■V-:^'


 
 
 
 
                    THE


             UTILITY

                    OF THE



"UTERINE   SUPPORTER,'

                 AS INVENTED BY

           MRS.  JAMES BETTS,

                OF PHILADELPHIA,

 IN THE CURE OF PROLAPSUS UTERI, &c. &c.

   Contained in various Testimonials of Eminent Professors
       and Practitioners), of Philadelphia,. New York,
        Virginia, St. Louis, &c, and in a Lecture
             by William Harris, M.  D.,
                 of Philadelphia.

  ALSO, A LETTER TO A DISTINGUISHED PHYSICIAN OP PHILADELPHIA.


         FIFTH EDITION, WITH ADDITIONS.
       PHILADELPHIA:

         MRS. JAMES EETTS,
North East corner of Eleventh and Walnut streets.
             1847. 
  p
*1
              MRS. JAMES  BETTS'  UTERINE  SUPPORTERS,
  \/\( f        N. E. corner of Eleventh and  Jf'alnut Sts., Philadelphia,
Jl^   ^      ORIGINAL INVENTOR AND  SOLE PROPRIETOR.

po^UTo Physicians,  Ladies and Druggists.
             lMRS. BETT'S most res pec l fully  communicates the continued suc-
           cess, and increasing demand  for her Uterine Supporters ; they are now
           very generally adopted by Physicians  as the most successful medium of
           relief for the distressing malady for which they were invented,  of any
           offered to the public.
             The evil results attending  the use  of Pessaries, are obviated by the
           application of her Supporter, and the patient is enabled, in a short pe-
           riod, to resume  her domestic concerns and duties; and the long confine-
           ment to the Sick Chamber, with all its attendant distressing consequen-
           ces, rendered unnecessary.
             20,000  Ladies are  now using them with  the greatest ease, comfort
           and advantage.
                                    CAUTION.
             Plt.ase Obskrvf.—That unprincipled counterfeiters are putting off various wretched
           imitations of her invention, as the genuine Supporter of Mrs. Betts, and imposing on un-
           wary purchasers a  spurious article.  It is also sometimes attempted to foist them off with
           the addition of the  name of an eminent Professor of Philadelphia, the better to deceive
           the Piofession and the public.  Be sure to see that her Signature and  Residence are
           attached to each Supporter.
             Mrs. B. refers with pleasure to eminent Medical Professors of all the schools in Phi-
           ladelphia, and to celebrated Professors and Physicians in other cities of the United States.
             Mrs. Betts offers the following.
             The fine Supporter for Ladies, adapted to the various dimensions of Patient,   $8 00
             An entire new Supporter tor SUMMER use, for Ladies requiring the use of a
                very cool, light and transparent article;  weight  only from 2 oz. to 3 oz.,
                and  possessing all the important requisites,    -    -    -   -   -   $7 00
             A very strong and durable Supporter with all the latest improvements in its ar-
                rangement, (for poor patients.)     -    -   -    -    -   -   -  ' $5 00
             The above are subject to a very liberal discount to sell again, when three or more
                are taken.
                                  Authorized Agents.
Philadelphia, G. W. Carpenter, & Co.
     "      E.&C. Yarnall&Co.
     »      C. Ellis & Co.
     "      Frederick Brown.
     "      Cuthbert & Wetherill.
     <■'•      Maris & Co.
                      Columbia, S. C, Toland & Curtis.
                      Winnsboro, S. C, Dr. J.N. Smith.
                      Mobile, Haviland, Blair & Co.
                      Natchez,  McPheeters & Co.
                      Memphis, Tenn., J. C. Macintosh.
                      Nashville, Tenn., Dr. J. H. tiwen.
C. Schaffer.            Milton, N. C, Dr. J. R. Galium.
T. VV. Dyott& Sons.   'Alexandria, Va., VV. Stabler & Brother
F. Klett & Co.         'Charlestown Va., Dr. Straith.
                      Albany, N. Y., F. Phelps.
                      Ripley, Miss., Dr. J. B. IMis.
                      Galena, III., Dr. Johnson.
                      Washington, D. C., McClay & Cle-
                          ments.
                      Boston, Mass., William Brown.
                      Springfield, Mass., Dr.  Wm. VV. Bliss,
                      Troy, N.  Y., G. VV. Bull,  River st.
New York, Haviland, Keese & Co,
    "     J. Milhau, 183 Broadway.
Baltimore, Mackenzie & Co.
N.Orleans, G. N. Morison, Magazinst
St. Louis, McCloud & Wheaton.
Pittsburgh, Dr. Thorn, Market st.
Cincinnati, J.  & C. Reakirt.
Lexington. Ky., Dr. J. S.Wilson & Co.
Charleston,S.C.Drs.P.M.Cohen & Co.Iflavre de Grace, Md.. A. W. D
K. Fenderbh, Pittsburg.            Ij.A. Perry, Druggist, Manchester,N  H
Dr. Wm.  S. Metere, S-ilmonaville, Ga.lJ. V. McKinney, FayeUeville, Tenn.
                   To procure a Supporter.
   Take the measure round the body at the top of the  hip  bones, and
S3ni the  number of inches, and it can be forwarded bv mail or rail 'road. 
PART   I.
Caution  to  Purchasers of the Uterine Supporter.
  Mrs. Betts respectfully cautions medical gentlemen and ladies against impct
sition by the substitution of  various counterfeits; they can be detected imme-
diately by observing that the genuine uterine supporter has her name in  her
own hand writing, affixed  to each in a circle of letter press.  Counterfeits  are
offered in various parts of the United States—and ladies are peculiarly liable
to imposition.  Very frequently ladies call and show her the paltry and delete-
rious substitute which they have purchased for her supporter.  Those reputable
establishments whose names are contained in her publications can b-e depended
oti, and Mrs. B. respectfully suggests that  her friends should obtain  the sup-
porter through either of those mediums,  or direct  from her  establishment,
Eleventh and Walnut Sts., Philadelphia, Penn.
  A variety of persons, male and female, are making up a wretched imitation;
they are destitute of all the most essential  requirements of an uterine  suppor-
ter, and are doing an immense injury to females—such persons being altogether
destitute of the necessary anatomical knowledge of the human body.
  Many of those saprent individuals, have  made  the uterine support  to take
place just below the waist—and have suspended it by straps o.ver the should-
ers.   I have  found many ladies wearing them bind part before, and it is a very
common occurrence to find it upside down.
  It is to be regretted that ladies do not  see their own  true interests; and by
getting an instrument that will either cure or effectually relieve, and  the  cost
of which will be but a small charge over the price of the- counterfeit,  will be
the cheapest policy in the end.
  A corset  maker at the  upper part  of Broadway, N. Y., has made a poor
attempt at counterfeiting my uterine supporter; it is imperfect, and wretchedly
put  up.  She offers it "as the  best thing out."  It  is certainly  one of  the
worst I ever met with :  six dollars !!! is wanted  for it—it is  not worth  six
cents!   A man is travelling through the West offering  a counterfeit of  rny
supporter, to which he appends the name of a valued Professor of Philadelphia.
Many persons have suffered by his imposition;  his name and description will
shortly be published through the United States as a caution.  If those impos-
tors  would bring out a supporter of their own invention, I would with pleasure
welcome them to a fair and  honorable competition, but while  they mutilate,
imitate, cut up, and destroy my inventions, and put them off on the public as
mine and sometimes as  those  of  an eminent Professor, F.ommon justice to
myself, ladies and physicians, call for an  exposure of their unprincipled con-
duct.  If they understand what they are about, let  them invent something
new ! '!
  O^j- Please to take the measure at the top of the hip bone, round the body,
and  send the number of inches.

                      TO LADIES  SUFFERING.
  The Supporter was originally invented by myself when laying on  a bed of
affliction, from a similar complaint to that which it is so  successful in curing.
  Having had a great number of patients sent by  Medical gentlemen to be pro-
vided with the "Supporters," opportunities of forming inferences and conclu-
sions from a vast variety of cases, have presented themselves, from all  parts
of the United States, in addition to many who have been  recommended by
private friends.                                                .
  I have heard from many hundred ladies,  an account of their sufferings, inclu-
ding cause, stages, treatment, &*.—their various mental, as  well as bodily
affl-ctif ns, arising not only from  the organic displacement itself, but yet  more
from the placinir^replacir.g, removing, &c, the various pessaries ordered from
time to lime, prior to  my Supporter having been obtained.  It is indeed  to be
u / -.CM',.  *r 
4
  deeply regretted that the pessary is yet tenaciously persevered with, in spite of
  its repeated and continued failure.
    It is with much sorrow I have witnessed the great amount of misery among
  the fairest  portion of  created beings, from  the extensive prevalence  of  this
  weakness, which  is much beyond any calculation I had ever formed, previous
  to my  knowledge of the fact, and it is a cause of ronch heart-felt  pleasure  to
  me, independent of all other considerations, that an apparatus has at length
  been discovered, which so fully meets the objectjn view, viz.: its removal or
  great  mitigation.
   Candour compels me to  announce as my conclusion, resulting from the
 above named extensive experience, that, to the ill-judged (however well meant)
 use of the Pessary may be ascribed the diseased state of the uterus, as well as
 leucorrhoea, irritation, &c. Independent of the pain, inconvenience, &c, atten-
 ding the wearing of the Pessary, there is a feeling extremely hostile in a delicate
 female mind, to the introduction by a medical  attendant, of that  invention,
 which  difficulty is entirely obviated by wearing the Supporter.
   The  friends of the Pessary have never yet discovered any form or modifica-
 tion of it that has  proved satisfactory, either to the patient or even to  them-
 selves, else why  the continual  change of  shape and material! and I always
 found  that cases  were attended  with much more difficulty where  the Pessary
 had been  introduced than otherwise.
   Can  any thing be gained  by wearing of the Pessary, which cannot  be  ac-
 complished by the Supporter—supposing feelings of female  delicacy can be
 overcome ]   My experience  prompts  me, conscientiously,   to reply  in  the
 negative.
   But if asked,  whether any thing can be gained  by wearing  the  Supporter,
 which could not equally  be obtained by the Pessary ?   My answer is emphat-
 ically, much—and  I will  point proudly to the hundreds of grateful females who
 are continually calling on me, with the most ardent expressions of acknow-
 ledgment, after  enduring the greatest mental and  bodily prostration and  an-
 guish from the opposite treatment; many once single young ladies, now happy
 mothers, many married ladies,  with increased families.
   Positive danger attends the wearing of Pessaries.—This  was my  conviction
 from long experience, the result of careful observation.   It  has been fearfully
 demonstrated to me in many cases, that have come under my notice in nearly
 ten thousand  instances, which I have personally seen.  I would wish  to  be
 understood, as not  only confirming the facts  as mentioned by Doctors Blundell,
 Moreau, Professor Jackson, and Dr. Harris, in every particular, but also to men-
 tion important and  lamentable facts in addition thereto, viz. :—those of nervous
 debility—brought on hy the nature of the treatment pursued ; the suffering of
the patient—and  almost hopelessness of a final restoration to health.   My own
 experience in this matter, will, no doubt, be confirmed  by many Medical gen-
 tlemen in Philadelphia, &c.
  The symptoms of Prolapsus  Uteri, are also fully explained  by extracts from
Professor Samuel Jackson's and Dr.  Wm. Harris' Clinical Lectures delivered
in Philadelphia.
  This  complaint I have frequently found has been  the medium of extraordi-
nary treatment to young and interesting, as well as ladies in a more advanced
period  of  life, single, as well as married.  Omitting what is  in my opinion
unfit to appear in print—I will  merely mention the using of Caustic everyday
for alleged ulceration—the Confinement  to bed for long periods, even months'
and finally the use  of the Pessary.  Then the announcement of a perfect cure'
 But this cure amounted  to this, that the sufferer was really worse  than ever'
and was finally obliged to have recourse to Medical gentlemen of conscience
and of principle; who,  by the application of  my invention, have restored  the
 patient (so far as a shattered and dibilitated  constitution  was susceptible of
restoration) to comfeit.  Many Ladies have had their sufferings prolonged  by 
5
this and other modes of treatment., for year*—some seven yeairs, sonve even ten
years, and many, very many are yett suffering, who could 'be «©on relieved by
the Supporter.
   Ladies  very frequently cail'lom me, and  inform me of their long suffering,
and of their prostrated general health.  They say  "Our Medical  advisers do
not HnderstaiBd o«r weakness, or the cause of o«r sufferings.*'   I correct them
—I say, " Madam, they understand yoar malady, but you have unfortunately
happened to fall under the csre of a Physician who has his prejudices enlisted
in favor ef the old method of treating  this complaint, viz.—by the Pessary,
and it is therefore mot  surprising that you should  have that  opinion, as you
judge from yoar own  feelings and from what yoti have unhappily suffered."
   Many Ladies of Philadelphia call  an me, after paying visits  to distant
places, viz. j Washington, Virginia, Baltimore, New York,  Pittsburgh, Sara-
toga, Boston,  fee. kc. and «ay, u I am surprised at  having been recommended
your Supporter by Ladies arid Medical gentlemen when at a distance from
home!  i have been suffering for years in Philadelphia,, and could never obtain
any relief—why did not my Physician  advise it V"   Thus the Physician Joses
the confidence of the family.
   in such cases I have mostly spoken in extenuation of the Medical attendant,
and have  endeavoured to account for its not having been ordered in various
way?.  Sometimes I  have even  advised  Ladies  to mention the Supporter to
the Physician, and call again on rae.   The  result has  been  that I have fre-
quently never seen the Lady again; awd  she continues a sufferer  even to the
present time.   Sometimes I have to complain of a  want of candour.   Ladies
liave been fitted by me, and the ebange for the better has been almost imme-
diate ;  the substitution of my Supporter for the Pessary, making an astonishing
improvement in the general health, and feeing visafele to every one;  but  yet
they do not acknowledge the source, not even to the Physician, and he is kept
in error, and is eneoaraged to proceed  in his old  mode of treatment, to  the
manifest jajjury of those under him.
   A Lady eslled  ©n rae  very  recently, to introduce  a friend :—she said, h I
have found your Supporter of the greatest advantage to me.  I have now worn
it upwards Gf two years, and have two fine living  healthy children.  I  was
never before able to go my time, and had had nine abortions, and began to dis-
piir of ever recovering my strength."
   Some few  Medical Practitioners, place particular stress on the  ulcerated
state of the Uterus, but I appeal to the  experience and judgment of the Faculty
in treneral in this instance,  with full confidence.  My position is, that ulcera-
tion of  the Uterus is of rare occurrence;  in my own experience, 1 rarely meet
with it.   I have seeu at least fifty ladies who have been under the care  of  a
gentleman of large practice, and they all have said, "' we have been treated for
ulceration of the°womb ; for polypus of the womb ;—we have bad lunar caus-
tic applied almost daily—-and what we  have  gone through,  we shudder to
repeat,  and now our cases have become aggravated by long confinement and
general debility."  Ladies  may rest assured that the ulcerated  etate of  the
womb is not prevalent; it exists only,  as one to two hundred, or thereabouts.
The majority of eases which I meet with, are those of  simple displacement,
caused by relaxation of the system and, by the pressure of the viscera on the
womb—my Supporter will benefit  all such cases.
   Counterfeits of my Uterine Supporter, are offered by a notorious firm in this
city, and much injury has been done by them ;  two cases this  week, one lady
of Baltimore, who had her sufferings aggravated by its application—and finally
called on  me personally, wheu I discovered the imposition.  Men  who have
not ability sufficient to procure  an  honest subsistence, by their own industry,
but must pirate upon the discoveries of others, should be treated with universal
indionation.   Besides, life itself is endangered  by their spurious imitations,
and°the trifling saving is a mere deceit, and who  in their senses would pur- 
6
rhase a counterfeit?   Please observe, my Supporters are  all marked with  my
own hard writing—all others are impositions.
   Prolrpsus uteri, is often occasioned by the fashionable system of tight lacing,
and the wearing of the French cotsets, with a view to procure an unnaturally
small and taperin? waist.   I  cannot too seriously caution youn<r  and married
ladies against this fashionable folly,  It  is too often also occasioned by  using
tlve erect posture too soon after  ar.  accouchement,  and  various other causes,
without due regard to future health ; I think no lady should leave her room in
less than a month, which is the time poor women are allowed in even the poor
houses in Great Britian.
  The method of taking the dimension?, is to measure the lady round the body
on the top or little below the hip bone, and the number of inches  will be  the
correct size.
  My earnest advice is to consult an eminent physician on the first appearance
of this weakness.
  My Supporter could never have attained its present position of usefulness
and popularity, but for the kind and  disinterested patronage (rn  the first in-
stance) of Professor Samuel Jackson, cf the University  of Pennsylvania, and
subsequently by many eminent professional rrentlemen, whose disinterested
patronage I am equally proud to acknoweldgp.
  It is a pleasing task to me  to take a  retrospective view of the  progress  of
my Uterine Supporter, fan its beginning to the present time.   It  had  the
combined force of prejudices, and, 1  may say, of the passions of some persons
arrayed against it; but now, after a  few  years of peaceful  struggling—after
pursuing the even tenor of its way, disregarding minor opposition, it has been
enabled to take the very first rank amongst  the instruments  of its class,  and
can be proudly  pointed to as the very best of all.   I mean by this  that it is
more successful than any other in use ; and  that it is adapted  to an infinitely
greater number of cases than any other.
  Thus eminent Professors of the schools, in this city, have  had  the pleasure
of seeing this instrument, fostered as it was almost exclusively by one or two
of that enlightened body, (in its early day.) now  connected  with  professional
practice, from one  extremity of the  Uuitecl States to the other; certainly from
.Maine to Louisiana, and from Pennsylvania to the Far West, to which may be
added Canada.
  As to those who would sell a counterfeit  of my invention, thus adding to
the snfferings of ladies for the sole object of money making, they are entirely
too low for notice.   Ladies and Medical Gentlemen, of course, would not soil
their hands with any  thing  so base, but, for the s".ke of those who are  liable
to imposition,  I would merely repeat my  caution, to observe  that each genuine
instrument lias my name and residence, (to counterfeit which is  felony) and
those not having  it may be recognized as spurious.
   At this moment in Philadelphia, its native city, its popularity is very  "Teat,
and its celebrity is commensurate with  its success.  It has had more extensive
notice from the very  eminent Medical Professors and Lecturers in the different
Medical  Colleges, than at any preceding period,  in their  lectures  delivered
before most numerous classes of enlightened young men  from all parts of  the
Cnited States of America.
   A medical practiiioner asked me a short time since,  whether I did not  think
it high time the profession  had adopted a better method of treating this weak-
ness, than by the old method.  I  replied, certainly, sir;  after havmg used the
wretched invention of Hipocrates for about TWO THOUSAN D YEARS  I
think  the time has  certainly arrived, when the march of intellect ought to" be
tried  in favor of a better  medium  of  relief, for ladies suffering from this weak-
ness! ! !
             I am, with much respect,                 SARAH BETTS
   N. E. corner of Eleventh and Walnut Streets.      "J
                    Philadelphia, March 4th, 1846.   ^ 
7
    Extract from Dr. Wm. Harris' Clinical Lecture upon Prolapsus Uteri
  "Symptoms of Prolapsus.— W hen in  the  erect position, the  patient com-
plains  of  an aching in the back, or a dragging sensation about the loins ; a
sense of weight about the lower part of the vagina, as if something were falling
ilirough—irritation  of the bladder, and  a frequent desire to make water; a
bearing-down sensation;  pains in the hips and thighs,  and often  a fulness and
sense of weight about the  anus, and if much standing or long walks aggravate
all these symptoms, and a few hours in  the recumbent posture either mitigate
or cause them to subside,  she has good  reason  to suspect she is afflicted with
 Prolapsus Uteri."

    ON  THE  BAD  EFFECTS  AND DANGERS OF  PESSARIES.
 Extract from page  13. "/a Work on Obstetric Medicine, b v James Blunder,
    M l) —tale Professor of Obstetric  Medicine, al Guy's Hospital, London.
   "The following (says Dr. BUtndell,).are some of the most important, viz:
 obstruction of ihe"bladder;  obstruction  of the rectum ; bruises ;  inflammation;
 ulceration ; thickenings ;  insomuch that  the very walking of the patient becomes
 painful to her.  Sometimes the rectum has been laid open by ulceration into
  he Vagina.  I once saw  a case in which a very large Pessary  had been intro-
 duced, and the rectum opened inconsequence; the  woman died—(I had al-
 most said happily) and thus became relieved of her misery.

 Jin Extract from Dr. Wm.  Harris' Clinical Lee urc published in the 2d Vol. of
                the Medical Examiner, page 326, Philadelphia.     ...
    • 'The Pessary produces irritation of  the vagina and leucorrhaza;  irritation ot
  the  mouth and neck of  the womb, and sometimes causes a scVurrous or can-
  cerous'ondhbn of that organ.   It'also affects the rectum, producing consttpa-
  tion, stricture or haemorrhoids.

  r.  ,   ,  f „„, 905//,  nacre of the " Traitc Practiqne des JiccouchtmensJ'' by  Dr.

    f,2FacX of dduineal A™, und aavuchmr to h,r Royal »«4nm,

    l%°:tZfi »S„ here relates a case of redo ^W  fiStola; i «. .n




  Z'%ilhe^,! " A  folmhU^i» which the Pessary had, b,  ulceratton

  "tC m^^l^ZTtC use  of the Pessary and introduced the Sup-
  porter into his Hospital and piivate practice.




   pes,ari," and other means lor  the core of smple P™"£*\r Treaties on A/torn-
   laxafton of J ^^^^gelnZS i^^, ™,ade,PMa ifo.
   ma'ion §~c. oj the uterus.   j- «&           _      T?ch*„nr,i  24th.  1844.  By


     A subscriber has sent u for msertton                ^.^ jn ihe ^



   ~nf fZddrcaTand"=Xr'moder„  Others it the  English 
8
 language;—and besides, it is not denied by any respectable physician of th^
 present day, that much mischief may, and occasionally does result from the use
 of that instrument.  The question, however, is not whether  the improper use
 of the instrument may be productive of injury, but whether it may not be dis-
 pensed with altogether, at least  in a majority of the cases in which it is em-
 ployed by respectable practitioners.  Nearly twenty years have elapsed  since
 we have adopted the affirmative side of this question, and time and observation
 have only strengthened our conviction,  that the cases to which it is property
 adapted are kxceedingly rare.
  "Except  when the  prolapse of  the uterus is so great  that the organ falls
 without the sphincter vagina, or, where there is recto, or vesico-vaginal hernia,
 we can  hardly conceive of a condition of the parts  requiring the use of this
 mechanical means—a means most offensive to the moral feelings of the female,
 and at variance with cleanliness and personal comfort."
  The following are the objections  to the use of the pessary by Dr. Hamilton,
long the distinguished Professor of  Midwifery, in the University ofEdinburg;
they are sufficiently intelligible  without note or comment.
  Firstly.—They can only act  as  palliatives, whatever may be the  degree of
the disease.
  Secondly.—They necessarily keep up  a continual irritation in the passage,
and of course excite a mucous discharge in the vagina.
  Thirdly.—Unless properly adapted they make injurious pressure on the con-
 tents of the pelvis.
  Fourthly.—If not frequently taken  out and cleaned, they become encrusted
with a calcareous manner, which proves highly irritating.  |
  Fifthly.—They subject the patient to the charge of a medical attendant for
 ft!
  And  lastly.—Cases from time to time occur, where from the laceration of the
 perineum, &c, no ordinary pessary can be retained!
Extracts from Prof Moreau's work on Midwifery, page 294—French Edition.
  " Yet spite of all precautions it sometimes happens, that the pessary contracts
a disagreeable odour, that it is covered with incrustations, composed of con-
densed mucous, and of a peculiar kind of calcareous deposit.
  " Rousset has reported  the case of a female, whom he considered affected
with inflammation of the bladder, or of the womb, who was cured bv  the ex-
pulsion of some  pieces of putrified cork, the remains of a pessary which had
been worn 18 years ! ! !
  " In 1810 a female came to the Hotel Dien at Paris to solicit medical assist-
ance.  She had received injury  from  wearing a pessary of box-wood, or cup
and ball pessary, which she had  worn fifteen years, and from which the stem
had been long separated.   She had  suffered severe pains in the hypogastric
region.  Dupuytren having made an examination, found the portion of the pes-
sary remaining in the vagina, had worn and perforated the  recto-vao-inal parti-
tions  in such a palpable manner, that a  portion of its circle could"be  clearly
seen in the rectum, and another part had penetrated the bladder.   It beino im-
possible to withdraw this foreign substance in its entire state from either of the
three organs into which  it had  introduced  itself, he had recourse  to a  pair of
rippers (expressly  made for the  purpose,) which he introduced—thus  taking
hold of the  socket of the pessary and broke it all abroad, removing the frag-
ments, some by the anus and some by the vagina."                        °*
  Moreau also mentions a case in the  practice of Janin, of a female, who had
worn the pessary (Bilboquet) of ivory.  She neglected  it, and thirteen  years
afterwards he was again consulted and  found her entirely prostrated  by the
difficulty and  pain she suffered in urinating  or passing the other evacuations
of nature.  On examination, he found in the rectum, more than half the bed of 
9
the  pessary;  it had penetrated there after having destroyed  a portion of the1
recto-vaginal partitions.
  The ulcerations were enlarged and forced open, so as to permit the pessary'
to pass from the vagina.  During the above time, the excrement had passed by
the vagina in large  quantities, but afterwards they appeared to take their natu-
ral course.  It is spoken of as having been a most painful, difficult and distres-
sing case.
A case in  which a glass Pessary broke within the body, while worn  by a lady,
         Recorded by Dr.  W., in the Boston Med. and Surg. Journal.
  "January 14th, 1846.  I was called early this morning to visit Miss R. E. The
patient is a maiden lady of about forty, and has been troubled for several years
with prolapsas uteri, and for a long time has been obliged to wear a  pessary.
Those used have generally been of thegumelastic kind, which after being worn
for two or  three months, it was necessary to remove to cleanse, as the secre-
tions, which gather about them, become too irritatifig to bear.   On this account,
after attending to the removal and introduction of the instrument several times,
I recommended the use of the glass pessary as less irritating, less liable to col-
lect the secretions, and more durable.
  On enquiry, I found that the pessary had broken, that while standing at the
window, doing nothing; she heard a noise, and that uny effort since had caused
pain.  On examination I found it broken indeed, into a great number of pieces;
parts of the periphery were in situ, and all the parts were at  the upper part o
the vagina. I  found 1 had an unenviable task before me—the extraction of these
sharp angular and pointed pieces of glass from the vagina.  I had some doubt
as to the° feasibility of the operation, and some apprehension for  the  result.
After two hours and a half of most diligent and most careful manipulations,  I
succeeded  in  extracting every  vestige of the glass.  The number of  pieces
extracted  was fifty, of all shapes and  angles.
  The inference from the above is very plain, that there is danger attending the
use of glass pessaries.   In future in my own practice I think I shall not employ
them, so long as others can be obtained.                              »»•
                       Note to the above by Mrs. Belts.
  There are also other inferences which cannot be less appropriately drawn,
viz :  Whether the whole class of instruments called Pessaries, are not injurious
and'dancrerous. and therefore improper to be employed in cases of Uterine dis-
placements.   It is not denied that gum elastic pessaries cause much  irritation
from the secretions and incrustations, which accumulate around them, and if
not frequently removed, and replaced, a corroding of the partitions between the
vaeina and rectum will certainly take place; causing all the dreadful  effects
 noticed by Morean, Blundel, Dr. Wm.  Harris, Philadelphia; Dr. Churchill,
 Dr -Hamilton of Edinboro ;  Prof. Huston, Philadelphia, &c. &c.  The same
 may be said  of other pessaries, constructed of box-wood, ivory, cork, or even
 of the precious metals.   There is in fact no  security  in any one of the above
 unless continually subject to the annoyance and indelicacy of frequent removal
 of the pessary, and  its replacement;  and ladies are apt to neglect  attent.on to
 this important matter because of the  inconvenience attending doing so.  My
 Sunnor ers have been before the Medical profession about twelve years, and I
 only reeret that Dr. W., and many other Physicians who continue to  use the
 nessarifs  had not used my  apparatus in cases similar to that here  reported,
 Xre Us good  effects would have been immediately  apparent, and  the feelings
 of ladles and physicians been spared the trials attending them.  It  would have
 been decidedly better  for all parties.  The worst  cases I ever met with are
 those wh ch have been  previously treated by pessaries, and the longer subjected
 to Uiat treatment the worse the patients become ; the mind as well as the body
 becomes disused ; and this from  the long and anxtous state of suspense and
 seclusion to which ladies are subject under that treatment.   '1 he loss  that faint- 
10
lies suffer while the mother is kept for months in a recumbent position, cannot
he appreciated unless by families who have suffered that deprivation.   Young
ladies  too, deprived of exercise and its invigorating effects become listless,
apathetic, and  finally  consumptive.   I  am fully  satisfied that if  ladies were
properly supported, by a  lifting up and  supporting of the abdominal viscera,
in delicate and relaxed constitutions, that consumption might be stayed, and in
many cases,  (say thousands; prevented altogether.   S. B.    April 1847.

                           pTrttTi I.

                         TestimoniaSs.
From Samuel Jackson, M. D., Professor of the  Institute of Medicine, in the Uni-
                        versity of Pennsylvania.
   "Some years  past, Mrs. Belts, at  my suggestion, made an instrument for
giving  support  to the abdomen and perineum, which I have continued to em-
ploy from that time, in my practice, with most decided advantage.
   It frequently happens that the tone of the abdominal muscles is lost and they
become relaxed.  The large and  weighty packet of the intestines, losing, in
consequence, their  support, gravitate on the pelvic  viscera, pressing on the
uterus, and sometimes deranging its  position; the liver and other viscera  fol-
low the intestines, sink downwards, and dragon their ligaments.  Lesions will
result from this condition; there is a most  exhausting sense of emptiness and
dragging felt in the superior position of the abdomen, and a feeling  of weight
and pressure in the lower, attended with pain in  the back.  The patient can-
not stand erect, exercise or walk, without inconvenience or suffering.  There
is often disability for any kind of exertion.
   Artificial support of the abdomen remedies  more or less effectually this train
of disorders and  rarely fails to abate  the most uncomfortable of the symptoms.
   The  apparatus of Airs. Betts is well adapted to accomplish this purpose.  I
have been enabled to give prompt relief, in many distressing cases, by its ap-
plication.  1 have no hesitation in recommending it to the Medical Profession,
as an effectual means, in the class of cases to which it is applicable."
   Philadelphia,  Dec, 13,  1842.
       From  T.  D. Mutter, M. D., Professor in Jefferson Medical College.
   "Dear Madam—It affords me much pleasure to state that I have repeatedly
employed your Supporter in prolapsus uteri, and wi'th the most decided benefit.
I have  no question of its value, as a remedy for the complaint, for the relief of
which  it has been invented."               Philadelphia, Dec. 11, 1842.

     From Wm. Harris, M. D., Lecturer on  Obstetrics, fyc, Philadelphia.
   " Radical  cures have been made "repeatedly, after every  other means have
failed to afford relief.
   Ladies affected with procidentia uteri, who were unable to leave their  cham-
bers without great  suffering, found such immediate relief from the application
of the  Supporter, that in a few days they were able to pay  morning visits on
foot.
   One of the worst cases 1 have  ever seen,  was completely cured in a  little
more than a  year, and some less formidable have been relieved  in from three
to six  months.  1 recommend this instrument cordially to  the medical profes-
sion, believing it to be one of the greatest improvements of modern times "
   Philadelphia, Feb. 24, 1843.

From Samuel McClelland, M. D., Prof, of Midwifery and diseases of women and
                  children in Pennsylvania Medical College.
   tlI found  Mrs. Betts' Supporter the very best instrument of the kind  1 have
ever yet met with, in the whole of my professional  experience,
   I have recommended  it, and  will  continue to do so, as the most successful 
11
of its class, in cases of uterine displacements.  Make reference to me as to its
merits."                                           Philadelphia, May 5.

                From  Dr. R. W. Roysterr Powhattan Co., Va.
  "The success which I have met with during the last twelve months, in the
the treatment cf the most aggravated cases of prolapsus uteri, with Mrs. Betts'
uterine Supporter, induces me to give preference to it, over all instruments that
have been suggested, for the treatment  of that most distressing malady."
  "P. S.   l'do also assure you 1 have had under treatment during the past
twelve  months, some  of the" most aggravated  cases, that bade defiance to all
the different modes  of practice;  the use of the different  shaped pessaries,
which have contributed not a little to  render the cases  more complicated, by
producing irritation of the vagina, os tinc»,  and the consequences of pressure
on the rectum."                                           Feb- 6> 1843-
>    CUnique at the College of Phys. and Swrgs., New York,  April 22, 1842.
   " Professor Oilman  made some judicious remarks on the treatment of pro-
lapsus uteri.   Hecondemned, in toto,the use of the pessary, and recommended
the Supporter introduced by Mrs.  Betts.                  April 22,1842.
                                              Baltimore, April 11, 1844.
   I have carefully examined the application of the ''uterine supporter" inven-
ted by Mrs.  Betts, and find in it every thing to  praise and nothing to blame
Ten ladies of this city, who have made use  of it  at my suggestion, have  found
it quite comfortable and superior to those  made  in  Paris, or  m this country ;
and it is with pleasure, that I approve  of its application  in  all cases of uterine
prolapsus.                                      P. Chatard, sr., M. D.

        Letter from  Professor Samuel Jackson of  the University offPa.
   "The abdominal  and the perineal Supporters  made by Mrs.  Betts of this
 city, I can recommend to the medical  profession, and to others, afier several
 years experience of their use.                          .
   These instruments are adapted to remedy  the inconvenience depending on a
 sinking down of the uterus, and its  compression, from  the incumbent weight
 of the abdominal viscera pressing into the pelvis from a relaxation of the ab-
 dominal muscles. In this state of the organ, exercise is attended with so much
 pain and other sufferings as to be difficult or impossible.
    Mrs Betts is a lady of intelligence, education, probity, and excellent man-
 ners.  The greatest confidence can be placedjnh^ .^^ M D

        Professor of the Institute  of  Medicine  in the University of Pa.
    Philadelphia, Feb.  26, 1842.
        From Drs. Carmichael and Mills, Richmond, Va.   To Mrs. Betts.
    All  accounts  which  we have  received  concerning your  Supporters, have
 been most favorable,  and in our own practice they have been very successful.
    Richmond, Va., August 6th, 1844.
  To Professor Parker,  New  York,  from Professor T. D. Mutter, of the  Jefferson
                        Medical  College,  Philadelphia.
    " Mrs  Betts has for some years past been entirely employed in the manu-
  facture of an instrument for prolapsus uteri, which, in  my own  practice, and
  that of many of my friends, has been of immense service to the subjects of that
  severe disease."
                 From the New York Lancet, April 16,;?. 249.
    " We have recently had an opportunity  of examining the  uterine supporter
  introduced a few years ago by Mrs. Betts, of Philadelphia, and  we  can very
  cordially add our favorable opinion  of its merits, to the almost unanimous ex-
  pression of approbation which the invention has received, from our professional 
1:2
brethren, in the city of brotherly love, where it has  been heretofore more ex-
tensively ir.trodu-ed into practice than in this place.   We have  no hesitation
in saying, that in a great manv cases of prolapsus uteri, this simple apparatus
will be found infinitely preferable to the pessary, against the  use of  which,
there is, in the minds of most females, a strong, and  often insurmountable pre-
judice, and which is at best,  in  our opinion," a very  indifferent contrivance.
Mrs. Beits' apparatus is  perfectly  simple, can be applied without the least
difficulty,  occasions no inconvenience, and  certainly  effects, to  a  very  great
extent, the important purposes of its invention.  Mrs. Betts intends making
periodical visits to this city, for the purpose of disposing  of, and  applying her
Supporters, and we have great pleasure in recommending our brethren here to
avail themselves of her invaluable assistance, in the treatment of a numerous
and most interesting class of sufferers."

                        From a New  York paper.
                  Mrs. Betts' Abdominal Supporter.
  Mrs. Betts, of Philadelphia, the celebrated inventress of  the  Abdominal
Supporters, has arrived in this city, and may be seen  at the Astor House.
  Her invention has received  the unanimous approbation of the most  distin-
guished members of the  Faculty, and is rapidly acquiring the  most extensive
reputation amongst the interesting class of sufferers,  for the'proitiotion of whose
comfort it is intended.
  Professors  Delafield, Francis, Stevens, Rogers, Parker, Gilman, the  editor
of the Lancet, and all our most eminent Physicians  unite in recommending
Mrs. Belts' invention to public approbation.   Of course it must  succeed.

                    Certificates from St. Louis, Missouri.
  "1 take great pleasure in recommending  4 Mrs. Belts' Uterine Abdominal
Supporter' as quite superior to any other row in use.  From its  mechanism
and mode of action, 1 am decidedly of the belief that it is an instrument admi-
rably calculated to fulfil the object  for which it was invented.   I have em-
ployed them in my practice, and  feel well satisfied as to their practical utility.
                                            Robert  P. Chase, M.  D.;'
  "I have for several years past used  Mrs. Belts'  Utero Abdominal Suppor-
ter, and have found it most admirably adapted tomostcases of  the troublesome
affection for which it  was invented.             S. Gratz Moses, M,  D."
  " For some time past I have used Mrs. Betts' Utero  Abdominal Suppoter,
and from  my experience, I can recommend it as the best adapted apparatus  for
the purpose for which it is intended of which I have any knowledge.
                                                  J. W. Hall, M.  D."
   " I have repeatedly advised the application of Mrs.  Betts' Uterine Supporter,
and it affords me much pleasure in observing its effects, to offer  my testimony
to  its value, in the complaints for the relief of which it  was invented.
                                              R.  V, Simmons, M.  D."
   i'l cordially ppincjde wjth  ll^ above  testimony of  Dr. Simmons.
                                            E. F.  Machonough, M.  D."
    f'l have recommended Mrs: Betts' Abdominal Uterine Supporters, and from
 the relief afforded, I am prepared to say that they  answer the purposes for
 which they are intended better than any olher mechanical means of relief.
                                          H.  Augustus  Prout, M.  D."
    '* I cheerfully subscribe to  the above  testimony of  Dr. Prout.
                                           H. Van Studdipord, M.  D."
    Extract of a letter from J. K. Sappington, M D., Havre de  Grace, M. D.
    u As to my testimonial of the efficacy of your instrument in the treatment of
 Prolapsus Uteri, if I could add any to its superior  claims in my opinion, over 
13
all other means yet recommended, 1 would have no hesitation to send it, at any
time you may request it; and I may also add, that in the medical treatment of
Chronic Diarrhoea, Chronic Dysentery, Prolapsus Ani, and to prevent Ovarian
Dropsy, great benefit would be derived from the judicious application of your
Supporter.                                       September 10,  1846.
                                          Ripley, Miss., Nov. 22, 1846.
  My Dear Madam—•' I have disposed of four out of the six Supporters you
sent me, and have no doubt I can do better another year.  They have answered
the purpose in every case that I have applied them  to; 1 would  like you to
send me eight more of assorted sizes."
   Very respectfully, your obedient servant,           J. B. Ellis, M.  D.

  It is hoped that enough has been shown to evince the excellence  of the Sup-
porter, and its adaptation to the objects in view ; conscious, herself, of its good
effects, by  its lightness, the ease with which it may be worn, and the renovat-
ing effects  produced when on, its having raised many ladies almost from  the
grave, to perfect health, the inventiess trusts she will be excused in not adding
snore on this occasion, from the great mass of testimony in her possession.
   Mrs. Betts wishes to communicate the success which has attended its appli-
cation in severe cases of Chronic Diarrhoea.  She will be happy to give refer-
ence in this particular.
CIRCULAR.—To the Medical Profession, and  to the Medical
                  Journals of the United States.
                 On  Counterfeits of Mrs. Berts' Supporter.
  I respectfully ask your attention for one moment.   My Uterine Supporter is
now standing very high in favor with medical gentlemen  and the public, and
you have forwarded me various orders for it at different times.
  Its extensive reputation has induced a firm in this city, bearing the cogno-
men of Wiegand & Snowden, to disgrace themselves by counterfeiting, and
offering it for sale as mine, and this  they had the audacity  to offer to myself
personally, at their own shop, where 1  happened to call yesterday.
  I wish, sir, to caution you against this base counterfeit, as the sufferings of
the patients must, and will be increased  and  prolonged by its use, as it is de-
fective in many of the important requisites of my Supporter,  and  so  worthless
is it,  that unless the fraud is practised  of calling it by my name, it would not
sell at all.
  Two cases of imposition have this week come to my knowledge, by the arri-
val of a lady from Baltimore, and who was supplied with the counterfeit;  it
had some resemblance to mine in mere appearance, but us  effect was disas-
trous—it increased all her bad feelings and  added to, instead of diminishing
them '! She was supplied by me with the original, and she was much relieved
immediately.   Another case, was that of a lady who had been supplied with
it  and  findino- its effect bad, had loaned it to a  friend, both  of whom came  to
in'e to explain0the circumstance, and thus discovered the fraud.   Such is the
conduct of these persons, who thus  deprive persons of their money, by coun-
terfeiting my inventions, and me of the reputation derived from my Supporter,
 passina'offa dangerous and injurious  substitute.
    1 have also reason to believe that it has been circulated in the city  of Wil-
mington and its vicinity.
   That man must be low indeed in the scale of morals, who would stoop  so
 low as to plunder a lady of her property or business-such a man is loo de-
 graded and base for the notice of honorable persons, and is worthy only your

 C°SincePthe above was written, and which has  been very extensively circula- 
H
 led in the way of caution to purchasers, the reputation of my Supporter has
 much increased ; ten thousand  ladies have had it  applied with the greatest
 benefit to them, and to the great gratification of the medical <r,ntlemen order-
 ing it.   VViegand & Snowden now sell it as " Doctor Hamilton's Supporter,
 thus covering the counterfeit with an assumed name, though they  artfully put
 (Belts') in brackets, to let persons know  that it is, in point of fact, the same
 counterfeit they before sold as mine.   This thing is a very  dangerous imposi-
 tion ; it has been attended with the worst effects.   Be sure to see that each
 instrument has her name, " Sarah Betts," and residence, Eleventh and Walnut
 streets, Philadelphia, attached.
  Proofs of the above statement are in my possession.        S.  BEi IS.
  October 22,  1845.
  My friends will much oblige  me by informing me where  a counterfeit is on
 sale, and transmitting the intelligence by mail fit will be thankfully received.

                           A LETTER TO

 A DISTINGUISHED  PHYSICIAN   OF PHILADELPHIA.

             ON  PESSARIES  AND THE UTERINE SUPPORTER.
                  Br Mns.  James Betts, of Philadelphia.
  Sir,—On Friday the 22dult., Dr. -------, (who is a very gentlemanly man)
 called at my residence for the purpose of asking for the loan of my Uterine
 Supporter, with the object, as stated, of showing it to the Medical Class.  My
 respect for the members of the profession always induces me to do with plea-
 sure all in my power to assist their views, in the great object of relieving suffer-
 ing, or to advance their interests.  1  sent my  supporter to Doctor-------s
 office, willingly and cheerfully.  I afterwards discovered by a  Medical Stu-
 dent that it was borrowed for "the purpose of enabling you to make various re-
 marks upon it;  and through it also upon  the numerous and  eminent Medical
gentlemen, who patronize  my Supporter, impressing your class (or endeavor-
ing to do so) with the impossibility of its beinn an  efficient instrument in any
hands of its relieving prolapsus  uteri.  You might  have been excused  in this
 if you had ever giving my  Supporter a sufficient trial, testing  its efficacy or
non-efficacy, in the purpose to which it  is applied-^but as  you  have never
made trial of even ONE, in any  solitary instance, you must have  drawn largely
upon the supposed jrullibility of your audience and their credulity, to expatiate
upon, and endeavor to  destroy  the reputation of an instrument of which you
have never made a solitary trial.  Can your opinion of that Supporter be worth
anything; can it be of any weight compared  with that of eminent medical
practitioners, who have constantly and successfully used it for seven years in
their daily practice?  Is it not presumptuous in you, to endeavor, (for after all
it will amount to only that)  to subvert the testimony of gentlemen at the head
of the profession, many of  them  eminent when you were an  obscure man,
scarcely acquainted with the rudiments of your profession.  You have said.
 Sir, that you suppose the  public  must decide  the  question. Sir, the  public
 will decide, but not in favor of the pessary.  1 know, sir, that this is an effort
to put down my Snpporterand its adherents, becauseyou  know that it is rapidly
increasing in public favor, and  that the public  favor shown to my Supporter
 goes against the pessary, an instrument which, allow we to tell you, has nearly
run its raee.
  The treatment of Prolapsus Uteri by the pessary  is offensive to  female deli-
 cacy. In my experience I find an invincible repugnance on the part of ladies
 to its use, and they escape from it at the earliest possible moment.  It is. they
 say,  " treatment tiie most offensive and indecent ; it leads to the final abandon-
 ment of those sentiments of female delicacy which  are the chief ornament of
our sex.  It is a mode of treatment which we are unable to make our fathers 
15
husband and brothers acquainted with in all its offensive particulars."  The
exposure attendant on the treatment, the degradation which a lady of modesty
feels after it. the wounded feelings, the  depressed  mind, her fears  of loss of
character, of self-esteem, and by possibility of the esteem of others—.a danger
(near or remote, as it may be) of real demoralization in youth or inexperience,
—are some of the moral evils attendant  on the use of pessaries, and ought to
induce a man of Christian principles, oreven of moral habits, to pausein the use
of an instrument like the pessary, and to adopt any other, in preference to it,
particularly a more suocessful one:  and you will recollect the French adage,
" Cest le premi&r pas qui coute."  And  humanity will  dictate  the importance
of this view of the subject.   Due regard ought to be paid to the various mental,
as well as physical sufferings of females, "arising not only from the  organic
displacement itself, but yet more, from the placing, replacing, removing, &e.,
the various pessaries ordered from  time to time, prior to my Supporter having
been obtained.'"  (Vide my addiess to  Ladies, page 1.)
   I  have been repeatedly urged by ladies to make my Supporter more known
 to the public,   1 had always been anxious to keep it exclusively as an adjunct
 to professional practice, because it was with  repugnance that I contemplated
 treating this affection on my own account.   It was for this reason  that 1 have
 always avoided public advertisements in the ordinary manner by daily journals.
   It has not been rny wish to deprive medical gentlemen of ihe pecuniary re-
 wards of the profession, (particularly the profession of Philadelphia, to whom
 I am under many  obligations.) I positively deny assertions  to the contrary,
 defying any man to point out an instance in which, 1 can be fairly charged with
 any such thing.  The prejudiced,  ihe malignant,  the obtuse may assert it, hut
 the  man of honor and reputation will not dare to. do so, because he knows that
 veracity will be sacrificed thereby.  I consider my duty terminated by the ap-
 plication of my Supporter;  never can it be said that I ever charged one dollar
  for  advice.  The brilliant success and reputation of my Supporter has been suf-
  ficient to enable me to confine myself to making, selling, and applying it; this
  id, all I wish to do.
   It is true that hundreds of ladies have been to me and said, ll Mrs. Eetts, I
  have called on you to get relieved from my sufferings, if possible; I am worn
  out with protracted illness; my family is losing the benefit of my services; I
  have worn  different pessaries, but none of them reach my case or do me any
  „00dt   Dr. -------has attended me a lonsr time."   My reply is this, I feel
  very confident, madam, that my  Supporter will very much benefit you; it has
  reached a thousand similar cases before, but there is a necessity for candor,
  and it is due  to you and myself to say, that it will fail in the hands of the gen-
  tleman you have  named, (as it may be)  because he does not understand  the
  principles on which it acts, or any thing at all about its operation; besides  he
  isr.hostile to aught else besides pessaries.   It will relieve you in the hands of
  a physician who  is favourable to this new mode of treating your  complaint,
  therefore change your physician.   Some of its most violent opponents have
  never yet tried^it,  in a solitary instance; I am sorry to say it, but  so it is, they
  do  not and  cannot understand it, and more than all, they suffer their  prejudices
  to get  the better ot their judgment.   The lady then applies to another physi-
  cian, dismisses the previous one, 1 get merely paid for my Supporter, and the
  successful  physician reaps the reward to which  he is entitled.
     I wish, Sir, to be entirely respectful to you in  this communication, but there
  is something more than pride of station or of office, to be consulted at this time.
  You have  iTre-conoeived notions  and  opinions.   I have eminent station, high
   talent  areat names, in both hemispheres in my favor.  1 have (and which is
   more to'ne than all besides) the voice of conscience and humanity—to mitigate
   female suffering to shorten the period of pain, to raise  up  the  prostrate  suf-
   ferer  is my  object, and it is accomplished by my Supporter.  You as a man
   occupying an important  station  should rejoice  at such a result; but what do
   ue hear—the praises  of your horse shoe or sleigh pessary ! 
16
   I trust you will excuse me, but at this time I feel impelled to come <or™&l*
 as a friend  to  my sex, the welfare  of  whom  ought to be dear to me, ana on
 those who are our natural protectors it  is more incumbent.  My respect to you
 as a medical gentleman, holding an important office, (and I desire to pay every
 respect,) must be limited in its extent; you have no  blame that can attach  to
 me, as I merely vindicate myself, whom you have injured by an attack on my
 invention.  Sir, I know the feelings of ladies  on this subject; there is a great
 and growing dislike and invincible repugnance to the use of the pessary in any
 form.  I am sure, Sir, that you never will experience pleasure, profit or success
 in the use of your horse shoe  or  sleigh  pessary, which you now extol, and
 which I have now before me, and I am free to confess (knowing something ot
 its effect on one of my patients) that  1 would rather a child of mine should
 continue to suffer than that she should endure the torture of that instrument.
  Ladies suffering by the pessary know well the advantage of my  Supporter;
 they are acquainted with the cure of other females, their friends and^ relatives,
 by it; they  see  them out  and  about:  they are anxious to  get it.   They say,
 oh, why cannot "I be allowed to try Mrs. Betts' Supporter, it will I know do
 me good."   They pine for it; all their respect for their medical attendant will
 not be sufficient to compensate for, or induce them to submit to a continuance
 of pessary treatment any longer, therefore, the practice of the adherents of the
 pessary will become so irksome to them, by its continued ill success and their
 growing unpopularity with  their own patients, that it must be consigned  to
 the »' tomb of the Capulets."
  A lady very recently called on me from a  northern state, by desire  of her
 physician, in that city, an accoucheur of the very first  eminence.   After her
 arrival she  called on a relative in  this city and a fellow sufferer in the same
 complaint; she stated  that she  had  been directed by her medical attendant to
 get Mrs. Betts' Supporter.   "Oh  pray do not do so," said the Philadelphia
 lady,  "for my doctor assures  me it cannot do any good."  The other lady an-
 swered, I have such full  confidence in the recommendation of my  own medi-
 cal attendant that although I do not know any thing of Mrs. Betts' Supporter,
 I will get it at any rate.  The lady being fitted with  my Supporter received
 such  benefit, that although she had been scarcely able to walk at all for three
 years, was shortly able to walk a square or two, and is now at this time able
 to walk a mile and a half, and the same distance back again, to visit me. The
 Philadelphia lady is still suffering with the pessary, but is as dissatisfied with
 it, as  she is with her doctor, and will get rid of them both as soon as possible.
 She complains of beingdeceived and imposed upon.  This is the way in which
 the treatment recoils back again on its friends; it is an almost every day oc-
 currence.  Is it politic even to continue it?
  I am free to confess that the respect  which I owe you prevents   my addres-
 sing much more to you, than this short letter can contain; but {encore un coup,)
 as you are  known never to  have employed  my Supporter, not even once, are
 you acting with propriety in saying any thing at  all"about it?  Are you jus-
 tified  in attempting to raise prejudices  in the minds of others against it?  As
 you havehad no experience in its use, you ought at all events to remain quies-
cent.
  I would respectfully also caution  you against the effect of your remarks upon
 the medical students themselves.  Sir, my respect to the medical profession is
 so great, I wish to caution you against any delusion  that you may be labor-
 ing under which will operate disastrously in  the " long run."  Candor is al-
 ways best, and particularly on  this  occasion.  Young gentlemen  coming  to
 tr.iscity for medical education,  particularly those of them who form your class
 in the---------, will have other views than those of yours on this subject;
 they are naturally of an enquiring disposition; they will not embrace the view
 that you  present to them, if a more popular and a better method of treatment is
(taught by others.  The bias of education may do something, but   reason and 
17
experience will do much more.   They are independent in thought as well as
action—they will not be tied down by dogmas and paradoxes—they are men
of intellect, and highly educated; at least most of them are so.  After gradua-
tion, if  not before, they discern that this is a question  of absorbing interest  to
them, in their practice, and as brothers, relatives or friends.   They look back
to their  professors' instructions—they  are unsatisfactory,—a rival in  practice
succeeds admirably with the supporter,—he  drawls along  with the pessary,
and finds he makes no  progress, while his competitor reaches Ihe goal of suc-
cess in  triumph.  He then says, I find now that I was misled by  my  instruc-
tor; and the result is disappointment,  perhaps  disgust,—you  may give it the
name of the "abominable,"—you may style it  the "abhorred," but abuse, you
know, sir, is not argument.  When your  students know that the pessary will
not cure displacement  of the uterus, and that my uterine supporter will do so,
they will  know what your assertions are really worth.
  With all due  respect,  sir, I would  submit that the greatest friends to my
uterine  supporter are those medical gentlemen who are best acquainted with  it;
and who have become as tired of the pessary,?after long  trial, as itis possible for
you  to  feel warm in its support, and have at  length]  totally discarded it as  a
worthless and inefficient concern.  They have tried itin every shape and form
for a number of years.
  A medical gentleman of longer standing, greater talent, and higher eminence
than yourself, told me  repeatedly that he had given them all a thorough trial,
in all their various shapes and phases, but never one with a satisfactory result.
I myself  have seen at least six thousand ladies with  this  weakness, and  I
solemnly declare that 1 never heard one out of the whole number speak well of
the pessary.   I  am, sir, competent to  speak to you in this  matter :  my large
experience gives  me a  right to do so, and your attack on my Supporter warrants
my doing so.   Perhaps there is  not another individual in this city who could
speak to you with the same freedom, and at the same time, I hope, with the
greatest respect and consideration for your position  and talents.
  Other medical gentlemen of eminence tell  me that after using the pessary
for twenty years in practice they have utterly abandoned it.   An aged gentle-
man of a southern city says he has been for forty-five years in practice, has
narrowly watched, and always found  them unsatisfactory—giving a vast deal
of trouble and pain;  he  now uses my Supporter altogether;  his  practice  is
among  the highest families.   Another of thirty years practice told me almost
the same  words.   A young friend of my own, who graduated only a few years
ago, in  the______________, said, " I attended Dr.------class;  he strongly
advocated the use of  the pessary, and I must say my bias was in its favour.
At the same time in the summer course in Locust street, Mrs.  Betts'Supporter
was warmly spoken of as an excellent instrument; determined, however,  in
favour of Ihe pessary,  I gave it employment, and the  result was disappoint-
ment both to mvself and patient; there was so much inflammation and general
prostration, such tilting over, such falling through, that I was  very glad  to
have done  with  it, and now I send my  patients to get fitted, Mrs. Betts, by
VOL).
   A ladv from a  distant city came here to receive the advice of Dr.----She
was persuaded by another'lady  to get Dr.----She said  the former gentle-
man will lay you in bed  for months, perhaps six, or  even  twelve, as he did
Mrs  so and so;  and finally, by using the pessary, make you worse than ever.
Dr  ____Uses the improved method ;  he is very successful, and a very eminent
man.   The result was the Doctor ordered her my Supporter, and in one week
the lady was able to reach home perfectly well.                  .....
   My respect  to the ladies of this community compels me  to speak  with Ihe
openness and  candour befitting  the occasional  the same  time, I  trust, with
due consideration to you as a physician.  Yon may, sir, lay to yourself a kind
of " flattering unction," that your position ensures to you a certain, ready, and 
18
 tacit acquiescence in your opinions.  You never were more deceived. Mci i
 men in distant places  are offended with the treatment their patients receive
 this way.  I have been told over and over again by ladies,  " Mrs.  B«,ts-  r '
 • 'ret to say this is not my  first visit to this city :  I  have been treated before r>y
 Dr. ----; he sent me home with  the pessary;  I never was benefitted in tna
 least by  its use ;  it has been a source of sorrow to me ; my Doctor at home w as
 very angry at being treated in this manner.   Yon might have had all this done
 for you at home, said he, and have saved your fatigue and  money^ but go on
 again and apply to Dr.----, who employs Mrs.  Betts' Supporter.       _
 °A lady of great wealth,  of another city, who has just returned from Pans, in-
 forms  me that the Paris physicians never employ a pessary now.   She  came
 home with a Supporter of a peculiar construction,  which she removed to give
 place to  mine.   1 have, Dr.------, public opinion on my side ; you will nnd
 it  very hard to work up hill your sleigh pessary ;  you will require a very strong
 team, and most likely locomotive  power will not get  it along against the op-
 posing force.
   The pessary is unpopular, unsuccessful,—my Supporter is in  full  tide of suc-
 cessful operation; but it is yet in its infancy;  when the veil which conceals
 it  is drawn aside,—when it  is more fully known than at present, the pessary
 will be in complete oblivion.
   As to the mode of treatment by the pessary I have a few words to offer.
   The lifting up  the uterus by the pessary, is insufficient to conquer the com-
 plaint.  There is a pressure at  the  fundus, bearing it down, and  the viscera
 around and above it, by their  weight, keep it from  recovering its position.  A
 general support to the abdomen is necessary, and is the desideratum.  Thus an
 opportunity is afforded  for the recuperative energies of the  abdominal viscera
 to  commence their work with success.   A mere application of the pessary to
 the vagina, I humbly conceive, sir, will do little or nothing,—it will merely
 cause a flattering, if I  may so term it, of the shape of the womb, which you
 know is pearshaped ; a weight pressing on its top and another at its extremity,
 it  appears to my  view, must  be attended with bad  effects.  The tone of the
 uterus  cannot be restored by any such process.  It  is said also, restore the tone
 of the vagina. How can the tone of the vagina be restored while it is distended
by an instrument like the pessary?
   The lady is ordered, however, to  keep in the recumbent position; possibly
 to  lie in  bed ; during this  time by tonics and  tonic  injections, you endeavo rto
 restore tone to the system ; to reduce inflammation and to replace the prolapsed
 organ; this being accomplished, and the  patient feeling relieved, then the  pes-
 sary is introduced—she attempts to rise, the pain is  intense—the weight of the
 viscera pressing as befoie  on the uterus brings back all her bad feelings, and
 it  is exceedingly difficult to walk or stand erect ;  then commences a train of
 medical treatment, which  scarcely  ever ceases, and the unhappy lady is a me-
lancholy  instance of pain and  suffering, and the usual train of nervous diseases
 follow, and other disorders, as described  by eminent medical men.
   If not  trespassing too much on your attention, sir, allow rne to add the view
 I take of the improved mode.   A lady having prolapsus uteri, and being ready
 for the application of my Supporter, has it applied, and she feels immediately
 a delightful change :  the heavy, dragging, bearing-down pains are immediately
 mitigated ; she is as it were, entirely a changed woman;  she walks with ease,
 attends to her domestic duties, and speedily the parts recover their position.
 The taking off the pressure on the uterus is the cause of  this great change,
 combined with the moderate and gentle pressure of the perineum, by the peri-
 neal pad. No time is lost; a rapid and perfect cure in general takes place.*
   My  wish is to  be perfectly explicit, and to be understood.   I have, sir, en-

 ' *I speak of my  gupporter.  I cannot answer for counterfeits, of which there arevarioua
 Wieeand & Co., of this city, have made and Bold a counterfeit of my supporter the effect of
 which has been serious.                                             '         * 
19
 deavored all in my  power  to preserve a good understanding—a  fair, candid
 mode of procedure.   My respect to yon has caused me considerable pecuniary
 loss.  Many of your patients have called on me expressly to get fitted with the
 supporter, of course without your knowledge; I have told them I did not like
 to interfere between Doctor and patit/nt.  I would feel gratified  by your.being
 again spoken to before I fitted them.   This will  not be construed  as wishing
 to deprive medical men of their emoluments, of which I have been accused !
   Before I conclude, Dr.------, allow me to speak as to  the practice in this
 branch, in other places.  In New York, in  the Crosby Street ^School, your mode
 of treatment is  exploded—the learned professor of your branch recommends
 MY  SUPPORTER as  the very best instrument to employ; and  a  young
 southern gentleman  in the University of Pennsylvania at present, in attending
 the last summer class, in July, informed me of it.   The great majority of medi-
 cal men in Baltimore are in favour of its application, and employ it in their
 practice, if I may judge  by its increasing sales.  1 must conclude it is growing
 in favor in every part of the United States.   On the other side of the Atlantic,
 you  know, sir, that  all the eminent men  are against the use of the  pessary.
 Prof. James Blundell,M. D., of Guy's, London, in his work on Obstetric Medi-
 cine, thus speaks of it.   Page 13. " The following (says the Dr.) are some of
 the more important bad effects.   Obstruction of the bladder, obstruction of  the
 rectum, bruises, inflammation, ulceration,  thickening, insomuch that  the very
 walking of the patient becomes painful to her.  Sometimes the rectum  has been
 laid  open by ulceration  into the vagina.   1 once saw a case in which a very
 large pessary had  been introduced, 'he rectum opened, in consequence,  the
 woman died, (I had almost said happily,) and thus became  relieved of her
 misery."   Any one possessed of any knowledge of Dr. Blundell, or of Guy's,
 will acknowledge this to be authority  of the first order.
   You also know, Dr_____, that Prof. Moreau, of the Faculty of Medicine, at
 Paris, and Physician to her Royal Highness the Dutchess of Orleans, and Prof.
 of Mid vvif  ry and the diseases of women and children, has the following passage
on page 295, of his  " Traiiepratique des accouchemints.''''  He relates a case of
 recto vaginal fistula, i  e., an opening between the  vagina and rectum, caused
 by wearing a pessary :  in this case the faeces passed out of the vagina.  Another
ease, in which the pessary produced ulceration, fungous excrescences, and he-
 morrhage.   Another case, in whieh the pessary  had caused by  ulceration, an
 opening, both into the bladder and rectum.  A fourth case, in which  the pes-
 sary worked its way into the rectum.
  Dr. Moreau has therefore abandoned the use of the pessary, and  introduced
the Supporter into his hospital and private practice.
  This  is  the "modus operandi," Dr.----, of the pessary; you may blame
 your  brethren of this city for discarding its use ; but if they cannot see the pro-
 priety of employing it any more, they  will  be justified and commended for dis-
carding it,  by  the force of reasoning and fact.  You may say in poetical lan-
guage—but ineffectually,
                   " It has no faults, or I no faults disery,'"
                   " It's beauty all, or all Mindless I."
  In this city, the chief seat of Medical Science in the United States, the great
majority of medical menaie opposed to it—men of theory first authority. The
reputation of this city is to a certain extent in jeopardy—many southern ladies,
l'well know  "0 to New  York for treatment, because there it is well known the
pessary is nofemployed ; and here it is known that some men of  standing are

%*inaHv X  permit me to allude to  one circumstance :—On Friday the 22d
inst   you alluded to a case of retroversion of  the uterus, caused, as you were
pleased to say, by my Supporter. This, of course, you know was not your own
patient, because you know no patient of yours ever used my Supporter.  It
must  have  been  a consultation  case.  You said after three years wearing it;
y0H  did not of course, watch the  patient during the three years wearing it— 
20
therefore, at what precise time the displacement occurred,  (a  very important
circun.stance,) is not stated.  Do you know that the uterus was not retroverlert
at ihe tjmP or evPn before my  supporter was obtained?   It may have  taken
place durinir jts removal, for most ladies  remove it occasionally, as is known ;
removing itand applying it again, as it suits their pleasure or convenience.
   It is well known that retroveision arises in most cases from the distension
of the bladder during pregnancy, by sudden emotion of the mind, &c, &c, &.c.
Dr. Grpgoire, of Paris, about the middle of the last century, first called  the at-
tention 0f the  faculty to it.   Through his means Dr.  Wm. Hunter, of London,
also directed his attention to  retroversions of the uterus.  He states a case of
distended bladder, from which he, with the catheter, by the assistance of Mr.
Walter  \\ all, drew 7 or 8 quarts of water.   And  this distension produced re-
troversion of the uterus, (Vide  Aled. Observations, vol. 4.)  You know also
that a number  of cases of retroversion occur where the pelvis is capacious and
the fundus of the uterus falls low  down  into the pelvis, so  that the os uteri is
pushed against the neck of the bladder, preventing thereby, the free egiess  of
water—and of course,  giving the bladder a disposition to  distend.—(Vide Dr.
Hunter's Work.)
   Dr. Denman (Introduction to  Midwifery) also imputes retroversion to dis-
tended bladder,  "either by the reserve of women in a superior  rank of life, or
by the restraint of those in inferior stations; neglectingor being prevented from
attending the calls of nature."
  Dr. Merriman admits the theory to be correct; he adds,  (at page 18,) though
over distension of the bladder be considered as the principle cause of retrover-
sion, and though "it is hardly possible that complete retroversion should take
place, unless the bladder be so over distended, yet great emotion of the mind,
or exertion of the body, may  give that shock to the distended bladder which is
sufficient to retrovert the womb."
  You know  also, sir, that it occurs in  the early periods after delivery ; be-
cause, observes Dr. Merriman, "  the contraction which the organ has undergone
has reduced its size, and renders it fit to undergo such a  displacement; also,
when the uterus is in a  diseased condition, it is very liable to retroversion."
  Dr. Merriman  relates the  case of  Mrs. F., of Wellbeck street, Cavendish
Square, London,—a case of retroversion  during pregnancy, caused by sudden
emotion of the mind on hearing of the death of a near relative.  " She was terri-
fied and much affected ; she expressed herself as feeling her whole inside turned
upside down."
   Dr. Wm. Harris, of this city,  observes " that the causes of retroversion are
a preternaturally large pelvis, and overdistended bladder, violent vomitino-, great
physical exertions, blows, falls, &c." (Vide Med. Examiner,  Vol. ii., page 347.)
   Let us then for one moment, ask each other, on which side lies the balance of
testimony, with you or with  met   >Ti3  very true, I am an unimportant  indi-
vidual, and not to be placed on the same level  with Dr._______.   ''It is most
true "—but yet my influence is considerable.   But if the veriest worm should
cross our path, we might let  it pass uninjured ; but, being a female, I am more
entitled to courtesy on  that account, and persecution to me will  be  looked upon
with disgust.*

  ♦The list of physicians in London, favourable to the Uterine Supporter, contains amone
many others, the na*nes of                                              '     S
    Sir Astley  Cooper,           Sir .lames Clark,            Sir  T? Bro<i;#»
    Dr. T. Watson,             Dr. Holl-.md,               Dr  Cat-
    Dr. Bloxham.                Dr. Ryan,                 Dr.'Conquest
    Dr. James Iilundell,         Dr. H. Davis,              ]),..  jj  \)a^s '
    Dr. Chowne,                Dr. Rigby,                 Dr  «?»'», l  a 'i   ,i
    Dr. F. H. Ramsbolham,       Dr. Robert Lee,            Dr'. Sweatm      '
   And in Paris.                                                    an-
    Dr. Moreau,                Dr. Velnean,                n,. p    n ■  .
    Dr. Marjolin, &c, &c &c.                                '' ' dU  Dub°«. 
21
  1 beg to add, with every respect to your important station, that I entirely dif-
fer from your views as to the result of wearing my Supporter in the case  you
allude to.   It is a suspicious-looking sort of thing—a poor resource to fly to, to
aid a sinking cause.   It is remarkable and worthy of attention that this comes
from Dr--------, known to be the most active opponent the improved treatment
has met with, perhaps, in America.  Therefore the charge is vitiaied  by the
prejudiced source from whence it springs ; it  deprives the charge of its power.
  You could not, sir, if you would, produce retroversion by my Supporter.
  It is worthy of notice that Dr.------, who never  himself employed it, has
yet been able to  present such an allegation ; it carries contradiction on its face.
Your motives and objects are clearly discernible, and will be duly appreciated
by the enlightened body of which you are a member.
  It will, I trust, sir, be out of your power to  impede the use of my Supporter.
The attempt to do so, in my opinion, will be deemed  a last resort—a poor  kind
of Ratio ultima  Regum.                             SARAH  BEITS,
   Philadelphia, Dec. 26th, 1843.             Eleventh and Walnut  Streets.
   From the Medical Examiner, No, 13, Vol.  I.,  New Series.  Philadelphia,
                            March 26th, 1842.

                 ON THE " UTERINE SUPPORTER."

                           BY WM. HARRIS, M. D.

  A Lecture upon Prolapsus Uteri, which 1 delivered at the Medical Institute,
in the spring of 1839, was published in the May number of the Medical  Ex-
aminer of the same year; and since that time the advantages  and disadvan-
tages of the uterine supporter have been freely discussed,  and its  usefulness
extensively tested.
  Like every new improvement, the Supporter met with formidable opposi-
tion, even from gentlemen of elevated standing in the profession, but it slowly
crept into favor, and its superiority is now almost universally acknowledged,
More than  a hundred medical gentlemen in this city, among whom are Pro-
fessors in each of the four Medical Schools, have tried it on their patients af-
flicted with prolapsus uteri, and are testifying  to  its great advantages over
eveiy other apparatus employed by the profession;  and more than a thousand
females, either radically cured, or  materially benefitted, are earnestly recom-
mending it to their fellow sufferers.
   With°whom the idea of an external  uterine supporter originated is uncertain;
I apprehend, however, that the honor is due to  the late Dr. Dewees,  whose
labors have contributed so much to enlarge the boundaries of obstetrical science,
and to adorn the history of the earliest and most celebrated  medical institution
of our country, that  he well deserves the appellation of the  Father if American
 Obstetrics.                           .      FT  .    .
   While attending one of his lectures, in the University of Pennsylvania, upon
prolapsus uteri, I'heard him remark that the pessary occasioned, in some fe-
males so much  uterine  and vaginal  irritation, and  consequent,  leucorrhoja,
that they were obliged to discontinue the use of it, and that he hoped an  instru-
ment would some d"iy ba invented that would restore the displaced organ, by
 makino- external  oressure upon the abdomen and perineum.   This remark, per-
 haps through some medical student, reached the ear of Dr. Hull of New York,
 and induced him to bring  forward the  first uterine supporter  that was ever
don  now residino- in Philadelphia.   Mrs. Betts invented the apparatus for her
own case, which,"tinder the  care of Professor Jackson, was conducted to such 
a successful issue, that sho was induced afterwards to offer the  instrument to
the medical profession.  In the last three years, I have tried her supporter in
my own practice, and inconsultation, on upwards of fifty females, with great suc-
cess, in some producing radical cures, and in others   great comfort,  so  that
feel constrained to give it  my cordial  recommendation.
  The time required to perform  a radical cure by the supporter, varies from
three to eighteen months,  in most cases one year.
  A lady of this city, 38 years of age,  afflicted with  procidentia uteri, con-
sulted  me in  her case about three years since.  She remarked that she  had
worn pessaries  of  various kinds for  a length of time, all of which produced
great iritation and  leucorrhcea, and that she ascribed to this cause an abortion
that she had had a few weeks before.  She said this misfortune had caused
her deep sorrow, having but one child, and that she was determined never again
to submit to  the introduction of a pessary.  Besides the  depression  of  her
spirits, her general  health was very feeble, and the only exercise she  attempted
to take, was to walk down three or four steps, from her chamber  to the  dining
room to eat, her meals.
  I procured  for her a uterine supporter, and after  it was applied and  proper-
ly adjusted, she felt so comfortable and strong,  that it being Sunday morning,
she decided to walk with  her  husband to  church, and, returning home little
fatigued, she  went again in the afternoon.  By the use of the supporter, chaly-
beates  and exercise in the open air, on foot and  in  a carriage,  she  improved
so rapidly that after one year her health was established and her procidentia
cured ; and now she is able to attend to all her usual avocations, without  the
incumberance of a  supporter.  Nevertheless, as a prophylactic measure, when
she expects to walk for three or four hours, shopping, or making morning calls,
she puts it on.  She is now one of the  most healthly  and  efficient ladies in
Philadelphia.
  Another lady, about six weeks  after  her confinment, fell down  stairs, by
which  a prolapsus  uteri was produced.   Being sent for immediately, I ordered
her to bed, where she was confined three days, at  the end of which time Mrs,
Betts applied a supporter,  which in three months effected  a radical  cure.   A
number of other cases, under my care, were radically cured,  after a great vari-
ety of pessaries had been tried in vain by  the most skilful physicians.
  For my success in the treatment of  these cases, 1 am much indebted to  the
assistance of the inventor of the apparatus.  I now cause her to apply it to all
my patients laboring under the complaint, unless objections  are made, so that
she can alter and  adjust it to  each female's particular  shape.   Without  this
precaution, the instrument will not give so comfortable a support to the patient
and a cure will not be so rapidly or effectually accomplished.
  Again : the perineal  pad, when first applied, sometimes produces  great irri-
tation of the skin, and unpleasant heat in the soft parts ; when this is the case,
1 cause the pad to  be removed  for a few days, and instead of it, to have applied
under the perineal  strap, a soft folded napkin; and  this substitution  of  the
napkin for the pad  is always  necessary during  the menstrual period, or what
sometimes answers equally well, to roll the napkin round the pad, to prevent it
from being soiled.   Females, indeed, that are very particular, wear a piece of
old linen or muslin around the pad always, that it may be  kept clean.   Mrs
Betts'  supporter has been  introduced  into practice in New  York, and in vari-
ous other parts of the United States, and  the testimony in  its  favor, from all
quarters, is unequivocal.
  1 have found the supporter to be, also, an  effectual preventive  of habitual
abortion.  Some females of leuco-phlegmatic temperament, great nervous irri-
tability and  feeble  health, are subject to habitual abortion^which ordinarily
takes place  during the early months  of pregnancy.   At  the return of every
mensuual period, regular  periodical uterine pains come on, threatening a pre-
mature delivery.   Such cases, under proper management, may be conducted 
23
safely to the full period, and the accoucheur have the pleasure of presenting to
the anxious mother a living child, as the reward of her repeated sufferings.
  As soon as the threatening pains come on, direct the patient to go immediately
to bed, order dry cups to be applied over the sacrum, sometimes scarifying two,
or four, so as to take away  from two to four ounces of blood, according to cir-
cumstances, administering at the same time an anodyne enema, consisting of
• wo ounces of flaxseed  tea, or of a thin solution of starch, and from forty to a
hundred drops of laudanum, according to the urgency of the symptoms, and
the capacity of the patient to bear narcotics.   The foot posts  of the bedsteads
should be raised, at the same time, about six inches, by placing blocks of wood
under them, so that the womb may be thrown upward, and points of irritation,
thereby, be removed.   This treatment, in a few hours,  will put a stop  to the
threatening symptoms, but the patient must not be allowed to rise from her
bed under  two or  three days, as the erect posture is apt to produce a relapse.
Before she rises from her bed, a supporter should be carefully applied,  which
will give her great comfort, and enable her with safety to attend to her usual
avocations.
  Some authors recommend that patients,  under such circumstamces, should
be kept in  bed throughout  the  whole period  of gestation ; but  such practice
cannot be too much condemned, as in almost every instance itinjures  or destroys
the female's health.  Pregnant females  that suffer from prolapus uteri during
the three first  months  of gestation,  but at no other  period, have also derived
great comfort from wearing the supporter.
  For a description of this apparatus, and the manner  in which it is  applied,
I refer the reader  to the 329th page of the Medical Examiner, vol.  2d.  Every
medical gentleman, however, from a glance at the  apparatus, would at once
comprehend the manner in which  it should he applied.  Mrs. Beits' last im-
provement, which  she  calls her laced supporter, is decidedly the best.
  Notwithstanding the success that has attended the use of  the  supporter  in
Philadelphia,  there are still a few medical gentlemen, who occupy an enviable
position in the profession, that resist the introduction of this apparatus in their
respective  circles of practice.   They object to its  use because, as they allege,
the pressure by the broad pad or belt over the hypogastric region,  must force
the intestines downwards  against the pelvic viscera, and thereby increase, in-
stead of removino-  the disease.  If this be true, it is  a valid objection, and  the
supporter ouo-ht to be laid aside.   Let the facts decide.  The  axis of the pelvis
is not parallel with the axis of the  body, but strikes off from it at an angle of
forty-five deorees.  The centre of  gravity being, therefore, in the direction of
the axis of the bodv, the weight of the intestines must fall upon the  symphysis
pubis and  upon the parietes of the abdomen, especially  if the female has borne
children, and is consequently a little corpulent.  Now it must be admitted, that
if the pressure by  the supporter were backwards and downwards, the intestines
would be crowded upon the fundus uteri, and the displacement be consequent y
increased; but as  the force which it exerts is upwards and backwards, exactly
in the direction of the plane of the superior strait of the  pelvis, or at right
anales with its axis, I  contend that it completely removes the  weight  of  the
intestines from the pelvic  viscera, and that the uterus has consequently a ten-
dency to rise to its natural position through  the contractile power  of its liga-

"'Tnts objection then, being, as I apprehend, completely  removed, I proceed
to examine another, which is, that the perineal pad, supported by^the strap that
passes between the limbs, does not raise the uterus  sufficiently high to  restore
it to Us primitive situation, and that a radical curecan therefore never be effect-
ed.   As those aentlemen who condemn the supporter maintain that the pesoary
is better calculated to restore the  displacement under discussion, I  shall con-
sider this opinion  first.                                  ,      ,    ,   a
   Pessaries are made of various materials, and of different shapes,  but the flat
circular pessary and the spherical pessary, made of glass or silver gilt, are the 
24
 kinds most in use in Philadelphia.  The flat pessary is about  half an inch in
 thickness, and two  inches in diameter;  in  introducing and  adjusting which,
 it is recommended that it be placed in the vagina upon its  edge, with the con-
 vex surface towards the rectum, and  pdrallel°with it, tl)3 upper edge in the cul
 de sac  at the upper  end of the  vagina, and behind the posterior lip of the 03
 uteri, and the lower edge resting upon  the perineum  or  floor of the pelvis,
 near the point of the os coccygis.  It is maintained that the  pessary thus  ad-
 justed will raise the  uterus iis whole breadth, nearly two inches, and their sus-
 tain it  until  the ligaments that support the uterus have time to contract and re-
 cover their primitive tonicity, and  a radical cure thus be accomplished.  This
 is very plausible in  theory, but difficult to reduce to practice.
   If we commence at the posterior part of the superior strait of the pelvis, and
 pass along the hollow of  the sacrum and  coccyx,  and  the floor of the pelvis,
 up to the top of the symphysis  pubis, we shall describe  an arch amounting
 to nearly a  semicircle.   Now it is  known that a weight capable of sliding
 upon a curved surface, will not rest until  it reaches the lowest position; conse-
 quently, if a  pessary be placed  in the vagina parallel with  the rectum, while
 the  patient is lying upon  her back, it will remain  in that  position so long as
 she retains the recumbent posture; but as soon as she assumes the erect atti-
 tude, the pessary will slide down and rest with its convex surface parallel
 with the perineum;  and now the thickness of the pessary, half an  inch, is  all
 that interposes between the os uteri and floor of the pelvis.   The  uterus is
 therefore, only raised half an inch  higher in the vigina than it was  before  the
 pessary was  introduced, and if instead of the flat circular, the oblong or oval
 ring pessary  were used, after it slides down, the os and  cervix uteri would
 pass through it, rest upon the  perineum, and therefore not be elevated at all.
 The globular pessary would answer a better purpose,  if the mouth  of  the
 womb would rest upon  the top of the sphere—but as  it  will slip behind  or
 before the spherical pessary, it is very inefficient.
   Besides, if the pessary is found to  answer effectually the purpose for which
 it  is designed, why such an interminable  change in its shape and dimensions?
 Now if it can be demonstrated that the perineal pad and strap of the supporter
 is  capable of  raising  the uterus  more  than half an  inch, and retaining it there
 permanently, as much will be accomplished by  the  supporter as can°be done
 by the pessary, and the patient have the advantage  of using an apparatus  that
 is  less irritating, and less offensive to her   sense of delicacy.
   To prove this will  not be difficult. The distance from the point of the os occy-
 gis on the arch of the pubis is four inches  and a half, which is filled  up by very
 elastic soft parts, that extend in  the antero-posterior direction, not in a straight
 ine, but curved  downwards, so that  the  centre of  the  convexity  projects'at
least one inch below  a straight line.  Now it requires no  gieat stretch of the
irnaginanon to suppose that the  convexiiy of the perineum  could be  pressed up
by the pad to  a straight line, nor is  it difficult to conceive that by gradually
shortening the perineal strap, the pressure  might in time be so increased as  to
 raise these parts one inch above the straight line,  thereby raising the uterus
 two inches, which 1S more than can be  accomplished by the pessary, even  if
 it could  kept upon its edge, and parallel  with the  rectum
   The principle on which  the Supporter acts in restoring the  prolapsed uterus
to  its natural  position, may be better understood  by stating that the direction
of the vagina is backwards and upwards, a little  above thehorizontal line, and
 hat the perineal pad,  by pressing the lower against iheupper side of this canal,
would prevent the uterus rom descending, if applied as it  ought to be, before
 the patient rises from her bed.                              °       ' uc,u,p
   Again, if the uterus be low down in the vagina, that organ beino-  somewhat
of a conical shape, and the apex downwards, the pressing the two  Sdw of
the vagina together, would make the womb rise         "
  Such are the views which I entertain with  regard  to the use of the sunnor-
 er in cases of prolapsed womb ; and I have the satisfaction  to know  ffin
hold  these opinions in common with a lanre maioritv of ihe  mpHi„,i ^  r  •
in  and around Pdilahelphid.           ° raajom? °' '^medical profession, 
 
 
 
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