On curettes and curetting / by Alexander Keiller.

  • Keiller, Alexander, 1811-1892.
Date:
[1878]
Catalogue details

Licence: Public Domain Mark

Credit: On curettes and curetting / by Alexander Keiller. Source: Wellcome Collection.

    6/10 (page 328)
    by easy distances. This I objected to, from the danger of travelling with a retained placenta, and suggested that Dr Keiller should see iier. In consultation with Dr Keiller, the small placenta, partly adherent, was removed with little difficulty. She has since, by good nursing and nutritious food, made a good recovery, at the same time taking small doses of sulphate of quinine at short intervals.”] The terminating of such cases by the curette or otherwise is generally so evidently successful—the patient being, as it were, rescued from pending dissolution, and so shortly thereafter regain¬ ing her lost strength—that the party who has been fortunate enough to see and treat the case when perhaps little or no special tact or manipulative skill was required, beyond expediting the completion of the process of separation and expulsion naturally going on, receives undue credit for performing what may be deemed no ordinary marvel. In his paper Dr Munde dwelt on the great ease with which the curette can be used, spoke of the almost complete harmlessness of the instrument, and lauded its efficiency in strong terms. I cannot think so well of the curette, and for this simple if not ample reason, that, although there may be little difficulty in using it, the very ease with which it can be used may lead to the abuse of a useful and safe instrument, and in many cases go far to counteract not only its harmlessness but its curative efficiency. Dr Mundd in his paper expresses himself, I think, too strongly in regard to the absence of any difficulty in using the instrument he referred to, which was that of Dr Thomas, a drawing of which was exhibited to the Society. The curette he prefers and uses is no doubt a small instrument, and in most cases in which curetting is called for its introduction would not likely be attended with difficulty; but apart from the comparative ease in applying the ‘‘ dull wire curette of Thomas,” there is something else to be considered, viz., the free discharge of what may by it be separated from the interior of the uterus. This I hold to be of consequence, and therefore make it a point to see that the os and canal of the cervix will offer little or no obstruction to the exit of blood or more firm substances requiring expulsion oT free dis¬ charge. The instrument which I have hitherto been accustomed to use for exploring and curette purposes is larger in its eye extremity, and therefore may require a more dilated condition of the cervical canal than the smaller eye of Thomas’s instrument demands; but, nevertheless, I consider it important not only to have sufficient space for the easy and painless introduction of even a small curette, which, in the gropings often necessary to overcome contractions, resnlting, it may be, from chronic induration or flexion, or other cause of' encroachment on the cervical space, frequently causes