Practical and operative gynecology / by J. Clarence Webster.

  • John Clarence Webster
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Practical and operative gynecology / by J. Clarence Webster. Source: Wellcome Collection.

    50/336 (page 30)
    pass it gradually into the rectum. It should be passed well up through the folds of the third sphincter \\ inches above the anus ; these sometimes obstruct the finger. The abdomino - vesical and abdominal vesico - vaginal examinations are made chiefly for the investigation of bladder conditions, and will be considered later (p. 33). The abdomino-recto-vesico-vaginal examination is very rarely employed, and is practically unnecessary. The abdomino-rectal examination is important. It is carried out in virgins when it is not considered advisable to pass a finger through the hymen, in atresia or narrowness of the vagina, in cases in which a tumour fills the vagina, in shortness of the vagina, in malformations of the internal genitals, for the purpose of studying the condition of coccyx, rectum, or recto-vaginal septum. The forefinger is used. It should be lubricated, and gradually passed through the anus with a slightly rotatory movement. With it the state of the sphincters, sensitive- ness of the parts, the presence of fissures, tumours, piles, or prolapsus may be made out. Above the anus the wide ampulla is entered, and the third sphincter passed. The following structures may then be palpated : — Posterior vaginal wall, cervix, posterior part of body, utero-sacral and broad ligaments, tubes, ovaries, posterior bony wall of pelvis ; also, pathological conditions in these various structures. Those who have not been accustomed to this method of examination are at first generally in doubt as to the relations of the uterus; the cervix may be mistaken for the body or for a tumour. Bi-manual examination must be conducted with special