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
This form of tampon has the additional advantage of
being antiseptic. I have allowed it to remain for three days, and upon
removing it satisfied myself that there was no decomposition of the
blood or the vaginal secretions. When the tampon is removed it will not
be found difficult to wash out all the granular clots caused by its
presence. It may be repeated as often as necessary, but usually, if
allowed to remain forty-eight hours, the hemorrhage will not return. It
may be said that for small losses this is unnecessary, but it is
convenient and harmless, and will answer the purpose. In dangerous
cases no one will question the propriety of its employment.
Another very important means of arresting hemorrhage which can be used
by the physician when necessary is the introduction of a compressed
sponge into the cervix uteri. This will temporarily act as a tampon and
stimulate the uterine fibres to contraction. The free incision of the
cervix, as directed by I. Baker Brown, may be tried between the times
of the paroxysms of hemorrhage.
The pressure of the tumor upon the pelvic viscera is another
inconvenience which calls for attention. This takes place usually at a
time when the tumor has acquired a size sufficient to fill the pelvic
cavity. Consequently, the elevation of the tumor above the pelvis is
the remedy. This may be done sometimes by placing the patient in the
knee-elbow position and pressing the growth upward. The powerful
influence of atmospheric pressure called to our aid by the position and
opening of the vagina is a very material auxiliary in the process of
elevation. If this is not sufficient, we may pass the fingers into the
rectum and elevate the tumor. I once succeeded in this operation by
using an ivory-headed cane in the rectum when the fingers failed to
reach high enough. If we cannot elevate the tumor by any of these
means, we may introduce into the vagina or rectum a gum-elastic bag,
and by means of a powerful syringe fill it with water to as great
distension as the patient will bear, permit it to remain, and thus do
the work more gradually.
Dysmenorrhoea is another symptom of fibrous tumors, and sometimes a
very distressing one. It depends, no doubt, on the imprisonment of
blood in the uterine cavity in consequence of the tortuosity of the
canal causing the closure of some part of it. The remedy consists in
dilating these narrow places. I know of nothing so well calculated to
effect this object as the slippery-elm tent. One or more of these
tents, long enough to reach the fundus uteri and of sufficient size,
moistened so as to render them very flexible, may be passed up through
the tortuous places with great facility. If introduced as soon as the
symptom begins to manifest itself, and allowed to remain an hour or
two, the relief will be pretty {259} certain. If used once a day for
four or five days before the attack, and three or four hours at a time,
dysmenorrhoea may be generally avoided.
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