. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. t pessaries made of gutta percha or ebonite are the best form ofsolid pessaries. The ring-pessary, known in America by the nameof its inventor. Dr. Meigs, is a good instrument. It is, as origi-nally constructed, a piece of watch spring covered with thread,and dipped in a solution of gutta percha in chloroform until ofsufficient substance. This ring readily admits of pessary has the great advantage of preventing the descent ofthe uterus, while it does not touch the os or cervix
. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. t pessaries made of gutta percha or ebonite are the best form ofsolid pessaries. The ring-pessary, known in America by the nameof its inventor. Dr. Meigs, is a good instrument. It is, as origi-nally constructed, a piece of watch spring covered with thread,and dipped in a solution of gutta percha in chloroform until ofsufficient substance. This ring readily admits of pessary has the great advantage of preventing the descent ofthe uterus, while it does not touch the os or cervix uteri. Modi-fications of this pessary may be used: the ring may be composed^of stouter material, gold or silver gilt, or iron or copper coveredwith gutta percha. The size must be carefully adjusted. Thering-pessaries I employ are described at p. 522 ; they are veryconvenient, and readily adjusted to the particular case. Hodgesquadrangular pessaries answer the same purpose as the ring-pes-saries. Zwanks pessary consists of two oval, flat, rounded, ear-shaped PROLAPSUS OF THE UTERUS. 545 Fig. pieces of ebony or other hard substance connected by a hinge (seeFig. 85). The two wings are sepa-rated after introduction, and keptapart by a simple mechanism. Thestem of the pessary is external tothe vulva. I consider it very in-ferior to the ring-pessary. Other pessaries are contrived onthe principle of transmitting sup-port by means of a stem, the fixedpoint of which is outside; others bymeans of a perineal pad; othersagain by a wire framework attachedin front of the pubes. A good form of this pessary was shown at the Obstetrical Societys conversa-zione in 1866, as used in Denmark.* Lastly, it may be mentioned that small pieces of sponge actexceedingly well as pessaries, but they require to be frequentlychanged and cleansed. 3Ianipulations necessary in Cases of Prolapsus.—We aresometimes called upon to return the uterus within the vagina, thepatient being unable to accomplish it;
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