What to observe at the bed-side and after death in medical cases / published under the authority of the London Medical Society of Observation.

Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: What to observe at the bed-side and after death in medical cases / published under the authority of the London Medical Society of Observation. 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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    228. Protrusion from vulva externally.—number of protrusions; amount; form;—condition of surface of protrusion; colour; presenting appearance of os uteri upon it, etc.—Effect of posture or catheterism on protrusion. -— Palpation of protrusion; — distin- guished as uterus by its form, size of uterus;—pro- trusion soft, elastic, fluctuating.—Percussion of pro- trusion, resonant, dull. Examination by the touch, through the Vagina. 229. Vagina:—orifice, its size; contracted by muscles; surrounded by swollen mucous membrane;—direction of vagina in relation to pelvis ; length ; breadth; nar- rowing of any part, its exact seat and degree, its apparent cause; complete closure of canal, its seat; — mode of termination of vagina. — Mucous mem- brane : smooth, velvety, rough, corrugated, swollen, or thickened; presenting puckering, frama, vegetations, etc. (their seat, etc.)—Pulsation of arteries perceptible or not ? generally or limited (to what part) P—Tension, hardness, or resistance to pressure at any part of the wall?—Ruptures, into rectum, into bladder;—other abnormal openings, them seat, communication with felt tumours;—nature of matters discharged from the open- ings, hail-, portions of foetal substance, bones, etc.— Tumours attached to wall of vagina; their position, size, form, etc.; sessile or pedunculated ? their sen- sibility.—Contents of vagina; a clot; a polypus, its size, shape, consistence, sensibility, etc., traced to os uteri (232); foreign substances in vagina (pessaries,etc.) 230. Urethra:—thickening in its course, its extent, hardness, etc. (judgment assisted by simultaneous use of catheter). 231. Bladder: — distended; protruding anterior vaginal wall; fluctuation felt on impulse over supra- pubic region;—effects of pressure in supra-pubic region on tumour; effect of catheterism, of efforts at mictu- rition. — Hard tumour about situation of base of bladder; its form, irregularity, extent, mobility, etc. 232. Uterus.—Neck: its position, elevated, de- pressed (amount of each), displaced towards either side of pelvis, forwards or backwards;—axis altered in direction, placed horizontally (partially or completely ?); os uteri directed forwards, backwards, or to either 49 e Protrusion from vulva— inspection. palpation. percussion. Examination by Vagina. Vagina— orifice, direction, size. closure. termination, mucous mem- brane. pulsation of arteries. resistance, ruptures, etc. tumours, contents, clot, polypus, foreign sub- stances. Urethra. Bladder— distension. tumour. Uterus- neck.