The student's guide to the diseases of women / by Alfred Lewis Galabin.

  • Galabin, Alfred Lewis, 1843-1913.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to the diseases of women / by Alfred Lewis Galabin. Source: Wellcome Collection.

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    rectum is more effectual than by the vagina, since tfc leverage is greater, and it may sometimes be coi veniently applied when the uterus is found incomplete] restored after adjustment of a pessary. (2.) In the postural method the object is to plao trie patient m such a position that the inlet of th pelvis looks vertically downward, the abdoimna- muscles are relaxed, and the weight of the abdomina contents tends to produce a negative pressure in the pelvis. If air be at the same time allowed to enter tlxl vagina, by separating the labia, if necessary, the va«i5 becomes distended into an actual cavity, the uteru] recedes, and the fundus may be restored by this mean! alone, its own gravity assisting in some small measure} ine recession of the fundus may also be assisted bj pressure _ from one or two fingers in the vagina o{ rectum. Sometimes, however, the fundus nierell recedes out of reach, the retroflexion or retroversion remaining unrectified, and the third method is tlier) the only effectual one. In carrying out the postural method, the patient may be placed in the knee-elbcrsj or genu-cubital position on a hard bed or sofa] Care must be taken that the thighs are exactly vertical! and the chest low. In this way the axis of the trunH may be inclined as much as 35° to the horizon, thd hips being higher than the shoulders, a position which] will give the best result, taking the normal pelviij inclination as 55°. Some authorities reject the kneel elbow, and are content only with the genu-pectoral knee-chest position. Most persons, however, will fl if they try the experiment of kneeling in this posit on the floor, that it is impossible to touch the sa plane with the chest. Moreover, to increase the ink™ nation of the trunk beyond 35° would diminish thcj efficacy of the position. It is often of use in retro- flexion or retroversion to instruct patients themselves to adopt this position once or twice a day, as well as to lie, as far as possible, in the prone, or semi-prone position when in bed. or nd, i>'ii 1116 idi-