Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier.
- Pierre Cazeaux
- Date:
- 1885
Licence: Public Domain Mark
Credit: Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
65/1140 (page 61)
![tissue. During coition, blood aecumulates in it, dilates it, and thereby causes its erection. The arteries of the clitoris come from the perineal artery, and are distribviied aa in the male, presenting therefore the cavernous artery, which on each side enters the corresponding corpus caverrjosum, and the dorsal artery, -vrhich is disti ibuted to the mucous membrane known as the prepuce of the clitoris. The veins form a plexus arranged in two planes, the most superficial of which furnishes the dorsal vein, whilst the deeper communicates with the veins of the bulb, of the vagina, and of the bladder. The nerves proceed from the perineal branch of the internal pudic; tht y send brandies to the corpus cavernosum, and terminate in the prepuce, which is the principal seat of voluptuousness in the female.] 4. The vestibule is a small triangular space placed at the upper pxrt of the vulva. It is bounded above by the clitoris, below by the urethra, and laterally by the nymphse. 5. The Urethra. — The meatus urinarius is situated just below the ves- tibule, about an inch from the clitoris, and immediately above the promi- nent enlargement of the anterior part of the vagina. The orifice is usually more contracted than the canal, but the tubercle or enlargement just alluded to, enables us to sound females without uncovering them, for it is only necessary to recognize it by the finger in order to direct the instru- ment properly. In my estimation, the following is the most simple method of introducing the catheter without uncovering the patient; I first intro- duce my finger into the orifice of the vagina, and rest its palmar face against the anterior vaginal wall; I then slide the instrument along this palmar face until it is arrested by the fold already alluded to; then I depress the extremity so as to elevate the point of the instrument one or two lines, and in the majority of cases, the canal is easily entered in this manner. [If the first attempt should fail, it may be tried again in another way. The point of the forefinger finds the clitoris, and passes from above downwards to the middle of the vestibule ; the first inequality met with is the orifice of the urethra, into which the instrument can then be inserted. I have often succeeded in this way, after having failed by the ordinary method. In some women, those especially who have borne children, the parts adjoining the meatus are so deformed, that it becomes absolutely necessary to expose the parts in order to introduce the catheter; even then it is by no means easily done, and I have seen the most skilful foiled in attempting it. It may be accomplished with certainty by separating carefully the greater and lesser labia, and then sliding the extrernity of the catheter from above downward along the median line of the vestibule below the clitoris, which is the chief rallying point. During this movemi?nt the instrument falls, so to speak, of its own accord into the orifice of the urethra ; but if slid either to the right or left, it will be sure to go astray. We shall learn hereafter (article Pregnancy) the cause of the difSculties met with in catheterizing pregnant women.] The urethra, a continuation of the meatus urinarius, just described, varies in the female from one to one and a half inches in length. It is large, conical, and slightly curved. Its inferior portion is confounded](https://iiif.wellcomecollection.org/image/b21515013_0067.jp2/full/800%2C/0/default.jpg)
