IMPROVEMENTS IN PESSARIES
Year: 1877

page_text: LETTERS PATENT to William Robert Lake, of the Firm of Haseltine, Lake,
& Co., Patent Agents, Southampton Buildings, London, for the Invention of
IMPROVEMENTS IN PESSARIES." A communication from abroad by William
Harvey Willson Campbell, of Norwich, Connecticut, United States of America.
"
Sealed the 8th March 1878, and dated the 26th September 187
PROVISIONAL SPECIFICATION left by the said William Robert Lake at the
Office of the Commissioners of Patents on the 26th September 1877.
WILLIAM ROBERT LAKE, of the Firm of Haseltine, Lake, & Co., Patent Agents,
Southampton Buildings, London. "IMPROVEMENTS IN PESSARIES." [A commu-
nication from abroad by William Harvey Willson Campbell, of Norwich, Con-
necticut, United States of America.]
This Invention relates to pessaries made either solid or hollow, and of india-
rubber, celluloid, or other suitable material.
The object of the said Invention is to provide a mechanical support for the
uterus, and is intended to correct versions, flexions, and displacements of that
organ.
The said Invention is based upon the theory that the position. of the neck of
the uterus determines the relative bearing of the entire organ to the other pelvio
viscera.
The said Invention consists of a ring for the fixation of the cervix uteri, and of
a prolongation, concave on its upper surface, adapted to the convex surface of the
anterior part of the body of the uterus which is to rest upon it. The length of this
prolongation determines the distance of the cervix uteri from the symphysis pubes,
and should not be larger than is necessary to provide against the possibility of
retro-displacements.

page_text: Properly adjusted, my pessary moderately distends the vagina, and forms with
the perineum a perfect floor to the pelvis, and holds the neck of the uterus at any
desirable point in the hollow of the sacrum. No pain or irritation will attend the
use of such a pessary if the right size is employed. The pessary affords a complete
support for the uterus, and effectually controls cases of retroflexion, retroversion,
anteflexion, anteversion, and prolapsus of the uterus. It is simple and perfect, and
in its shape is such as to have no angles, joints, or ends to produce irritation of the
parts. As the pessary does not interfere with the evacuations of the uterine
secretions, its removal at the menstrual periods is unnecessary. The pessary is
adapted to the uterus in its natural position, and its tendency is always to that
position. This tendency prevents the possibility of an accurately adjusted pessary
being displaced.
In constructing a pessary according to this Invention I provide an anterior
portion or beak, upon the upper surface of which the anterior body of the uterus is
to rest. There is a canal through the body of the instrument from above downward,
to permit of uterine discharges. When the pessary is in position the cervix uteri
rests upon the upper rim of this canal or opening, thus giving additional support to
the organ. The opening in the body of the pessary is to admit the finger to
facilitate its adjustment and removal. The superior lip of the cervical ring overlaps
the cervix far enough to prevent the body of the uterus from turning backward
at a point of flexure, even while the cervix proper is held by the ring.
When no flexion or tendency to it exists a narrow ring is preferable, as it is more
easily adjusted and removed, and is as efficient for retroversions of prolapsus ;
besides this, by boiling or bending just in front of the cervical ring, the relation of
the ring and body may be changed, so as to lengthen or shorten the pessary for
special cases.
Another form of pessary, constructed according to this Invention, consists of a
cervical ring and a prolongation convex on one side to conform to the hollow of
the sacrum, and concave on the other side to adapt it to the posterior surface of the
uterus, and is adapted to anteversions and anteflexions, forcing the neck of the
uterus toward the hollow of the sacrum. It is adjusted to the neck of the uterus,
but its prolongation, instead of resting in front of the uterus, occupies a position
between the hollow of the sacrum and the posterior wall of the uterus.
In another modification of my Invention the pessary has three openings, any one
of which may be employed to retain the neck of the uterus, and is available in
cases where adhesions interfere with the adjustment of the cervix to other forms,
the successive openings being used as the adhesions yield.
These pessaries yield to the ordinary movements of the uterus, exerting no
injurious force, but effectually guard it against unnatural deviations.
In cases of retroflexion, where the flexion is unusually high, the superior lip to
the cervical opening must be long enough to overlap even the lower part of the
posterior surface of the body of the uterus to render retroflexion impossible.
The pessaries constructed according to this Invention may be still further
modified to suit special circumstances, but all will have the same general construc-
tion, being modifications of the well-known "Hodge" pessary, only, instead of
being a mere frame, my improved pessaries are filled out and rounded to conform to
the parts, and broader at the posterior portion than at the anterior portion, and
having a swell at the posterior part. The pessary being generally made hollow, it
is exceedingly light.
All cup pessaries heretofore introduced simply push the neck of the uterus back,
doubling it on the body, and thus retaining the organ in its abnormal or retroverted
position. Their primary force and their sustaining power act on the direction of
the long axis of the vagina, but my said improved cup pessary first restores the
body of the uterus to its proper position and then retains it so. Its action is in
the direction of the normal position of the uterus, which is at a right angle to the.
axis of the vagina. It is really a cup pessary acting on the principle of the well-

page_text: known "Hodge" pessary, with many advantages over the latter in special cases.
It is applicable in anteversion as well as retroversion, and is well adapted for
prolapsus or procidentia.
SPECIFICATION in pursuance of the conditions of the Letters Patent filed by
the said William Robert Lake in the Great Seal Patent. Office on the 26th
March 1878.
•
WILLIAM ROBERT LAKE, of the Firm of Haseltine, Lake, & Co., Patent Agents,
Southampton Buildings, London. "IMPROVEMENTS IN PESSARIES." A commu-
nication from abroad by William Harvey Willson Campbell, of Norwich, Con-
necticut, United States of America.
This Invention relates to pessaries made either solid or hollow, and of india-
rubber, celluloid, or other suitable material.
The object of the said Invention is to provide a mechanical support for the uterus,
to correct versions, flexions, and displacements of that organ.
The said Invention is based upon the theory that the position of the neck of
the uterus determines the relative bearing of the entire organ to the other pelvic
viscera.
The said Invention comprises a ring for the fixation of the cervix uteri, and a
prolongation, concave on its upper surface, adapted to the convex surface of the
anterior part of the body of the uterus, which is to rest upon it. The length of
this prolongation determines the distance of the cervix uteri from the symphysis
pubes, and should not be larger than is necessary to provide against the possibility
of retro-displacements.
When properly adjusted this improved instrument or pessary moderately distends
the vagina, forms with the perineum a perfect floor to the pelvis, and holds the
neck of the uterus at any desirable point in the hollow of the sacrum. No pain or
irritation will attend the use of such a pessary, if one of the right size is employed.
The said pessary affords a complete support for the uterus, and effectually controls
cases of retroflexion, retroversion, anteflexion, anteversion, and prolapsus of the
uterus. It is simple and perfect, and is so shaped as to have no angles, joints, or
ends to produce irritation of the parts. As this pessary does not interfere with
the evacuations of the uterine secretions, its removal at the menstrual periods is
unnecessary. The said pessary is adapted to the uterus in its natural position, and
its tendency is always to that position. This tendency prevents the possibility of
the displacement of an accurately adjusted pessary.
The accompanying Drawing shows various plans and modifications of my
Invention.
In Figures 1 and 5 a indicates the sides of the instrument; b is the anterior
portion or beak, upon the upper surface c of which the anterior body of the uterus
is to rest; d is a canal through the body of the instrument, from above downward,
to permit uterine discharges; e is the posterior portion of the said instrument.
When the pessary is in position the cervix uteri rests upon the upper rim of this
canal or opening, thus giving additional support to the organ.
Figure 1 represents the form most suitable for the majority of retroversions,
retroflexions, and prolapsus of the uterus. The opening c' in the body of the

page_text: pessary is provided to admit the finger to facilitate the adjustment and removal of
the instrument. The superior lip of the cervical ring overlaps the cervix far enough
to prevent the turning backward of the body of the uterus at a point of flexure,
even while the cervix proper is held by the ring.
When no flexion or tendency to it exists, a narrow ring, Figure 3, is preferable,
as it is more easily adjusted and removed, and is as efficient for retroversions of
prolapsus; moreover, by boiling or bending the instrument just in front of the
cervical ring, the relation of the ring and body of Figure 3 may be so changed as
to lengthen or shorten the pessary for special cases.
The instrument shewn in Figure 2 consists of a cervical ring, and a prolongation,
made convex on one side to conform to the hollow of the sacrum, and concave on
the other side to adapt it to the posterior surface of the uterus; it is adapted to
anteversions and anteflexions, forcing the neck of the uterus toward the hollow of
the sacrum, and is adjusted to the neck of the uterus in the same manner as the
instrument shewn in Figure 1; but its prolongation, instead of resting in front of
the uterus, occupies a position between the hollow of the sacrum and the posterior
wall of the uterus.
The pessary, shewn in Figure 4, is employed in extreme relaxation of the vagina,
owing to its greater thickness of body.
The instruments, shewn in Figures 5 and 7, are used only for prolapsus, or as
retainers of the uterus after retroversions, retroflexions, anteversions, and ante-
flexions have been overcome by the use of Figures 1, 2, 3, and 4.
The instrument shewn in Figure 6 has three openings, either of which may be
employed to retain the neck of the uterus; it is available in cases where adhesions
interfere with the adjustment of the cervix to other forms, the successive openings
being used as the adhesion's yield.
Figure 8 shews another modification necessary in special cases.
These pessaries yield to the ordinary movements of the uterus, exerting no
injurious force but effectually guard it against unnatural deviations.
In cases of retroflection, where the flexion is unusually high, the superior lip of
the cervical opening must be long enough to overlap even the lower part of the
posterior surface of the body of the uterus, to render retroflexion impossible.
The pessaries, shown in Figures 1, 3, and 4, if worn too long, tend to produce the
opposite displacement and convert retroversions into anteversions. When a retro-
version or retroflexion is corrected by the instrument shown in Figures 1, 3, and 4,
a simple ring pessary, illustrated by Figures 5 and 6, will serve to maintain the
normal relationship of the pelvic viscera. The same precaution is necessary to be
observed in the use of the pessary shewn in Figure 2.
It will be observed that all of my improved pessaries have the same general
construction; instead of being a mere frame they are filled out and rounded to
conform to the parts, and broader at the posterior portion than at the anterior
portion, and have a swell at the posterior portion. When made hollow the instru-
ment has very little weight.
All cup pessaries heretofore introduced simply push the neck of the uterus back,
doubling it on the body, thus retaining the organ in its abnormal or retroverted
position. Their primary force and their sustaining power act in the direction of
the long axis of the vagina, but said improved cup pessary restores the body of the
uterus to its proper position and retains it in this position. Its action is in the
direction of the normal position of the uterus, which is at a right angle to the axis
of the vagina. It is really a cup pessary acting on the principle of the so-called
"Hodge pessary," with many advantages over the latter in special cases. It is
applicable in anteversion as well as retroversion, and is well adapted for prolapsus
or procidentia.
Having thus fully described the said Invention as communicated to me by my
foreign correspondent, and the manner of performing the same, I wish it understood
that I claim, the pessaries constructed as shewn in the accompanying Drawing, and
embodying the above-described improvements, namely, the filling out and rounding

page_text: of the instrument, and the making of the same broader at the posterior than at the
anterior portion thereof, and forming the posterior portion with a swell, all as above
set forth and for the purposes specified.
In witness whereof, I, the said William Robert Lake, have hereunto set my
hand and seal, this Twenty-sixth day of March, in the year of our Lord
One thousand eight hundred and seventy-eight.
M DADE TATE
WM. ROD. LAKE. (LA)