File:The Principles and practice of gynecology - for students and practitioners (1904) (14765006271).jpg

Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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t the essential factoris inflammation, and the resultant tenderness may render mechanicalsupport intolerable. TREATMENT OF RETROVERSION AND RETROFLEXION. GG3 2. Adhesions and cicatriciiil hands may prevent or proliihit re))lace-ment, and tlierefort eontraindieate the use of any means designed tohold the organ in place. 3. A tumor or excessive weight of the uterus may carry the corpusbackward and downward with a force greater than any pessary cancounteract. 4. The pelvic floor, including the fascial and ligamentous suj)portsof the pelvic organs, may, from subinvolution or other cause, be sorelaxed that no pessary can hold the organs in place. It follows from the above that the field for the use of the pessarymust be restricted to those cases in whicli the displaced organs arereplaceable, and in which the pessary is capable of holding them inplace, and can be worn \vithout discomfort. Failure to recognize andappreciate the contraindication accounts not only for the failures FiGTJKE 377.
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A, the correct mode of introducing a pessary. B, section through pelvis shows: I, urethra;V, vagina; R, rectum; LV, levator ani muscle. and disappointments, but also for the many evil results which havefollowed indiscriminate attempts to treat all displacements by me-chanical support. The exclusion of unsuitable cases and the recog-nition of the necessity for accurate diagnosis are apparent. Thepessarv, according to the knowledge, judgment, and mechanical skillof the practitioner, will be useful, useless, or injurious. 664 BIS PL A CEMENTS. The Function of the Pessary. The function of the pessary is to maintain the uterus not only onthe health level in its normal location, but also, if possible, in itsnormal position, which requires the cervix to be about one inch fromthe hollow of the sacrum. The cervix in a properly selected casebeing thus placed, retroversion is not liable to occur, because if it doesoccur the fundus uteri will be arrested in its backward course by theover-arching

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