Operative gynecology : . t a symptomcommon to a number of diseased conditions, and to make clear its relation toa variety of pelvic affections which are most apt to escape detection upon asuperficial examination, I have analyzed 255 of my cases of pelvic peritonitiswith adherent ovaries and tubes, tubercular peritonitis, hydrosalpinx, pyo-salpinx, and catarrhal salpingitis, taken consecutively. Of these 255 cases,185 suffered from dysmenorrhea, and it was absent in but 70 cases; therefore,from this analysis it would appear that 72 per cent of pelvic inflammatory casespresent dysmenorrhea merel
Operative gynecology : . t a symptomcommon to a number of diseased conditions, and to make clear its relation toa variety of pelvic affections which are most apt to escape detection upon asuperficial examination, I have analyzed 255 of my cases of pelvic peritonitiswith adherent ovaries and tubes, tubercular peritonitis, hydrosalpinx, pyo-salpinx, and catarrhal salpingitis, taken consecutively. Of these 255 cases,185 suffered from dysmenorrhea, and it was absent in but 70 cases; therefore,from this analysis it would appear that 72 per cent of pelvic inflammatory casespresent dysmenorrhea merely as a complication. In spite of failure, even in many of the well-selected cases, the relief andthe occasional cures effected make dilatation one of the most important, andoften one of the most satisfactory, of all the minor gynecological procedures. The most suitable cases for dilatation are those in which the pain is spas-modic, begins with the flow, and is most intense during the first day or two. 579 580 Fig. 320—The Dilating Endsof the Three Sizes of theEllinger and Goodell-Ellinger Dilators, show-ing the Slight Curve andRelative Sizes. OrdinarySize. Operation.—Dilators of the Goodell-Ellinger pattern, of three sizes, areneeded; the smallest, having smooth blades, is 4 mm. in diameter, and the two larger 5 and 6 mm. in diameter, respectively, both corrugated, as recommended by the late Dr. William Goodell (see Fig. 320). My own dilators have a spring between the handles, but are not provided with ratchet or screw. The handles are bent at an angle and made large enough to be grasped in the full hand; the dilating end is blunt and but slightly curved (Fig. 321). Light instru-ments with a strong curve and a tapering point arc danger-ous and must be avoided. Slow dilatation by means of sponge or tupelo tents, for-merly so much used, has, by common consent, been gen-erally abandoned on account of the great danger of septicinfection. The uteri, which need dilat
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
