Report of forty-one cases of uterine polypi : with remarks / by J. Braxton Hicks.

  • Hicks, J. Braxton (John Braxton), 1823 or 1825-1897.
Date:
[between 1860 and 1869?]
Catalogue details

Licence: Public Domain Mark

Credit: Report of forty-one cases of uterine polypi : with remarks / by J. Braxton Hicks. Source: Wellcome Collection.

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    b. Within the os. 4. When they are within the canal of the cervix, or within the body of the uterus. The first class are easily manageable; they are readily seen, readily caught and snared, and easily severed. A medium¬ sized instrument, one with a rope of ten to fifteen strands, is sufficient; and the smallest kinds of all may be removed by the smallest instrument, with three strands to a rope. It is best not to underrate the tenacity of the compressed tissue, and it will always be satisfactory to have more power than is really wanted. As a rule, these smaller and generally more vascular polypi bleed most after division, partly because of the relatively greater amount of blood-vessels, partly because the line of ecrasement is narrower, and because the force required to crush is less; therefore it is well to have a styptic at hand to stop any bleeding, not that it is ever really much, but that the operation will be more complete to the appearance of bystanders; and the employment of a styptic to the base and surrounding parts is beneficial to get rid of abrasions, and the irritation caused by the presence of these growths. Now, in the second class, we are obliged to dispense with the speculum, and trust to our hands only. We thus lose two advantages : the first, the assistance of our sight to quickly seize the growth ; the second, the protection which the speculum gives to the vagina from the contact of the fingers and the instrument for removal. But there are some cases in which, although from its small size the polypus would readily fall into the speculum, still the external parts may be so rigid and undilatable as to cause so much resistance to the speculum, that the instrument, and finger to guide, can be passed less painfully than the speculum. A few of the cases recited were treated in this way; they occurred, as may be surmised, in single women, somewhat advanced in years, where much haemorrhage had not occurred to lessen the tone of the system. In the second class of cases, then, we may pass a noose of the ecraseur slowly through the vulva, in such a manner as to