Volume 2

A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    mends the introduction of a tampon covered with the extract of bella- donna against the vaginal imrtion. 'William Duncan* records three cases in which complete and rapid relief followed the local apj>lication of cocaine. A 15 per cent, solution was paintc<l over the vaginal ]>ortion and vaginal vault, while an ai)pli- cation was made to the cervical canal by means of a prolx; wraj)ped with cotton. The intriKluction of such an instrument within the cer- vical canal is obviously a hazardous experiment, even in the hands of an expert. Suc-cessful results with the local application of this drug have also bc>cn noted by other observers. In the event of some morbid state of the vaginal portion apparent to the eye or examining huger, local treatment in accordance with established ])rinciples is eminently indicated. Of the value of treatment under these conditions there can be no doubt. Jacob Price** commends this therapy in no equivocal terms when he says: “ I know of no disease of equal gravity that so surely yields to established rules of treatment as this one does to treatment base<l upon the view of a congestive or inflammatory causation—viz. rest in bed, emollient, mildly-astringent vaginal injections, the tepid sitz-bath, and especially, in extreme rases, the topical application of Pattev’s or a similar sedative lotion to the uterine cervix. I am sure that no one who carcfidly and intelligently carries out this ]>lan of treatment will fail to bring relief in the most obstinate case.” 3. C()))cmaiP of Norwich, desirous of inducing abortion in a case of the uncontrollalJe vomiting of j)rcgnancy, pushrl the index finger through the cervical ranal to the membranes and attcm))tcd to ])unc- turc the amnion with a sound. Failing to acconqJish his ])ur])ose, he went home for assistance, and rcturnrl at tlie expiration of two horn’s. To his surprise, the hvpcrcmesis had suddenly cea.sed. Since 1875, when this observer first jmblished the results of this experience, cases have raj)idlv multiiilicHl in which this mcth(Ml has In'cn succcssl'iilly apjJied. W. Gill Wyl ie* has devised a steel dilator as a substitute for the index finger. AVhen the os externum is at all patulous, the index finder is altotrcthcr the .safest and most efficient instrument. The plan of dilatation of the os externum and cervix by the index finger is a purely empirical ])rocedure, does not always s<*cure the desinsl result, and frequently causes abortion or jircmature labor. Neverthek's.s, as the ultimate resort before the evacuation of the uterine contents it has inqioi-tant functions. Obstetrical.—The artificial evacuation of the uterine contents, if ' The Lancet, Oct. 15, 1887, p. 754. ’ I’ranmctione of the Medical Society of the Slate of Pennnjlrania, for 1884, “ .tdilrew in Olislctrics.” “ Beit. Med. Journ., 1875, 1879. * -V. Y. Med. lieeord, Dec. 6, 1884.