. Clinical gyncology, medical and surgical. Reposition of retroflexed uterus in left lateral position, second step. os, the intra-uterine part not touching the fundus at all. There is, there- DISPLACEMENTS OF THE UTERUS. 497 fore, no danger of injuring the organ by this instrument, for which reasonI prefer it. The uterus having been replaced by any one of these methods, shouldbe at once retained in its now normal position by a properly-fitting support,or, if it does not seem advisable to use such a one at once, by balls of cottonor the common substitute nowadays, iodoform gauze packing. Should
. Clinical gyncology, medical and surgical. Reposition of retroflexed uterus in left lateral position, second step. os, the intra-uterine part not touching the fundus at all. There is, there- DISPLACEMENTS OF THE UTERUS. 497 fore, no danger of injuring the organ by this instrument, for which reasonI prefer it. The uterus having been replaced by any one of these methods, shouldbe at once retained in its now normal position by a properly-fitting support,or, if it does not seem advisable to use such a one at once, by balls of cottonor the common substitute nowadays, iodoform gauze packing. Should the uterus be found unreplaeeable by any of these measures, itmay safely be inferred that it is adherent and that nothing short of operativeinterference will succeed in replacing it. Pessaries are, therefore, not indi-cated unless the organ has been restored to its normal position. At times it may be impossible to replace a uterus at the first attempt orto keep it in that position after it has been replaced. In that case repeated Fio. Reposition of retroflexed uterus in left lateral position, third step. attempts must be made, the vagina being in the interval well tamponedwith cotton or ;auze in order to retain the advantage which has beengained at each sitting. Excessive tenderness or impaction of the uterus, orgreat relaxation of the vagina, may be the reason for failure in such cases. Pessaries.—There is such a diversity of opinion on the use of pessariesin the treatment of backward displacements of the uterus that I think itworth while to devote a special section to their discussion. In the first place, let it be understood that in my opinion a pessary is anecessary evil, so to speak. If we could do without pessaries no one wouldbe better pleased than I; but, as I have already said under general re-marks, if I were compelled to give them up I should feel almost powerlessin the treatment of a very large proportion of backward displacements of 32 498 DISPLACEMENTS OF
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