. Clinical gyncology, medical and surgical. ely embedded inthe vaginal walls, the discharge being so foul as to simulate malignant dis-ease. In former days the cutting of one of the old-fashioned supports into DISPLACEMENTS OF THE DTEKUS. 501 the bladder or the rectum was a not very infrequent occurrence. Only thegrossest negligence could, with the supporters we are now in the habit ofusing:, result in such an accident. .V very large, ill-fitting pessary mayproduce an inflammation with exudate into the cellular tissue at some pointin the pelvic cavity, or it may press upon the bladder or the r
. Clinical gyncology, medical and surgical. ely embedded inthe vaginal walls, the discharge being so foul as to simulate malignant dis-ease. In former days the cutting of one of the old-fashioned supports into DISPLACEMENTS OF THE DTEKUS. 501 the bladder or the rectum was a not very infrequent occurrence. Only thegrossest negligence could, with the supporters we are now in the habit ofusing:, result in such an accident. .V very large, ill-fitting pessary mayproduce an inflammation with exudate into the cellular tissue at some pointin the pelvic cavity, or it may press upon the bladder or the rectum somuch as to interfere with the functions of these organs. Precautions.—The following rules may be laid down for the guidanceof the practitioner in the use of pessaries. First. Always replace the uterusbefore choosing and introducing the pessary. Second. Never insert a pessarywhich is so laro-e that it is not freelv movable in the vagina and does notallow the examining finger to pass easily between it and the vaginal wall. Fio. Retroversion pessary in position: woman in erect position. Third. Always adapt the pessary to the individual case. Fourth. Examinethe woman in the standing posture before allowing her to depart, in order tosee whether the pessary remains in place in that position. Fifth. Tell thewoman that she is wearing a pessary, and that it must give her no pain andinconvenience whatever, so that, if it does, she may know that it is not rightand may at once call to have it rectified or may, in a case of emergency,remove it herself; and show her how to do so. Sixth. Tell her to call againin about a week, so that you may see whether the pessary is doing its Tell her to use a tepid vaginal douche every day as a matter ofcleanliness, for all pessaries produce more or less leucorrhoea. Use no alumor other salt in the douches, as rough incrustations on the pessary are pro-duced thereby. Eighth. Do not omit to tell her that she will have to wear 50
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