69 
when the arm is introduced in the vagina, but do not mind 
the subsequent operations. 
I use for infusions and for the removal of the uterus con- 
tents a thickwalled rubber catheter (Fig. 17), which is closed 
at the end but has two openings on the side. Such a catheter 
is easily introduced and does not clog up; another advantage 
Fig. 15—Speculum. 
of it is that it does not become closed by sharp turns or by 
the pressure of the cervical canal. If the canal is so narrow 
that I can not introduce this catheter, then I try to dilate it 
by the use of a bigger one. If even that is of no use, I em- 
ploy a metal tube as a mandrin. (Fig. 18.) After I have in- 
troduced the catheter with the help of this instrument I draw 
it so far back that its end is on the os uteri internum. The 
rubber catheter is then in the uterus proper and the metal 
tube keeps open the cervical canal. The contents of the 
uterus can be then easily removed after they are diluted 
with water. To remove the contents completely it is neces- 
sary to massage the uterus from the rectum. It is quite 
possible to clean the uterus by repeated infusions. If tissue 
remnants or necrotic cotyledons are found which cannot pass 
the catheter, one must try to press them through the cervix, 
possibly after a dilatation of the latter with the knife. 
For the irrigations I employ first pure luke-warm water 
or weak solutions of lysol (14—1/10%), and afterwards a 
solution of iodine and potassium iodide in the relation of 
1:3:97 or 1:3:200, which, however, has to be removed again. 
