Minor surgical gynecology : a treatise of uterine diagnosis and the lesser technicalities of gynecological practice, including general rules for gynecological operations and the operations for lacerated cervix and perineum, and prolapsus of uterus and vagina for the use of the advanced student and general practitioner / by Paul F. Mundé.

  • Mundé, Paul F. (Paul Fortunatus), 1846-1902.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Minor surgical gynecology : a treatise of uterine diagnosis and the lesser technicalities of gynecological practice, including general rules for gynecological operations and the operations for lacerated cervix and perineum, and prolapsus of uterus and vagina for the use of the advanced student and general practitioner / by Paul F. Mundé. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    situated on the uppermost side, or its grasping between the fingers of one hand, if it be on the dependent side. Thus, in a case of double floating kidney, in a parous woman, I was able to gTasp readily the kidney of the uppermost side, as it was extruded by voluntary expiratory pressure from below the ribs, when in the dorsal position it was almost impossible to iso- late the organs. It is also useful in percussing for free ascitic fluid. For the ordinary purposes of diagnosis (except, perhaps, mere local inspection), the straight lateral position, in my opinion, is decidedly infe- rior to the dorsal, which, moreover, permits the use of either hand for indagation without change of position. It is also evident that whatever displacement of the peMc organs possibly occurs on the side, is not usual to the patient, and can therefore but serve to confuse the diagnosis. Nevertheless, the majority of English gynecologists persist in using the left lateral position, both for indagation and examination with the cylindrical and bivalve speculum. e. Latero-abdominal Position. Next to the dorsal, the latero-abdominal, or semiprone, position is un- questionably the most useful; not, however, for a digital examination, but for the employment of the speculum, and chiefly one pariicular speculum, the duck-bill of Sims. Fig. 5.—Latero-abdominal (Sims) Position. (Hegar and Kaltenbach.) A digital examination can, it is true, be performed, and the other varie- ties of specula introduced quite as successfully (and more advantageously, as will be shown hereafter) in this position as in the straight lateral; but it is chiefly for the exposure of the whole vaginal tract by the duck-bill that this position is useful. The patient lies on her side (right or left; the left is the one usually employed, and is recommended by the discoverer of this position, Sims, because the nurse can best hold the s^Deculum with her right hand), on a