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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    by sight was more thorough than uterine scraping in the human subject. Werth's paper was also important, for it showed that in the case of uteri removed after curetting the endometrium was never entirely removed. Some areas, especially near the cornua, were often left untouched, whilst the anterior wall was usually well denuded; further, the depth of the mucosa removed varied very much. In the cases in which the curette did not penetrate to the muscular coat there was found a mucosa with glands opening on the free surface in from eight to ten days; but where the muscularis had been reached, even after the lapse of seventeen days there were still bare areas. New epithelium was observed as soon as the third day after curetting in some cases, and Werth believed that the glauds were reproduced from the extremities left embedded in the muscularis mucosae. These papers have a special value in enabling us to form some idea of the changes consequent upon curettage. If we contrast the position of the curette now with that it occupied in 1878 we shall be struck with the great increase in popularity and extension in application which it has achieved in these eighteen years, as compared with its slow growth in favour during the twenty-eight preceding years. I believe I am right in saying that the curette is now scarcely ever employed without previous dilatation and angesthetisation; that it is used in the hospital rather than in the dispensary, and with the patient in bed rather than on the consulting-room couch; that the sharp curette, flushing or not flushing, is the instrument of choice; that the operation is looked on as one requiring as much care, caution, and skill as any in minor gynecology ; that in some cases it comes to have even the importance of a major operation; and that it is now as a therapeutic and not as a diagnostic agent that it has won its greatest triumphs and most widely extended its field of usefulness. Indications. It has doubtless been gathered from what has been said of the history of the curette, that the indications for the employment of this implement have greatly increased during the last few years. It is now more frequently used than it was some time back, and it is used in cases in which it would previously have been regarded as inappropriate and even as dangerous. These indications may be roughly divided into therapeutic and diagnostic, and under each of°these headings are grouped conditions, obstetrical as well as gynecological, which call for the use of the curette. Indications. A. Therapeutic Uses. I. Haemorrhage. a. Uterine.