File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14581553299).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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Fig. 39.—Average conformation of parts at vaginal orifice.a, anus; e, fourchette. bent at all (except in the workshop). None of these can belessened in size during introduction, and therefore theirapplication is painful. Greenhalghs pessary is of wire coveredwith indiarubber, the anterior end being of indiarubber alone.Hence the sides can be pressed together and the instrumentinserted with comparatively little pain. The drawback tothis is that indiarubber forms, with the vaginal secretions, anoffensive compound, and in some patients it is so offensive UTERINE DISPLACEMENTS: PROLAPSE. 129 and irritating that they cannot tolerate any indiarubberinstrument. In some patients a pewter instrument causesirritation. Vulcanite and celluloid are clean, but are some-times eroded by the vaginal secretions. Effects of a vaginal pessary.—If a vaginal pessary isretained and keeps up the uterus, relief is almost complete,
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Fig. 40.—Occasional conformation of parts at vaginal orifice, Perineum extendingforwards to symphysis. a, anus; d, fourchette ; u, urethra. and greater than can be attained in any other way. Thedrawback is the attention required so long as the patientis wearing the instrument. If the instrument fits, no harmresults from its presence. If it is too small, the reliefgiven will be less complete. If too large, the vagina willfeel tense and the pessary will cause pain. The introduc-tion of a pessary always causes slight pain ; but when this has 130 DISEASES OF WOMEN. passed off, the patient ought not to be able to tell whethera pessary is there or not. If she is aware of its presence, it isprobably too large. Worse results may happen from badly-fitting instruments. The continuous pressure of a hardinstrument on one point may cause ulceration. I have seena pessary embedded in the vagina, ulceration having taken

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