Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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een practised by different surgeons. The lesson to be learnedfrom the combined experience of these methods is that success isattained best by firm, steady, continuous, elastic pressure, and that itmay depend finally upon very prolonged and patient effort. The object is to overcome the rigidity in the cervical ring. Thepressure to accomplish this may be unyielding or elastic. The treat-ment includes the following possible procedures : 1. Replacement by the unaided hands. 2. Replacement by the hands aided by incisions or instruments. 3. Continued elastic pressure. 4. If reduction prove impossible, the final resort is hysterectomy.If one method fails, a combination of two or more methods may succeed. 1 Emmet. Principles and Practice of Gynecology. INVERSION OF THE UTERUS. 711 Preparatory Treatment.— It is always possible in the course ofan attempt at reposition that emergencies may arise that will necessi-tate abdominal or vaginal section ; hence, the necessity of making Fii;lkj-: 41G.
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Manual reposition of an inverted uterus. preparation for those operations. See Chapter II. In addition tothe above, iron may be required for anaemia, and hot water or asep-tic gauze tamponade in the vagina may be needed for hemorrhage. 712 DISFLA CEMENTS. In a very ansemic case several weeks or even months of recuperativetreatment may be essential. Reposition with the Hands, Emmets Method/—The patient,anesthetized, is in the lithotomy position. The left hand is passedinto the vagina, the fingers and thumb are forced as far as possibleinto the angle of reflexion, so as to encircle the part of the corpusuteri that is close to the constricted cervical ring. The fundus is incontacrt with the palm of the hand, and is pressed firmly upward by it,while the fingers are separated to their utmost to open the cervix. Atthe same time the right hand behind the pubes slides the abdominalwall back and forth over the peritoneal depression. This effort, theobject of which is to open out the contract

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