APPLICATIONS TO THE UTERUS.
Clay, Gautier, Gubler, and a number of recent writers, have insufflated powders into the uterus. We cannot see any advantage in this. More frequently the pencils (crayons, bacili) recommended by Becquerel and Rodier are used, and they are either inserted into the cervical canal or into the uterine cavity. For their insertion either long forceps or speci ally devised instruments are needed, although any suitably covered catheter, open at the extremity, with its stylet, will answer.
These pencils are made from gum arable and mucilage, from cacao butter, or gelatin (Trippier). The harder the pencils the more readily they may be inserted, but they are less soluble and more likely to irritate the uterus. I am in the habit of using cacao butter or glycerin, sufficient in amount to make them soft and flexible. The iodoform pencils which I use for disinfecting purposes contain 50 to 75 per cent. of the drug, and
are about three and three-quarter inches long, and of varying thicknesses. The more slender ones contain seven and a half grains of iodoform, and the larger about eighty grains.
The most convenient instrument for inserting them is the Dittel's pole retnede, which is a straight or slightly curved rubber tube furnished with a cylindrical stylet (Fig. 88). By means of this instrument the pencils are readily pushed into the uterus. It is advisable not to use too solid pencils lest they damage the uterus. The patient should lie still a few hours after insertion, in case she has pain. Where the uterus is not very irri table, soft suppositories and those not likely to cause large coagula may be inserted in the consultation room.