Cyclopaedia of Obstetrics and Gynecology Volume 5 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1887 Excerpt: ... regulator," is Amussat's ivory stem. The stem must be from one-quarter to one-half an inch less in length than the depth of the uterine cavity, otherwise it will touch the-fundus and injure the organ, but it must also reach at least three-quarters of an inch above the internal os, else it will not be effective in straightening out the uterus. The thickness of the cylindrical or conical stem should vary according to the width of the internal os; too slender stems readily slip out, while if they are too thick it is difficult to insert them and they ordinarily cause sharp pain. The stem may be either solid or hollow; in any event the extremity within the uterus must be well rounded, and the entire surface must be smooth and carefully polished. The hollow stems, which permit the free outflow of the uterine secretions, since the entire instrument is slender, necessarily have thin walls, and therefore readily break in the vagina. At the external, non-uterine extremity of the stem there is a concavo-convex, round, slender cup, a thick knob or a ball, which answers the purpose of steadying the stem. The diameter of this cup is at least three-quarters of an inch, ordinarily a trifle more, the greater indeed the wider the external os and the more relaxed the tissue of the uterus. The chief utility of this cup is to prevent the stem from slipping into the cavity of the uterus, and it further prevents the stem from slipping out, since it rests against the vaginal wall and indirectly against the levator ani (Hildebrandt), or else is supported by one or another of the means to be mentioned later. Flat cups and round knobs do not maintain the stem in position as well as those which are concave upwards, that is, towards the uterus, and I have had them constructed aft...