Essentials of pelvic diagnosis with illustrative cases : and an appendix on examination of blood, etc / by E. Stanmore Bishop Chas ... ... Chas. H. Melland.

  • E. Stanmore Bishop
Date:
[1903]
Catalogue details

Licence: Public Domain Mark

Credit: Essentials of pelvic diagnosis with illustrative cases : and an appendix on examination of blood, etc / by E. Stanmore Bishop Chas ... ... Chas. H. Melland. Source: Wellcome Collection.

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    CHAPTER II. ON FHE USE OF THE FAND: i OTHING is more necessary in abdominal or pelvic diagnosis than practice in the use of the hand. Every opportunity should be taken to develop the sense of touch, since, by its means alone, as in bi-manual examination especially, very many conditions can be detected. For this purpose both hands should be employed. The first thing is to see that the patient is in an easy position, and perfectly supported. If he or she has to balance himself or herself on an insecure support, or in an uncom- fortable attitude, all the muscles of the abdominal walls will remain in a state of tension, opposing a barrier which feels like wood to the attempts of the observer to detect what hes below. The patient should be placed first flat upon the back, with the shoulders somewhat raised and the abdominal wall exposed. In the young male patient, or female who has had no children, it will be gently convex, with firm but supple walls. In the male it is usually firm, convex, and, except in old men, unwrinkled. As age advances it becomes more flabby, or more bulky and convex. But in all, the condition of the abdominal wall depends chiefly upon the presence or loss of muscular tone and of fat. If the patient has suffered from any disease accompanied by rapid loss of flesh, the abdominal wall is likely to be relaxed and flabby. In the woman who has had children it will be either: (1) Flabbily lying upon its contents, with a tendency to bulge over at the loins, wrinkled trans-
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