The introduction of the stethoscope and the speculum constitute two important epochs in medical science—the former ascertaining, by the conveyance of sound, disease in the most hidden and inaccessible parts of the human frame, and the latter bringing to view structures which, without such aid, are necessarily veiled from our sight. The speculum consists of an instrument formed of silver or steel, that without pain or inconvenience is passed into the vagina, when, by a simple contrivance, it is made to expand and dilate the vaginal passage, and thereby expose to view the entire canal, together with the uterine aperture. The usefulness of such a method, whereby disease can at once be detected, admits of no dispute. It is physically painless; and if opposed to female diffidence and modesty, its importance and serviceableness should be balanced against the mental distress such a procedure may occasion. On the one hand, without its assistance, the treatment of the disease is at best but conjectural; on the other, by its aid, it is safe and sure—much suspense and suffering is at once put an end to. Experience has proved that many local disturbances, that were believed to have been merely vaginal irritation, have been discovered to depend upon absolute disorganization of the neck and mouth of the womb. Deep-seated ulceration has been detected, and cancerous enlargements; the disease thereby having been exposed, has had the necessary and successful treatment. In Paris, it is considered so valuable that a chair, termed a “speculum chair,” has been invented solely for its use. See engraving on previous page.
The speculum is now in the hands of every respectable medical man, and the class of disorders that hold it in requisition are being better understood, and consequently more successfully combated. In no cases is it more useful than in secretive irregularities, such as in leucorrhœa, gonorrhœa, or syphilitic ulceration. Without further comment, these diseases will be considered.