On Plugging the. Vagina with Vulcanized Caoutchouc. By M.
Diday.—M. Diday, having a case of metrorrhagia, in which the pa-
tient had become reduced to almost the lowest point of exhaustion, re-
solved to avail himself of one of Dr. Gariel’s ingenious applications
of vulcanized caoutchouc. The apparatus consists of a small bladder
of caoutchouc, to which is attached a long tube. Rolled up so as not
to exceed the little finger in size, it was passed as deeply into the va-
gina as possible, and kept there by the end of the finger; it was then
inflated through the tube, until the small body which had been intro-
duced almost imperceptibly, acquired a volume constituting a sphere of
about 33 centimetres in diameter. The air was retained by tying the
tube. No means of retaining it in situ were required, and the hemor-
rhage entirely ceasing, it was removed sixty-four hours after, as easily as
introduced, by allowing the air to escape through the tube. Any one
who is aware of the pain and uncertainty attending the ordinary mode
of plugging the vagina, must agree with M. Diday, that this is a most
useful apparatus. Its advantages consist, he adds—1. In its simplicity,
and the rapidity with which it may be employed. Thus, it only
weighs about half an ounce, is soft and flexible, admitting of being put
in the instrument case, and is applied in a few seconds. 2. It causes
no pain either during or after its application, and requires no bandage
to retain it. 3. It admits before insufflation, of being moulded on the
parts to be compressed, and thus can exert compression upon a cavity,
however irregular in form. 4. It allows of any degree of diminution
or increase of pressure to be made, according to the exigencies of the
case. 5. It is impermeable to, and incorruptible by, whatever dis-
charges it comes into contact with, and never loses its elasticity.
6. Distended only to a third or fourth of its natural extensibility, it is
just as smooth, and possesses nearly as great a resisting power, as when
fully distended. 7. A somewhat larger apparatus would be available
for plugging the cavity of the uterus itself, in hemorrhage after delivery.
Moulded on the inner surface of that organ during its state of inertia,
as this became recovered from, the air would be gradually let out, and
the size of the compressing vessel diminished, pari passu with that of
the uterine cavity.
Dr. Gariel has availed himself of the remarkable properties of the
vulcanized caoutchouc (its unalterability by corrosives, its preservation
of elasticity at all temperatures, its great strength, and its resumption
of its original size after however great extension) for the construction
of a vast variety of surgical apparatus, some of which exhibit great in-
genuity. Thus, there are bandages, means for making extension and
counter-extension, means of exerting compression from within, as in
stricture of the urethra, plugging the nares, plugging the vagina, pessa-
ries, or from without, as in hernia, and other pads. One of the most
simple of these is a portable urinal, which is of such trifling size and
weight, as to cause no inconvenience or ill appearance. The penis is
adapted to the orifice of this, just as the wrist is to the India-rubber band
of a glove, and the material being impermeable, no smell issues. When
opportunity offers, without displacing the vessel, the patient discharges
the collected urine by means of a little cock attached to it.—Ibid, from
Gaz. des Hopitaux.