. The Principles and practice of gynecology : for students and practitioners. levator ani muscle. and disappointments, but also for the many evil results which havefollowed indiscriminate attempts to treat all displacements by me-chanical support. The exclusion of unsuitable cases and the recog-nition of the necessity for accurate diagnosis are apparent. Thepessarv, according to the knowledge, judgment, and mechanical skillof the practitioner, will be useful, useless, or injurious. 664 BIS PL A CEMENTS. The Function of the Pessary. The function of the pessary is to maintain the uterus not only
. The Principles and practice of gynecology : for students and practitioners. levator ani muscle. and disappointments, but also for the many evil results which havefollowed indiscriminate attempts to treat all displacements by me-chanical support. The exclusion of unsuitable cases and the recog-nition of the necessity for accurate diagnosis are apparent. Thepessarv, according to the knowledge, judgment, and mechanical skillof the practitioner, will be useful, useless, or injurious. 664 BIS PL A CEMENTS. The Function of the Pessary. The function of the pessary is to maintain the uterus not only onthe health level in its normal location, but also, if possible, in itsnormal position, which requires the cervix to be about one inch fromthe hollow of the sacrum. The cervix in a properly selected casebeing thus placed, retroversion is not liable to occur, because if it doesoccur the fundus uteri will be arrested in its backward course by theover-arching sacrum, and because the direction of least resistance willbe forward into the normal anterior position. Figure The upper end of an Albert Smith pessary being pushed into place back of the cervix apparent lack of mobilitj at the normal angle of flexure in this uterus is a not uncom-mon result of the metritis which often complicates retroversion and retroflexion. It follows that the application of the pessary is based upon thegeneral proposition that if the cervix be normally placed the body of theuterus, in the absence of complications, will take care of itself. Since thevagina at its upper extremity is attached to the cervix, displacementof the latter is clearly impossible if the upper extremity of the vaginabe sustained in its normal location. The pessary restores and main-tains the relations of the relaxed vaginal walls by crowding the poste-rior vaginal cul-de-sac backward into the hollow of the sacrum. It TREATMENT OF RETROVERSTON AND RETROFLEXION. 665 also holds tiic attaelud cervix at a proper distaiic
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
