INVERSION OF THE UTERUS. 



595 



about one and a half inch. This prevents its injuring the genital organs, 

 when it is applied exactly in the same manner as the preceding pessary 

 — thecervix uteri being in the centre of the ring. 



A rondelle pessary has been devised by Leblanc, and Rainard has in- 

 vented a pessary (similar to Fig. 197) for small animals. 



A bottle pessary has frequently done good service, when nothing more 

 suitable has been at hand. An ordinary glass bottle, with a deep con- 

 cave and smooth bottom, has a long piece of wood fixed in the neck, 

 and can thus be made to act like the other pessaries ; though its weight 

 is objectionable, and there is also the danger of its breaking. 



A very ancient pessary — employed even by the Greeks of an early 

 period — and one which has been most usefully resorted to by Tolney, 

 Laubender, Willburg, and others, is the bladder of the pig or ox. When 

 required for use, the bladder is steeped in warm water, then a long 

 wooden tube, or a piece of india-rubber tubing, is fastened to the neck of 

 it ; the bladder is introduced into the uterus and inflated, the tube being 

 then closed. 



Rainard recommends that it be only placed in the vagina ; but the 

 majority of obstetrists prefer it in the uterus. It has been allowed to 

 remain there as long as ten and fourteen days. 



For valuable animals, it has been suggested that Gariel's air pessary 

 might be employed. This acts on the same principle as the bladder ; in 

 fact, it is an india-rubber bladder, which is inflated by means of a long 

 tube with a stop-cock. This tube may be in connection with another bag 

 and stop-cock, the former being already filled with air, which can be 

 transferred to the other bag when it is placed in the vagina or uterus. 



The smaller animals rarely require pessaries of this description ; though 

 there is no reason why, if necessary, modifications of the three first, and 

 on a proportionately small scale, might not be employed. The ring 

 might be made of india-rubber, or cork. For the Bitch, more particularly, 

 the cuvette pessary, however, has been recommended and used. This is 

 an imitation of that employed for woman, and is merely an oval, circular, 

 or oblong piece, made of gum, india-rubber, gutta-percha, or ivory, one 

 to two inches in diameter, and having a hole in the middle. When 

 required to be introduced, this pessary is well oiled ; the narrow end is 

 passed edgeways into the vulva, and the piece is pushed in beyond the 

 bulb of the vagina. Then, by means of the index finger, it is placed ver- 

 tically : the hole in the middle allowing the finger to fix it in the centre 

 of the ^allva, its two fends being retained by the branches of the ilium, or 

 at least in front of the ischium and the bulb. 



A spring, or elastic pessary, such as is now frequently employed for 

 woman, and which can be more easily introduced into the vagina, might 

 be useful with the smaller domesticated animals. 



Salt, of Birmingham, has introduced into human gynecology a new 

 flexible annular pessar\', which might be advantageously employed by the 

 veterinarian for the smaller animals. It consists of a watch-spring coiled 

 spirally, with the extremities left free, and encased in caoutchouc ; it col- 

 lapses for introduction, and when in situ, it expands to the circular form, 

 or such other shape as may best accommodate its contact with surround- 

 ing parts. 



The value of pessaries in inversion of the uterus in animals has 

 been a good deal discussed. We are not aware that they have been 

 much, if at all, employed in England j and in Germany they do not 



