A system of gynecology . DILATATION OF TUT. UTERUS. 357 The time required for a sponge or tupelo to reach its maximum dilata-tion is from six t twelve hours. Several small tents may be intro-duced at one time instead of a single large one. The tent may sometimes be removed by traction on the attachedthread, but when considerable force is required it is better to use the Fig. 1( Introduction of a Tout (Simss). speculum and forceps, and in making traction to use counter-pressureagainst the cervix, which may be steadied by placing two fingersagainst it, or by fixing it with the vulsellum forc
A system of gynecology . DILATATION OF TUT. UTERUS. 357 The time required for a sponge or tupelo to reach its maximum dilata-tion is from six t twelve hours. Several small tents may be intro-duced at one time instead of a single large one. The tent may sometimes be removed by traction on the attachedthread, but when considerable force is required it is better to use the Fig. 1( Introduction of a Tout (Simss). speculum and forceps, and in making traction to use counter-pressureagainst the cervix, which may be steadied by placing two fingersagainst it, or by fixing it with the vulsellum forceps, or by encircling it with the fenestrated end of a Simss depressor. After the removalof the tent some blood usually Hows from the intra-uteriue surface,which is usually more or less abraded, especially if a sponge tent hasbeen used, and the endometrium should therefore he thoroughly washedout with an antiseptic solution, to he followed with an application ofChurchills tincture of iodine over the entire uterine cavity. In casesrequiring further dilatation the iodine should he omitted until the las!tent has been removed. The danger of continuous dilatation by intro-ducing one tent after another is very great. As already stated, thealarming results have generally followed the use of the second or thethird tent, seldom the first. A tent should not he allowed to remainin the
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