71 
has to introduce the metal catheters with a boring motion, 
but has to bear in mind that the body of the uterus is only 
2-5 cm long. It is therefore easy to perforate the uterus 
wall if the necessary care is not employed. If it is difficult 
or impossible to penetrate the os uteri internum, it has to be 
enlarged with a forceps (Fig. 20) or with the knife. 
Fig. 19—Metal cathether. 
yy aa-= 
O 
Fig.20—Forceps for the dilatation of cervex. 
It is impossible to penetrate further with the metal 
catheter than into the body of the uterus, and one can there- 
fore remove only the discharge which is present there; no 
doubt one can fill the horns of the uterus with the solution, 
but it is impossible to get it completely out again with 
massaging. I use therefore the rubber catheters which I 
introduce with a mandrin; after the mandrin is removed one 
is able to push the rubber catheters without danger of per- 
foration inte the uterus horns. It is possible then not only 
to remove all secretion present, but also to infuse concen- 
trated solutions without bringing them into contact with the 
vaginal mucosa. 
I have used solutions of sodium carbonate, sodium chlor- 
id, creolin, lysol, lysoform, alum, argentum nitricum and of 
iodine. I had the best results with a diluted alcohol in- 
fusion, which dissolves very well the viscous and greasy 
secretion, followed with another infusion of Lugol solution, 
1:3:17 or 1:3:97. In most of the cases the weaker solution 
is sufficient, but in old and obstinate cases I always use the 
stronger one, which I inject with a rubber catheter and a 
glass syringe. 
