A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs.
- Marc Colombat de L'Isère
- Date:
- 1850
Licence: Public Domain Mark
Credit: A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![direction and elevation of the womb, or because it is less alarming to the delicate feelings of a person subjected for the first time to this trial. This method consists in placing her standing with her back against a partition, with her feet properly separated, and allowing her muscles to be as relaxed as possible. The surgeon kneeling on one knee, and pressing one hand on the hypogaster to force the uterus downwards, introduces the index, anointed with oil, upwards and backwards into the vagina, until he reaches the os tinea?, which, if natural, feels like a circular, firm and resisting ring, giving rise to a sensation, as the elder Dubois judiciously observes, very muclr like that one experiences when touching the tip of the nose betwixt the cartilages. [In the United States it is common to place the patient upon her left side, the hips about eighteen inches from the foot of the bed, the thighs bent at right angles to the body, and the feet against the bed post; a roll of napkins or a pillow betwixt the knees. The surgeon should be seated with his right side towards the patient, or with his face averted. This gives him the use of his right hand in the taxis. It is well to place the left hand outside of the bed clothes or dress, upon the sacral region of the patient, in order to guide the hand used in the exploration to the genitalia. In this way, it is thought here that the least possible shock to the delicacy of the patient is given. In Mr. C.'s method, that shock is too great.—M.] After having fully examined the vagina, the operator should pro- ceed to examine the cervix uteri as to its temperature, its form, its situation, the dilatation of its orifice, its sensibility, its volume, its con- sistence, and also ascertain whether there be any ulceration of it, any erosions or fissures, roughness, exuberance, excrescences, vegetations, haemorrhoids, varices, or polypus occupying the whole or a portion of its circumferance. He ought to be careful not to mistake for actual disease, the rents often met with in women who have had children; such solutions of continuity being nothing more than the consequences of those lacerations, to which the neck of the womb is liable during labour. Having carefully examined the os tineas, the operator ought to try, by pressing the finger as far as possible upwards betwixt the cervix and the surrounding parts, to ascertain the state of its surface. This information is best obtained by touching first with the one and then with the other hand, as, indeed, ought always to be done. The right hand explores the right side of the vagina, and the left side of the cervix, while the left hand operates in the inverse direction, and explores the opposite sides. When the state of all the parts has be- come sufficiently understood, and the successive steps of the inquiry carefully remembered, the hand should be removed as gently and speedily as possible, in order to avoid fatiguing the woman. The index should be examined for the purpose of learning whether it is stained with blood, which is a sign of organic lesion, provided the patient is not actually under her catamenial period. And lastly, for the purpose of more surely knowing the nature and colour of the blood](https://iiif.wellcomecollection.org/image/b21029313_0068.jp2/full/800%2C/0/default.jpg)
