Clinical notes on uterine surgery : with special reference to the management of the sterile condition . nowthe diagnosis of the worst case of dysmenorrhoeal ante-flexion is as easy and as painless as that of an oldretroflexion with a patulous canal. I have often had the greatest difficulty with theGerman silver sound ; and if I were to say I had seena score of cases in consultation where physicians assuredme it was utterly impossible to pass the sound, I wouldnot exaggerate the number in the least. I have feltand seen so much annoyance on this point that I may bepardoned for a little minutiae.
Clinical notes on uterine surgery : with special reference to the management of the sterile condition . nowthe diagnosis of the worst case of dysmenorrhoeal ante-flexion is as easy and as painless as that of an oldretroflexion with a patulous canal. I have often had the greatest difficulty with theGerman silver sound ; and if I were to say I had seena score of cases in consultation where physicians assuredme it was utterly impossible to pass the sound, I wouldnot exaggerate the number in the least. I have feltand seen so much annoyance on this point that I may bepardoned for a little minutiae. The cases that usually give us most trouble are thoseof complete anteflexion, with a fibroid in the anteriorwall. One will serve as an example of the class. Letfig. 41 represent an anteflexion with a fibroid, <2, as largeas an almond, in the anterior wall. If we shouldattempt to pass the large German silver sound, in itsfixed position, to the fundus uteri, it would inevitablybe arrested at £, it matters not how dexterously wemay elevate the fundus with the index finger to OF MENSTRUATION. 105;. Fig. 41. straighten the organ up atthe time we make the effort. I have seen such exces-sive pain thus inflicted thatthe patient could hardly bepersuaded to allow a repeti-tion of the process. And Ihave often passed the smallmalleable instrument undersuch circumstances when thepatient was not aware that it had been done. Weshould never inflict pain if it can be avoided ; norshould we carelessly shock the nervous system of one sodelicately organized, and that too, perhaps, when thatorganism is so intensified by diseased action as to exag-gerate to an unbearable degree the slightest movementor even sound. Valuable as the uterine probe may be for giving usthe direction of the fundus uteri, it is not to be dependedupon alone to measure its depth, if that should exceedfour inches ;. and for the simple reason that the curva-ture necessary to pass it along the pelvian axes wouldmake it stri
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Keywords: ., bookcentury1800, bookdecade1880, bookpublisher, booksubjectuterus
