(iv) _Frequent abortion in the early months._ Curetting often cures this by removing the diseased endometrium. (v) _Inoperable carcinoma of the cervix._ Removal of the redundant portions of the growth by the curette, followed by cauterization or other measures, relieves the hæmorrhage and foul discharge. Great caution must be exercised, lest the peritoneum or bladder be opened into by the curette and the sufferings of the patient thereby increased. Cells of the disease may also be pushed into the pelvic lymphatics; considerable febrile disturbance may also follow the operation. In this condition a blunt curette (Fig. 60, B) may be gently used; the same instrument is safest in abortion up to the eighth week of pregnancy; after this date it is better to use the fingers only. [Illustration: FIG. 55. VOLSELLA FOR FIXING THE CERVIX.] [Illustration: FIG. 56. HEGAR’S DILATORS (THREE SIZES) FOR DILATATION OF THE CERVIX UTERI.] Fragments removed by the curette are subjected to microscopical examination _for diagnostic purposes_. The various conditions which may have to be diagnosed are:-- 1. Carcinoma of the body of the uterus. 2. Retained products of conception. 3. Tuberculosis of the endometrium. 4. Chorio-epithelioma malignum. =Operation.= The following instruments are required: a volsella (Fig. 55); a self-retaining weighted speculum (Fig. 37); uterine dilators (Figs. 56, 57); a uterine sound; a Bozemann’s tube (Fig. 58); Budin’s celluloid catheter (Fig. 59); and one or other flushing curettes. There are many varieties of curettes, and each has its own adherents. The most generally useful is Murray’s sharp flushing curette, which has a groove for the recurrent flow (Fig. 60, A). There are many varieties of blunt curettes. The model depicted in Fig. 60, B, enables the operator to clear out the uterine cornua and is of the best shape. The patient is placed in the lithotomy position and the various antiseptic precautions already described are carried out. A speculum is passed and the cervix is steadied by a volsella applied to the anterior lip.