. The Principles and practice of gynecology : for students and practitioners. Examination with Sims speculum. The towels ordinarily used to cover parts around thevulva are omitted in order to show the exact position of the pelvis and thighs. Passage of probeor curette ; cervix steadied by vulsellum. Pathological discharges may be taken for microscopical examination,and their source, whether from the uterus or the vagina, may beobserved. Simons Speculum, shown in Figure 24, is a perineal retractor simi-lar to Sims, but with shorter and flatter blades, which are made 70 OENEBAL PRINCIPLES. of di
. The Principles and practice of gynecology : for students and practitioners. Examination with Sims speculum. The towels ordinarily used to cover parts around thevulva are omitted in order to show the exact position of the pelvis and thighs. Passage of probeor curette ; cervix steadied by vulsellum. Pathological discharges may be taken for microscopical examination,and their source, whether from the uterus or the vagina, may beobserved. Simons Speculum, shown in Figure 24, is a perineal retractor simi-lar to Sims, but with shorter and flatter blades, which are made 70 OENEBAL PRINCIPLES. of diiFereut shapes and sizes. It differs from Sims chiefly in themanner of use, which requires the patient to be on the back, and thethighs to be flexed in the lithotomy position. An objection to this Figure Uterus exposed by Simons speculum. Dorsal position. Cervix uteri steadied by canal being measured by Peaslees sound: a, uterine tenaculum: &, Peaslees sound;c, silver probe; and d, Simons speculum are reduced to about one-half the ordinary size. instrument is that the vesicovaginal walls are liable to fall toward thespeculum, and the lateral walls fall together in such a way as toobscure the field of operation. To obviate this difficulty one may use DIAGNOSIS. 71 a smaller though similar retractor which acts in the opposite direc-tion, like the anterior blade of the bivalve spccnlnni, and, itnecessary,lateral ileprcssors on either side. All of these instruments are moreor less in the oj)erators way ; besides, the introduction of the sound,curette, or other instrunu^nts to the int<rior of the uterus is more dif-ficult in the dorsal than in the Sims position ; moreover, if the organis anteverted or anteflexed, the instrinnent is especially liable to bearrested a
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