Practical midwifery; handbook of treatment . resort to ;i routine use of the dull wire curettein all cases in which the uterine lochia are distinctly foul—a rulewhich is justified by the fact that a careful use of this instrumentis probably never productive of harm, while the positive resultswhich almost invariably follow a thorough removal of the decom-posed contents of the uterus would be abundantly sufficient tojustify a much more dangerous procedure. The use of the cu-rette should always be preceded and followed by an intra-uterinedouche. The best curette for post-partum use is the large p
Practical midwifery; handbook of treatment . resort to ;i routine use of the dull wire curettein all cases in which the uterine lochia are distinctly foul—a rulewhich is justified by the fact that a careful use of this instrumentis probably never productive of harm, while the positive resultswhich almost invariably follow a thorough removal of the decom-posed contents of the uterus would be abundantly sufficient tojustify a much more dangerous procedure. The use of the cu-rette should always be preceded and followed by an intra-uterinedouche. The best curette for post-partum use is the large pla-cental curette introduced by Munde (Fig. 121). It should be bentto a curve slightly greater than that of the uterus, with itssharper edge directed to the concavity of the curve; passed withinthe cavity under the guidance of the finger, and made to passwith a gentle oscillatory movement from side to side over thewhole surface of the anterior wall of the uterus. It should thenbe withdrawn with a succession of scraping movements, and this. Fig. 121.—Mundes Placental Curette, Actual Size. process should be repeated until every portion of that wall yieldsthe firm and almost grating sensation which is characteristic ofuterine tissue. The curette should then be withdrawn; its shankshould be bent to a curve somewhat less than that of the uterus,and with the sharper edge directed toward the convexity of thecurve, and in this position should be made to explore every por-tion of the posterior wall in a similar manner. If necessary, itmay then be so bent as to be adapted for similar scraping oneach lateral w^all. Metritis and the peri-uterine inflammations can only be reachedby the removal of the endometritis which precedes and causesthem, when nature usually effects their cure. Salpingitis, ovaritis, and inllaiumations of the pelvic connec-tive tissues are to be detected only by bimanual are beyond the reach of local applications, and should betreated by the applic
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectmidwifery, bookyear18
