Practical manual of diseases of women and uterine therapeutics ... / by H. Macnaughton-Jones.

  • Jones, H. Macnaughton (Henry Macnaughton), 1844-1918.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Practical manual of diseases of women and uterine therapeutics ... / by H. Macnaughton-Jones. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    long, marked in a graduated scale from the point (2 mm.) to its other end (20 mm.) in diameter. The calibrator is pushed into the urethra as far as it will readily go, and the marking of the meatus is noted.' This indicates the calibre of the dilator to be first introduced. ' The average female urethra,' he says, ' can be easily dilated up to 12 mm. in diameter, with only a slight external rupture. I have never seen a tear more than 2 or 3 mm. in length, and from 1 to 1^ mm. in depth.' In introducing the finger, it must be boi'ne in mind that the safety with which it is used depends upon the size of the digit of the operator, and also on the care and gentleness with which it is inserted. I have never had any permanent bad results from such combined instrumental and digital exploration of the bladder. The circumference of the terminal joint of my fore- finger is 5 centimetres, that of the first 7 centimetres. Laminaria or tupelo dilatation is a thing of the past. Dilatation renders litholapaxy (Bigelow's operation), or lithotrity, comparatively an easy operation in the woman. We need never experience any diffi- culty in relieving the female bladder. Any short tube over 3 inches long, which has been disinfected, will successfully accomplish the necessary operation, if we happen to forget our catheter. Any little warty growth above the nymphse or urethra should demand our attention, also any discharge pouring from its orifice. In ordinary vaginitis the orifice of the urethra has not generally an inflamed, pouting appearance. It frequently has in gonorrhoeal inflammation. Caruncle, warts, tumours, and hypertrophied states of the nymphse occasionally occlude the orifice of the urethra. The Vagina.—This canal measures from 2J to 3 inches along its anterior wall, and 3^ to 4 inches posteriorly, varying in length in different women, and in the virgin and multipara. It is narrower below and above, and is very distensible in women who have borne children, widening at its uterine extremity. It is enclosed at the sides by the levatores muscles. Its dilatability explains, especially in atonic states of the vagina, the large accumulation of gas or fluid that collects in the canal. The lower end is surrounded by the striated muscular fibres known as the sphincter vagina?. An illus- tration of these facts is afforded by the forcible and audible expul- sion of air which occurs occasionally after a woman has been in the genu-pectoral position. The muscularity and elasticity of its walls are shown by the inherent power that the vagina possesses of expel- ling its contents; as, for example, expulsion of the after-birth, the speculum, or physometrous collections.