. The Boston medical and surgical journal . smaller are thenenclosed within those of the larg-er. (Fig. 2, next page.) The larg-er of the two selected is introduc-ed posteriorly, as Simss would be; the other enters beneath the pu-bic arch. The point of the latter, which, at the outset, is in the hol-low of the opposite blade, gradually emerges, as the blade is pushedforward. It requires a little practice to enable one to perform thismanipulation without inflicting some pain upon the patient. The re-sult is a perfect tube, through which the cervix may be readily in-spected. The four blades form
. The Boston medical and surgical journal . smaller are thenenclosed within those of the larg-er. (Fig. 2, next page.) The larg-er of the two selected is introduc-ed posteriorly, as Simss would be; the other enters beneath the pu-bic arch. The point of the latter, which, at the outset, is in the hol-low of the opposite blade, gradually emerges, as the blade is pushedforward. It requires a little practice to enable one to perform thismanipulation without inflicting some pain upon the patient. The re-sult is a perfect tube, through which the cervix may be readily in-spected. The four blades form three complete specula of differentsizes. The chief merit of the instrument is manifested, if, as often hap-pens, the cervix is so directed that no view of the os can be obtain-ed. By advancing one or the other blade, and, more especially, byrocking one upon the other, the vaginal portion may be tilted in thedirection necessary to bring its orifice into the lumen of the srecu-lum. When both blades are rocked forwards by means of the ban-. 138 MEDICAL AND SURGICAL JOURNAL. dies, the uterine extremities of the former separate and distend thevagina; this movement exerts a traction upon the uterus, which drawsit downwards, nearer the light and within reach of the finder, if its Fig. 2. density and firmness needs to betested by the touch. In this re-spect, it contrasts most favorablywith Fergussons speculum, whichalways pushes the organ awayfrom the vulva, and admits a com-paratively meagre light. By thesame divergence of the blades,the lips of the external os, whensoft and patulous, may be drawnapart, thus rendering the cavity ofthe cervix visible for a short dis-tance. When one blade is held firmlyand the other rocked, the tractionupon the vaginal portion is chieflyto the corresponding side, andserves to change the direction ofthe uterine axis, so that the cavityof the organ assumes the most fa-vorable position for inspection ortreatment. The same divergenceof the ends of the bla
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