Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    72/332 (page 52)
    3. Syphilitic or malignant stricture ; 4. Tubercular, malignant, or syphilitic ulcer. All the above are situated fairly low down, 5. On passing the finger higher up, on either side of the median line, tender and slightly enlarged ovaries can be easily palpated. 6. The usual cervical protrusion may be absent, but above its site another swelling may be encountered: this may be the fundus of a retroverted or flexed uterus, a prolapsed ovary, a prolapsed and dilated Fallopian tube, or cellulitic deposit. By a combined palpation or abdomino-rectal examination, the posterior and often the upper surfaces of these tumours can be made out, thus giving valuable aid towards an accurate diagnosis. 7. If a swelling is met with high up and projecting from the posterior rectal wall, it is probably a growth from the sacrum, such as enchondroma. The rectal speculum, described in all works on Surgery, may be inserted to inspect the condition of the mucous membrane. Insertion of the whole hand into the rectum as a method of exploration is not a proceeding to be recommended. In the virgin, the pelvic organs should always be explored by the rectum, in preference to making a vaginal examination. IV. Examination by the Bladder. A uterine sound is sufficient for this purpose. In the normal and empty bladder, it should pass to 5 inchc-s, including the urethra, which varies in length. Note whether there is pain in introduction of the instrument into the urethra, more especially at its orifice or when the bulbous end is travelling along the lining membrane. No abnormal sensation should be produced by pressure of the bulb against the healthy bladder wall, but in cystitis this is followed by acute pain, sometimes amounting to agony, and a desire to micturate. The condition of the vesical mucous membrane, whether rough or smooth, should be observed; stone may be examined for in the usual way. Vesico-rectal examination.—In the diagnosis of inversion of the uterus the sound should be held in the bladder, its concavity back- wards, and the left index-finger placed in the rectum; if the two can be brought into close apposition, rectal and vesical mucous membrane and peritoneum only intervening, this indicates the absence of the body of the uterus.