerablebenefit, treated such cases by an air-ball worn in the vagina, butthe new pessary I consider much superior. The tumor is not always on the same aspect of the uterus as that 464 PATHOLOGY AND TREATMENT. on which it is bent. Thus we may have a fibroid tumor in the an-terior wall opposite the internal os, and at the same time retro-flexion. Dr. Marion Sims has alluded to this circumstance, andnot long since I saw a remarkable instance
. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. the use of this new anteversion pessary, I had, with considerablebenefit, treated such cases by an air-ball worn in the vagina, butthe new pessary I consider much superior. The tumor is not always on the same aspect of the uterus as that 464 PATHOLOGY AND TREATMENT. on which it is bent. Thus we may have a fibroid tumor in the an-terior wall opposite the internal os, and at the same time retro-flexion. Dr. Marion Sims has alluded to this circumstance, andnot long since I saw a remarkable instance of it. The patientsuffered most intensely and severely from dysmenorrhoea ; theuterus was sharply retroflexed, and just opposite the internal oswas a stricture caused by a fibroid tumor in the anterior wall, com-pressing the canal at that point (see Fig. 48). The whole uteruswas in this case somewhat hypertrophied, and affected with chronicinflammation. The first thing to be done in this case was to treatthe flexion ; this was effected by a pessary worn in the vagina.(See chapter on Flexions.). Chronic inflammation and induration of the cervical tissues maylead to stricture of the canal. The dysmenorrhoea thereon de-pending may be summarily treated by incision and subsequentdilatation. Conjointly with this, however, means must be taken Fis. 48. Chronic retroflexion of uterus with fibroid tumor in anterior wall. DYSMENORRHCEA. 465 Fig. 49. /
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