A manual of gynaecological practice for students and practitioners / by A. Duhrssen ; translated and edited from the 4th German edition by John W. Taylor and Frederick Edge.

Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: A manual of gynaecological practice for students and practitioners / by A. Duhrssen ; translated and edited from the 4th German edition by John W. Taylor and Frederick Edge. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    introduced into the vagina underneath the left thigh of the patient. The advantages of this position, in which we may also carry out the massage treatment of Thure Brandt, lie in the complete relaxation of the abdominal walls, and in the ease with which the palpating right hand moves in all directions, while the finger within the vagina examines equally well the whole pelvic contents, the left forearm of the surgeon being suj)ported by the sloping end of the couch. Those attending my physicians’ and students’ course, in which I allow every one to examine the patients, first on the examination table and then on the couch, are always agreeably surprised at the facility with which on the latter they are able to palpate the previously incom- pletely or not readily felt uterus, and even the ovaries. The examination by Thure Brandt’s method can also be carried out with advantage when the patient is con- fined to her bed. It is only necessary to take care that the patient lies upon a firm mattress. The position across the bed, as used in midwifery practice, is the most com- fortable for examination with the speculum and for therapeutical manipulations. The Examination with the Speculum.—After the bi-manual examination the practitioner undertakes the inspection of the vagina and cervix with a speculum. At the vagina he considers the condition of the mucous membrane; the quantity and quality of any retained secretion; the situation and size of any existing fistulas, ulcerations, or new growths. At the ])ortio, its shape and colour (port wine colour in pregnancy) and the presence here of ei’osions or new growths. Within the os uteri he notices a greater or less amount of discharging miacus, either clear or streaked with yellow (in the latter case there is some uterine or cervical catarrh), and after removal of this with a wad of lint, he may view the lowest part of the cervical mucous mem- brane in patients who have borne children. After establishing the diagnosis, the speculum further