. The diagnosis and treatment of diseases of women. ce of a rule, when the measures previously mentioned fail, it is better to give the pa-tient an anesthetic and dilate thoroughly and curet. Occasionally, however,even in an unmarried woman, this partial dilatation is practicable and gives muchrelief. The patient is placed in the Sims posture, the Sims speculum introduced, thecervix caught and brought into view and, with the antiseptic precautions necessaryin all intra-uterine work, the graduated metal dilators (Fig. 101) are introducedinto the cervical canal and past the internal o
. The diagnosis and treatment of diseases of women. ce of a rule, when the measures previously mentioned fail, it is better to give the pa-tient an anesthetic and dilate thoroughly and curet. Occasionally, however,even in an unmarried woman, this partial dilatation is practicable and gives muchrelief. The patient is placed in the Sims posture, the Sims speculum introduced, thecervix caught and brought into view and, with the antiseptic precautions necessaryin all intra-uterine work, the graduated metal dilators (Fig. 101) are introducedinto the cervical canal and past the internal os—beginning with the smallest sizethat the canal will accommodate and passing to the largest. After dilatation, thevagina is again cleansed with the antiseptic solution, the speculum removedand the patient directed to lie down for a time after she gets home and to be ratherquiet the remainder of the day. This dilatation is made each month just beforethe menstrual time. The closer the dilatation to the beginning of the flow, thebetter the Fig. 672. Dudley Operation. Dividingthe posterior wall of the Cervix. (Dudley—Practice of Gynecology.) Fig. 673. Dudley Operation. The posterior wall of cervixDivided and the principal Suture passed. Before passing thissuture, a wedge-shaped piece of tissue is excised from the cer-vix on each side of the wound, as indicated by the dottedlines. (Dudley—Pr«c<tce of Gynecology ) DYSMENORRHOEA IN THE MARRIED 745 7. Stem Pessary or Wire Spring. In the exceptional cases in which partialdilatation is effective temporarily but must be repeated every month, the stempessary or the wire spring may be worn to maintain the dilatation. The useof the stem pessary must be attended with great caution. It was formerlyused frequently and led to serious pelvic inflammatory trouble in many harmful results were so frequent that the use of the stem pessary was prac-tically dropped. Later, it was found that in certain exceptional cases not
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