Curettage of the uterus : history, indications, and technique / by J.W. Ballantyne.

  • Ballantyne, J. W. (John William), 1861-1923.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Curettage of the uterus : history, indications, and technique / by J.W. Ballantyne. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    nioniiag, and special attention should be paid to the thorough cleansing of the inons veneris and external genitals. The Armamentarium.—instruments employed will vary with the individual tastes and requirements of the operator; the follow- ing are those which 1 usually provide:—A vaginal speculum (Marion Sims', or a modification thereof, e.g. Auvard's retaining speculum), and one or two copper retractors; two or more strong- toothed volsellae provided with clips; a set of uterine dilators, preferably Hegar's cones or Auvard's new hollow metal rods ; sharp and irrigating curettes, preferably Eecaniier's double scoop, Thomas's spoon-saw,and Rheinstaedter's flushing curette (curetting ibrceps and the blunt curette I never use); a set of three or four uterine sounds, or Playfair's probes armed with cotton wool; a male catheter, No. 10 ; an intra-uterine douche of an approved pattern ; a pair of curved packing forceps; and a sufficient number of pledgets of gauze (instead of sponges), and a long strip of iodoform gauze for packing the uterus, and another for the vagina. There ought also to be ready at hand a bottle of iodised phenol for cauterising the interior of the uterus, an anaesthetic, and antiseptic solutions {e.g., perchloride of mercury, 1 in 5000). Where it is possible, the instruments ought to be of metal, and should be previously boiled for fifteen minutes in soda solution (1 to 3 per cent.). Operator and his Assistants.—The operator ought to take the same personal precautions that he would in cases of abdominal section or hysterectomy. This is, I believe, a very important matter, especially in the cases in which curettage is performed, notwithstanding the existence of acute or chronic tubal or peri- metric conditions. He ought, therefore, to be rigorously careful with regard to the thorough cleansing of his hands, and should wear a waterproof apron and sleeves. His assistant and the nurse ought to be equally careful. The Operation.—The patient having been chloroformed, ought to be placed in the lithotomy (dorsal) posture rather than in the left lateral, on a table, and not in bed, facing a good light. The field of operation should be protected with sterilized towels, and the hips should be raised by and rest upon a pad of antiseptic cotton covered by mackintosh. The patient may be held in posi- tion by assistants, or in default one of the many crutches may be used. Before proceeding to the actual operation fifteen minutes should be definitely set aside for the thorough cleansing and disinfecting of the external genitals and vagina. The hair ought preferably to be shaven off, and the parts, both vulvar and vaginal, are to be thoroughly scrubbed with soap and water, and thereafter washed with perchloride solution (1 in 4000). Too much care cannot be taken to ensure the intra-vaginal cleansing, and pledgets of gauze (instead of sponges) in sponge-holders may be used to scrub the