The uterine sound / by Murdoch Cameron.

  • Cameron, Murdoch.
Date:
[between 1875 and 1895?]
Catalogue details

Licence: Public Domain Mark

Credit: The uterine sound / by Murdoch Cameron. Source: Wellcome Collection.

    3/4 (page 207)
    in common with it. If it is impossible to feel the point of the sound through the abdominal walls, as generally felt in the normal state, the cause may perhaps be a tumour situated in the uterine walls or near them. We remark at times that a movement communicated to the uterus by the sound does not displace at the same time the tumour in question, and so we are able to say that it does not adhere to the uterus. The sound may at times be useful for the dilatation of a stricture, chiefly of the os internum. This instrument is therefore of very great service, both as a diagnostic and therapeutic agent, but we must not trust too much to signs, many times mis¬ leading. The sound may be found to pass only a small distance into the cavity of the cervix, as, for instance, when a fold of mucous membrane arrests its further progress. In such a case it would be a great error to conclude that because the instrument was thus arrested, there existed an obliteration of the cervix. Again, you may have elongation with flexion. Here the sound might pass in a distance say of two inches, and might lead us to suppose that the uterine cavity was diminished, and that a tumour was present, but by closer observation we find that the sound can be passed further, and that the tumour first found upon examination is simply the fundus uteri, and as we would expect, with the replacement of the uterus the bulging felt in the vaginal space has disappeared. It may seem unnecessary that we should here repeat the warning, never to pass the sound where there is any reason to suspect pregnancy, as then you incur the serious responsibility of producing abortion ; but the too frequent mistake of over¬ looking such a condition demands the repetition of this caution. The utmost care should be taken in the introduction of this instrument, because without this you may perforate the tissue, perhaps already softened, or set up peritonitis. Malignant disease of the cervix or fundus excludes its use, as also acute inflammation of the uterus or its appendages. It has been recommended in special cases ; but it is better to avoid any examination during menstruation, and in no case should the sound be passed without previously having made a careful bimanual examination. To introduce the uterine sound, place the patient as in pass¬ ing the speculum, and pass two fingers of the right hand—viz., the index and middle, up to the cervix, with the knuckles toward the pubes, and in the groove formed by the fingers glide the instrument along, keeping the concave surface directed backwards. Never forget to have the sound warmed previous to its introduction. If the passage is straight, as in