. The Boston medical and surgical journal . the available length of which rarely ex-ceeds three and one half inches, and the lower blade of my instrument is fourand one half inches in length and the upper blades nearly four inches. If theos is not exposed when the instrument is expanded, the difficulty is not in thelength of the instrument, but in its position, or because it is not sufficientlyexpanded to raise the anterior wall of the vagina. To introduce the instrument:—The patient reclines on the back upon thegynaecological chair, with the hip near the edge of the chair. Having ascer-tained
. The Boston medical and surgical journal . the available length of which rarely ex-ceeds three and one half inches, and the lower blade of my instrument is fourand one half inches in length and the upper blades nearly four inches. If theos is not exposed when the instrument is expanded, the difficulty is not in thelength of the instrument, but in its position, or because it is not sufficientlyexpanded to raise the anterior wall of the vagina. To introduce the instrument:—The patient reclines on the back upon thegynaecological chair, with the hip near the edge of the chair. Having ascer-tained the position of the os uteri, grasp the speculum with the right handwith the forefinger resting upon and projecting beyond the lower blade, andhold the handles vertical. Then carefully introduce the forefinger into theexternal organs and follow it with the instrument. When the instrumenthas passed beyond the external organs, it should be rotated so the handlesshall lie horizontally; then, pushing the lower blade along the posterior wall. ABSTRACTS AND INTELLIGENCE. 287 of the vagina, it will pass under the posterior labium of the os. Then, com-pressing and bearing downwards and backwards upon the handles, the ante-rior vaginal wall will be raised and the os exposed, when the handles can befastened by the thumb-screw. The instrument is self-retaining when suffi-ciently expanded. If the os is not at first exposed, the instrument, partially expanded, maybe withdrawn a little so as to allow the lower blade to pass under the os; orthe os may be raised by the forefinger inserted through the expanded instru-ment, by raising the anterior wall of the vagina, there being ample room forthe forefinger to pass between the expanded upper blades. Or the os may beraised into the field of the instrument by a Simpsons sound, or like instrument,used as a lever. When the os is exposed, the uterus may be held in thefield by a tenaculum, which can be fastened to a hook on the right upperblade. My
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