. Atlas and epitome of gynecology . us membrane mustbe changed by using astringents or caustics. The strongercaustics (10 ^ zinc chlorid, for example) should not beused, as they may produce strictures, stenoses, and patho-logic adhesions. These substances are best applied inliquid form (sesquichlorid of iron in 50^ solution orpure, 2 c/c solution of silver nitrate, 5 c/0 solution of zincchlorid, fuming nitric acid) by means of cotton and thealuminum sound. At the same time the infectious virus must be removed,either by the foregoing caustics or by antiseptics. Inaddition to intra-uterine irrig
. Atlas and epitome of gynecology . us membrane mustbe changed by using astringents or caustics. The strongercaustics (10 ^ zinc chlorid, for example) should not beused, as they may produce strictures, stenoses, and patho-logic adhesions. These substances are best applied inliquid form (sesquichlorid of iron in 50^ solution orpure, 2 c/c solution of silver nitrate, 5 c/0 solution of zincchlorid, fuming nitric acid) by means of cotton and thealuminum sound. At the same time the infectious virus must be removed,either by the foregoing caustics or by antiseptics. Inaddition to intra-uterine irrigation (Fritschs two-waycatheter), pencils of itrol or iodoform may be introduced. The cervix may be dilated and the uterine cavity maybe disinfected at the same time by packing the uterus withitrol or iodoform gauze (following Abel, to be removeddaily). Landau introduces yeast cultures. The changed and infected mucous membrane may beremoved by radical methods—abrasion, curetment (rac-lage, excochleation). 1 See Therapeutic / TREATMENT. Ill After careful disinfection and dilatation the cervix isfixed with bullet-forceps and the uterine walls are care-fully and evenly scraped. Simons sharp spoon or thedull wire curet may be used. [The dull wire curet ispractically useless.—Ed.] The various portions of thecavity should be cureted in some definite order. Thecureting is to be immediately followed by packing withantiseptic gauze (itrol, iodoform) or with gauze saturatedwith some caustic (solution of ferric chlorid, formalin).This controls the hemorrhage, acts as a disinfectant, andbrings the medicament in contact with the remainingdiseased mucous membrane. It is still better to followup the curetment with atmocausis or zestocausis. (SeeTreatment of Chronic Metritis.) Narcosis is necessary in the majority of cases. Theintra-uterine irrigations may sometimes cause colic. For three or four days after the curetment daily intra-uterine douches of 2 c/c carbolic acid act favora
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