COMPLETE CASE 
O F 
instruments for Uterine (Iterations. 
For Sale by 
OM. TI1MAN1 & 
f 
F. A. STOHLMAXN. EDWARD PFARRE. 
MANUFACTURERS AND IMPORTERS 
Of all kinds of Surgeon's Instruments and Appliances for the 
Mechanical Treatment of Deformities, Debilities, and 
Deficiencies of the Human Frame. 
A Full Line of Instruments of the Most Approved Patterns, and tfte .Most Recent 
Inventions of 
American and European G-ynsecologists 
ALWAYS ON HAND. 
67 CHATHAM-STREET, 
NEW-Y< >RK. 
1870. A fund having been placed at the disposal of the faculty of the Medical College at Mobile for the purpose 
of purchasing prizes for distribution among the most meritorious members of the graduating class, last spring, 
they wrote to Dr. J. C. Nott, in New-York, a request that he would select such illustrated medical works, sur- 
gical instruments, &c„ as he thought suitable for the occasion. 
Among other things Dr. Nott planned a case containing many of the latest and most generally approved in- 
struments now used in this country by Gynaecologists, and accompanied it by a written description indicating 
the character and use of each instrument. We have been permitted to print this description, and in order to 
make it more easily understood we have had a series of drawings of most of the instruments executed and insert- 
ed in their proper places. There being a rapidly increasing interest in this department of the profession, and a 
growing demand for such instruments, we have thought it adviseable to keep on hand cases of this kind which 
arc the most complete we know of. 
Many physicians at a distance are desirous of knowing what instruments are now most used in New-York, 
(where so much attention is paid to the diseases of ferfiales,) and a list, such as we have given, together with 
the accompanying plates, will much facilitate practitioners in their selections, and enable those desiring instru- 
ments to choose what they want; and if they wish to order cases, to make such modifications in the one we 
give, as they may think proper. 
Besides supplying a list of Instruments which would enable the practitioner to perform all the operations 
on the Uterus and Vagina, a leading object has been so to construct the instruments as to pack the largest num- 
ber possible in a small space, and at the least expense. In order to do this, Dr. Nott has thought proper, as will 
be seen, to make important modifications in many of the instruments invented by others. We will therefore first 
call attention to the instruments which have been so modified. The first instrument, as sketched above, is a new speculum, which is used with the 
patient on the back, and though it may be used with the patient on a common bed, (like 
all specula) it is much more convenient with the patient on a table before a good light. 
This instrument affords a very good view of the os uteri-is self-retaining and enables the 
operator to examine the cervix, introduce a sound, cauterize-to perform any cutting 
operation on the cervix without an assistant; introduce and remove sponge tents or 
other dilating apparatus, and facilitates very much the removal of polypi or small fibroids, 
by the wide expansion which it givesxto the vagina. It is moreover so constructed that 
all the branches may be lengthened or shortened to suit the depth and size of the vagina. 
It may also be converted into a Sim's speculum, by detaching the feet and attaching a 
moveable handle which accompanies it. The speculum of Dr. Sims is now almost uni- 
versally regarded as the best of all instruments for Vesico-vaginal and all other operations 
on the vagina. In fact, the speculum of Dr. Sims is the most perfect of all instruments 
of this class where you can command a competent assistant; but as this want cannot 
usually be met in private practice, the above instrument is designed, as far as possible, to 
supply its place. 
A very simple tenaculum has been constructed of small steel wire, with a succession of 
loops in its shank. A little tooth, or pin is fixed at the mouth of the speculum. The 
tenaculum may be caught 'in the anterior lip of the os uteri-drawn as far forward as 
desired, and it is then easily and firmly fixed at any point desired, by attaching one of the 
loops to the tooth. The sketch of this tenaculum is seen below. 
Fig. 1. 
Fig. 2. 
The above is a Depressor, which is a very convenient, accompaniment of the Speculum, 
and will be found useful in pressing the folds of the vagina out of the way, and in mani- 
pulating the os-tincae fairly into the field of the speculum. It is also curved to suit the 
shape of the pelvis, and so constructed at the extremities as to be very convenient in re- 
placing the uterus in cases of version or flexion. The small end may, if necessary, be in- 
serted into the rectum, and made to act upon the body of the uterus, when the organ is- 
thrown backwards. 4 
Fig. 3. 
Fig. 3. The above series is a sort of multu'n in parvo and designed particularly to 
economize space , • , 
No. 1. is a modification of Roux needle-holder ; it is an excellent needle-holder, which 
may be used in the operations of vesico-vaginal fistula, cleft palate, &c., and is made to 
serve as a handle to the instruments accompanying it, and which are manufactured one- 
half their full length, When the handle is applied to either one it gives it its full length. 
No. 2-Combines the Applicator, with the sponge tent expellei. 
No. 3-Is a sponge holder, and ligating forceps. 
No. 4-A lead sound, which easily follows the curve of the uterus. 
No. 5-Intra uterine scarifying knife, blunt point. 
No. 6-Simpson's sound. 
No. 7-Uterine probe, of pure silver. 
Fig. 4. The above is a slight modification of instruments already m use, by Dr. Aott 
for dilating the cervix uteri when contracted ; particularly the internal os-the external 
os being generally quite safely and more rapidly enlarged by cutting. The instrument 
is made like forceps, with blades not exceeding 2 inches in length, and may be used either 
for gradual or rapid and forcible dilatation. This instrument is much safer, (particularly 
in inexperienced hands,) for dilating the internal os, than cutting instruments and sup- 
plies the place of a set of graduated metallic bougies now used by some of our best prac- 
titioners. 
Fig. 4. 
Fig. 5. 
Fig. 6. 
Fig. 7. 
e mi nk«vo inc+rnnipnfs: isii.n instrument devised bv Dr. Nott for 5 
injecting the cavity of the uterus in cases of haemorrhage, or uterine leucorrhoea. It is a 
double catheter, having on< tube with an eye at the extremity fully an inch long, and a 
second tube of much smaller size running along the inner surface of the concavity of the 
large tube, and opening opposite the middle of the eye. If water be thrown in with a 
syringe at the outer aparture of the small tube, it enters the cavity of the uterus, and 
through the large eye, and large canal it finds a free exit, without exerting any distend- 
ing force on the cavity of the uterus. 
It should be borne in mind that injections into the cavity of the uterus are always some- 
what hazardous, and if not performed with great caution, may be followed not only by 
painful, but dangerous consequences. Two precautions are therefore necessary in the 
commencement of every new case: 1st, to test the uterus by injecting very gently simply 
tepid water-if this is well borne (and the return current is well assured) the cavity of 
the organ may then be freely washed out with weak solutions of Iodine, Carbolic-acid or 
other mild preparation, that may be thought advisable.-2d, when strong preparations are 
used, such as ChurchhilFs solution of Iodine, concentrated solutions of Chromic-acid, Ni- 
trate of Silver, &c., never more than 10 or 15 drops should be thrown in at once, as the cavity 
of the organ when of normal dimensions, will not contain more, when a part of its space is 
taken up by the instrument introduced ; these articles too have the property of coagu- 
lating the albumen of blood or mucus so as to make their escape from the uterus difficult. 
2d. This coagulating power should also be borne in mind when we use the Subsulphate 
or other salts of iron, or when we use Tannin or other very astringent articles. The 
latter articles are not irritating (like many others frequently employed) to the surface 
of the uterus, but by strongly coagulating blood or mucus, they block up a double canula, 
or cannot pass on the outside of the tube of a syringe. They thus hazard the forcible 
dilatation of the uterine cavity (with all its dangers) if the injected fluid is forced in and 
finds no means of escape. If mild preparations be used, with the precautions above given, 
the uterus may be freely washed out with a syringe, not only with impunity but with 
much benefit. 
Dr. John Byrne of Brooklyn, conceived the same idea of injecting the uterus by means 
of a catheter so constructed as to secure a free return current. Instead of a double 
canula, his instrument has one small tube running along the back of an open gutter. It 
is well adapted to meet the indications. 
Fig. 5. The first of the instruments given above is made exactly on the same plan, but 
a little longer and differently curved. It is designed towash out the bladder either male 
or female and will be found particularly useful in washing the fragments of calculi in 
the operation of lithotrity-in vesical catarrh, &c. 
Fig. 6 is a double spring tenaculum, for catching the lip of the uterus, pulling it in 
position through the speculum and holding it steady during manipulations-the teeth are 
very small-it gives no pain and maintains its hold when once fixed, and may be left ly- 
ing loose in the vagina to be drawn open at any moment during manipulations. It will 
be found very convenient for all purposes when we wish to steady the uterus, draw it down 
and maintain it at any convenient line or angle-particularly when we are short of assis- 
tants. 
Fig. 8. 
Iig. 8. Is a small hard rubber syringe, to wash out the Vagina, or cleanse the neck of 
the Uterus,-the nozzle is also so constructed as to fit the double Uterine Cathetef 
already described, for injecting the cavity of the uterus. 
All the foregoing instruments, which to insure convenience, or compactness, are more 
or less modifications of instruments generally known to the profession.-Those which 
follow, are of the forms usually described in our systematic text-books, on diseases oi 
females. 6 
Fig. 9. 
Fig. 10. 
Fig. 9. We here give Lent's Ointment Syringe, which is now much employed by some 
distinguished practitioners in New-York and elsewhere, to apply caustic, &c., in the form 
of ointments. Dr. Messenger has substituted glass in the place of hard rubber.-The 
syringe has two pure silver flexible tubes, one for the uterus and one for the male urethra 
to be used in place of Lallemand's ports'can stique, in cases of Spermatorrhoea. 
Fig. 10. The last of the three cuts above, represents a platina spoon for melting caus- 
tic, which should accompany the uterine Probe, fig. 7. 
For detailed account of this instrument, the work of Dr. T. Gaillard Thomas, 
on Diseases of Women. 
Fig. U. 
Fig. 12. 
The above Figs. 11, 12, 13, are three forms of forceps much used by Dr. Emmet, for 
general purposes of driving, holding needles, catching and twisting silver wires, applying 
and moving sponge tents, &c. 
Fig. 13. 
Fig. 14. One of Sim's knives for paring edges in the operation of Vesico-vaginal- 
fistula. 
Fig. 14. 
Fig. 15 
Fig. 15. Curved knife for same operation and that of cleft palate. 
Fig. 16. Dr. Emmett's double curved scissors for same operations. 
Fig. 16. 7 
Fig. 
Fig. 18. 
Fig. 19. 
I he above are Fig. 17. the wire adjuster of Sims,-Fig. 18. the forked wire pulley, and 
Fig. 19. blunt hook, all indispensable in the operation of Vesico-vaginal-fistula, and very 
convenient in many other operations requiring accurate suture adjustments. 
Fig. 20. 
Fin. 20. Sims' Sigmoid Catheter, of hard rubber. /> t ' ° 
Fig. 21. This is Dr. Battle's uterine scarificator and leach, very efficient and conve- 
nient for abstracting blood from the engorged cervix-uteri. 
Fig. 21. 
Fig. 22. This cut represents the'syringe employed by Dr. T. G. Thomas for introducing 
suppositories, and also for exhausting and cupping. It makes a good accompaniment of 
the above scarificator and is in many respects a very useful instrument. 
See the work of Dr. Thomas, for particulars. 
Fig. 22.i3 
Fig 23. Ecraseur used with annealed steel wire, modified by Dr. Geo. K. Smith. 
The wire is made to pass over the curve, which gives it more power, and less liability to 
break. A capital instrument for polypi and other purposes. 
r Fig. 23. 
Additional articles belonging to the Case of which there are no wood cuts. 
6 Emmett's round pointed Needles, silk for sutures and for polypi, 6 other needles. 
Silver 
1 Whalebone, cotton swab. -t? J 
2 Glass Bottles for Caustic, &c. 
Sea tangle and carbolized sponge tents. :- 
I Delicate Tenaculum, long. /-•£_-5 
1 Pair long straight scissors. ~£, 5 "-cP 
I Curette for scooping out the uterus. i/~v 
i Glass Cylindrical Speculum. /f e>