Prolapse of the ovaries / by Paul F. Mundé.

  • Mundé, Paul F. (Paul Fortunatus), 1846-1902.
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: Prolapse of the ovaries / by Paul F. Mundé. Source: Wellcome Collection.

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    ♦ right, partly because, according to Portal,1 it is situated somewhat higher, owing to the dextral inclination of the fundus uteri; partly because the rectum, in its (in the fe¬ male) generally more or less distended condition, prevents the left ovary from sinking into the pelvic brim. Freund2 found the left ovary to lie more perpendicular to the uterus, and the left border of the latter organ slightly turned to¬ wards the anterior abdominal wall. The normal ovaries are often palpable by combined recto- abdominal examination, but this method usually offers no advantage over the vagino-abdominal plan, except where vaginal exploration is impracticable. The higher the perineum can be pushed up by the knuckles of the examining hand (the hand used by me be¬ ing generally the left), the easier will the ovaries be reached. Without bimanual palpation, the normal non-prolapsed ovaries are not ordinarily palpable. STATISTICS. Among i,600 unselected gynecological cases which have come under my care during the last few years, and of which I have accurate notes, there were 145 cases in which one or both ovaries were palpable. In 68 cases the ovaries retained their normal position ; in 77 cases they were prolapsed. in 53 cases the ovaries were normal in size; in 92 cases one or both were inflamed or enlarged.3 Of these 145 cases, 139 were married, and but 6 single ; 8 were nulliparae, and 131 parous women. In 36 of these 145 cases one or both normal non-dis- placed ovaries were palpable by bimanual manipulation ; 23 times the left, 5 times the right ovary, 8 times both ova¬ ries. 1 Anatomie medicale, tome v. 2 Die Lageund Entwickelung der Beckenorgane, etc. Breslau, 1863. 3 By “inflamed and enlarged” I mean that the ovaries were dis¬ tinctly palpable, and their increase of size and their outline clearly traceable. Mere diffuse tenderness or resistance in either or both ova¬ rian regions was, of course, much more frequent.