A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
For efficient application the cervix should be dilated if not
sufficiently patulous, and a cervical speculum should be used, or the
solution will be squeezed out of the cotton before it reaches the seat
of the disease. For injection the same articles are used, beginning
with weaker solutions and gradually increasing the strength. They
should never be resorted to without the utmost caution. The os should
be patulous as a sine quâ non, and the injection carefully
administered. In case the os is open the instrument may be the common
extra long-pipe rubber syringe bent to a suitable curve by heating.
This having been charged with a drachm or so of the liquid, the end is
served with cotton like an applicator; over this several clove-hitch
turns with a string are taken, so that the cotton may be withdrawn if
pulled off in the uterus. The pipe is then carried to the fundus and
the piston very slowly depressed. Buttle's syringe is a more elegant
and a safer instrument in cases where the os is not thoroughly opened.
The terminal pipe of this instrument is very slender and perforated
with minute openings, and the piston is forced in by screw-action of
the handle, so that the fluid is expelled drop by drop.
Nitrate of silver is sometimes applied in solid form to the interior of
the uterus, both as a means of checking excessive hemorrhage and to
effect a cure by modifying the condition of the endometrium. It may be
done with a probe, the end of which has been coated with the substance,
passed in detail over the inner surface of the organ. A piece of the
solid caustic is also sometimes carried into the uterus and left there,
the application à demeure of the French, some of whom claim that in
their hands this measure has never failed to check the hemorrhage.
In those cases where positive evidence has been gained that the disease
depends upon fungous growths of the endometrium there is yet another
and a more reliable remedy. It is the curette. By this instrument the
growths which are the origin of the menorrhagia can be certainly and
safely removed, their return prevented by a thorough application of
iodine to the surface from which they spring, and a cure often effected
when all other means have failed.
Intra-uterine applications, injections, and surgical measures affecting
the interior of the uterus have been detailed, as they are advised and
used by authorities. It remains to give an opinion as to their merits,
and to state the precautions which should be taken when they are
resorted to.
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