Soranus (II. x) describes plugging for uterine haemorrhage by means of the sound:
Καὶ τρυφερὸν ἔριον ἑνί τινι τῶν εἰρημένων χυλῶν διάβροχον διὰ δακτύλου ἢ μήλης παρεντιθέσθω τῷ στόματι τῆς ὑστέρας. καὶ πολὺ μᾶλλον ἐντεῦθεν τῆς αἱμορραγίας ὑπαρχούσης.
Hippocrates (iii. 34) alludes to applying medicament to the internal os with the sound:
‘Grind the pulp of colocynth, &c., and rub it up with honey and smear it on the sound (περὶ μήλην) making the consistence such that it can enter the os and always be pushed beyond until it has penetrated to the interior of the uterus. When the medicament has liquefied extract the sound, and again in the same way apply elaterium.’
If pus collect in the uterus post partum, or after abortion or from any other cause, it is good practice to pass a sound (μήλην ὑπαλειπτρίδα) into the cervix (i. 471). In another place we are directed to draw off gas in the uterus by fomenting the whole body and the uterus with vinegar and water, warmed specilla being afterwards inserted (μήλας διαπύρους ἐμβάλλοντα).
Again we find the sound applied to correct malposition of the uterus (iii. 140):
‘When the semen is extruded on the third day and the woman consequently fails to conceive, take small soft feathers and tie them together, and foment the uterus as we do the eyes. Make the feathers even at the tips and tie the ends with a very fine thread, and anoint with much rosaceum. Also place the patient on her back on a couch, and place a pillow under the loins, and, the woman’s thighs being extended and separated, insert a sound and turn it to this side and that till it project.’
In all these cases there is no special instrument designated as being used for a uterine sound, only the spathomele (ὑπάλειπτρον) and the olivary probe named. With both of these we have met before. However, I have thought it of historical interest to cast these passages together. It will also clear the way for the discussion of other instruments, whose use is entirely reserved for the purpose of dilation of the cervix.
A more questionable use of the sound is referred to by many authors. During the Empire the death of the foetus was frequently procured both by abortifacients and instruments. Frequent references to the use of drugs for this purpose may be found in the lay writers such as Juvenal and Suetonius (Domitian), and the later medical authors do not hesitate to describe the composition of abortifacient pessaries. It will be remembered that the Hippocratic oath specially forbids this practice.
Uterine Dilators—Solid, graduated wooden.