Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . Fig. 91.—Noeggeraths vulsella-forceps for dislocating uterus downward; also with sound attached forlateral dislocation. operation, the Sims or Simon is indicated. Occasionally indagation maybe practised on the uterus when it is drawn down in the speculum. Whenthe traction ceases, the uterus rapidly returns to its site. A supposed in-verted uterus is best drawn down by passing a broad tape about the pedi-cle and using
Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . Fig. 91.—Noeggeraths vulsella-forceps for dislocating uterus downward; also with sound attached forlateral dislocation. operation, the Sims or Simon is indicated. Occasionally indagation maybe practised on the uterus when it is drawn down in the speculum. Whenthe traction ceases, the uterus rapidly returns to its site. A supposed in-verted uterus is best drawn down by passing a broad tape about the pedi-cle and using it as a means of traction. A wire or thread loop may alsobe passed through one or the other lips of the cervix and used as a tractileforce. Counter-indications to this practice are fresh or chronic inflammatorydeposits about the uterus ; the latter, indeed, may fix the organ so firmly. Fig. 92.—Hanks double tenaculum. as to render its protraction impossible, while the former make it exceed-ingly dangerous. Occasionally an inflammatory reaction follows the arti-ficial prolapse of even the normally mobile uterus. This method shouldtherefore never be employed needlessly, and only when the examinationor operation cannot be as well performed with the uterus in situ. In this connection it will not be amiss to refer to the injuries whichmay be inflicted on the cervix by the single or double tenaculum. One ofthe objections advanced against the Sims speculum by those conservativegynecologists who have never really acquired the knowledge how to use GYNECOLOGICAL EXAMINATION. 105 it, is the wounding and laceration of the cervix by the tenaculum requiredto attract and steady the uterus; such lacerations, they claim, besides be-ing a needless disfigurement, open the channel to septic infection, and maybe followed by severe hemorrhage. It is true, the cervix is occasionallyquit
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
