Southern Medical and Surgical Journal - Georgia Regents University

—1858.] Eve's Notes on Diseases of the Cervix Uteri. 103tions, which might deceive the unpractised eye and possiblymislead the more experienced. Another great objection is thatif necessary to change its position at all, it must be withdrawnand re-introduced, for otherwise the expanded blades could notfail to irritate and cause pain :it is also very apt to give pain inbeing withdrawn ; unless closed with great care, the extremitiesof the blades will almost certainly irritate, and if not withdrawngradually and cautiously while closing, the mucous membraneof thevagina will be pinched.Having tried and rejected a large number of complicated andexpensive specula, I now decidedly prefer the glass mirror speculum,in general at least, to all others. Although it has noobturator, by introducing the projecting lip first carefully, andpressing it gently backward against the perineum, it may be introducedalmost if not quiteas easily as the bivalve or quadrivalvewith the obturator ; and then it may be moved freely inany direction after its introduction so as to bring the os andcervix in view, if needs be to hook them up and bring them forward,when, as often found,inclined too far back to be readilyseen.Much has been said against the speculum on the score of delicacy;but I cannot perceive that it is any more indelicate tomake a specular than a digital examination ; it is the necessityof the case that renders either proper, and I do believe a trulysensible and delicate lady would submit to the one as readily asthe other—indeed, were it not that a digital examination almostnecessarily precedes the introduction of the speculum, the specularwould involve less indelicacy than the other; for examplewere it practicable for the speculum to be introduced withoutthe intervention of the physician, as I have known, in a fewinstances, by the patient herself, or a female friend, and thephysician only required to look through it and, if necessary,make an application, would it not wound her delicacy less thana digital examination ? It is said that it involves more exposure,but this is not necessary ; for it certainly can, by propercare, and ought always to be avoided."When the speculum gives much pain,its use ought to be deferred,until the patient is better prepared for it, by soothincand sedative vaginal injections. I cannot conceive that any injurycan result from the speculum, when used with proper care