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"A new kind of pessary"

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London Medical Gazette
(7 April 1843): 100

PDF from photocopy; Taubman Medical Library, University of Michigan.

To the Editor of the Medical Gazette.


I shall be obliged if you will allow me, through your pages, to call the attention of the profession to a pessary I have invented, which I believe to be preferable, in most respects, to all the various kinds at present in use. It consists of a piece of sponge cut into the form of a sphere, or, what is better, of an oblate spheroid, and tied up, by means of small twine or silk thread, in a circular piece of oil-skin, in such a manner that a small stem or tail is left half or three-quarters of an inch in length. The firmer kinds of sponge, which possess a good resiliency, are best; and the oiled silk is closed as firmly as it can be by tying, but no extraordinary means are used, by cement or otherwise, to make it completely impervious to air.

When this pessary is compressed in the hand, the air contained in the cells of the sponge is gradually forced out at the neck, between the folds of the oil-skin. In this form it can be very easily introduced; and when passed above the narrow part of the vagina and left at liberty, the elasticity of the sponge, and the pressure of the atmosphere together, cause air to re-enter the instrument, and it assumes its expanded form. The small tail hanging downwards will facilitate its removal at any time.

The chief advantages of this pessary are, I consider--

1. Its capability of being diminished in size during its introduction and removal.

2. Its softness, which is such that it can scarcely cause any of the effects of a foreign body.

3. Its small weight.

4. The tendency of its elasticity to keep it in its position; for any sudden pressure of the viscera above will be spent in overcoming this elasticity, instead of forcing the instrument through the external parts; and, moreover, such pressure will flatten it and make it wider, and thus render its extrusion the less possible.

As additional advantages I may mention its cheapness and its durability, which will be as great as that of the oil-skin; and this, if requisite, can be applied double.

I have applied this pessary with perfect success up to this time, in three cases in which the uterus, except in the recumbent posture, had protruded entirely beyond the external parts for a number of years; and in two of these cases various other pessaries had been tried, but in one case would not remain, and in the other could not be borne. As it is only about two months since I first applied these instruments, I will postpone any more particular accounts of the cases till another time.

Sponges are occasionally used as pessaries; but as they become charged with mucus and other fluids, and soon decay or become offensive, and a source of irritation, they are only resorted to as a temporary expedient. A small sponge dipped, from time to time, in some astringent fluid, and applied in the beginning of prolapsus uteri, when it is yet but slight, as Dr. Denman suggested with the object of performing a cure, may, I believe, often fulfil that desirable intention. The pessaries which I have hitherto used I have made myself; but I have now got Mr. Read, of Regent Circus, to make some, and he can supply them to medical gentlemen. Of course care will be required in adapting the size of those as well as other pessaries: when expanded these should be somewhat larger than a rigid pessary for the same patient.

I remain sir,

Your obedient servant,

John Snow, M.R.C.S.

Frith Street, Soho Square,

April 7, 1843

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