: Treatise on gynæcology : medical and surgical
: Pozzi, S. (Samuel Jean), 1846-1918 Wells, Brooks H. (Brooks Hughes), b. 1859
: Gynecology Genital Diseases, Female
: New York : W. Wood
: Columbia University Libraries
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Fig. 273.—Borgnets Pessary. constipation or the use of clothing which compresses the waist, andthe immediate suture of perineal lacerations. Any relaxation of thevaginal tissue should be treated by hot astringent injections. Chroniccases of slight degree are benefited by the tonic effect of the hotdouche and by astringent tamponade, and according to many writersby elevation of the uterus and massage by Thure Brandts method. Pes-saries in general are unsatisfactory, as stated above, though many casesof cystocele receive great benefit and relief from the pessary devisedby Gehrung (Fig. 274). This instrument, while most efficient, needs to 496 CLINICAL AKD OPEEATIVE GYNCOLOGY.
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Fig. 274.—Gehrungs Pessary forCystocele. be carefully fitted, and is difficult to adjust unless fully understood.As it sustains a considerable weight, it must be watched to see thatits superior bar does not cut into the vaginal wall. It is inserted asfollows: Place the pessary on a table, with the superior arch (8) be-low and the inferior (7) above, the curvesJR, and L pointing toward you. Take thepessary by curve L with the right handand insert curve R into the vagina to theright of the patient until three-fourths ofthe instrument is buried within. Thenpush curve L toward the fourchette andthe left side of the patient, so that it slipsinto the vagina at the same time that Sturns upward in front of the uterus and/under the pubic arch. The curves M andL should rest squarely on the posterior vaginal wall, while S and/ support the rectocele between the uterus and symphysis.] Surgical Treatment.—This offers so much chance of relief, and isattended by so little danger, that it ought to
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