A text-book of diseases of women / by Charles B. Penrose.

  • Penrose, Charles B. (Charles Bingham), 1862-1925.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of diseases of women / by Charles B. Penrose. 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.

    30/570 (page 28)
    ureters are indurated by inflammation they can be plainly felt. By the method of examination here advised the physi- cian will always make a visual examination before mak- ing a digital one. There are several advantages derived from this procedure. In the first place, no examination of a woman is thorough unless a careful visual examina- tion of the external genitals has been made. The discov- ery of discharges and of lesions of the external genitals may throw much light upon the condition found higher up in the pelvis. Again, the examiner protects himself. A great many unfortunate cases of syphilis have been ac- quired by physicians from a primary sore upon the exam- ining finger. A preliminary visual examination enables one to guard against this danger. The primary sore occurs upon the end of the examining finger or upon the web between the index and middle fingers—the part of the hand that is pressed against the fourchette. The hands of the physician should, of course, be clean before making an examination, and the grease or oil which is used as a lubricant should be clean. The hands should always be washed, after separating the parts to make the visual examination, before the finger is thrust into the vessel containing the lubricant. It is best to place a small portion of the lubricant on a plate or a saucer for each individual patient, and thus avoid the danger of contaminating the rest. Carbolized oil, borated vaseline or cosmoline, and a thick sterile solution of soap are good lubricants. Neutral green soap diluted with boiled water to the consistency of thin jelly is a very agreeable lubricant which may easily be washed from the hands and the vagina. If practicable, the woman should receive a vaginal douche of bichloride-of-mercury solution, i : 4000, and the vulva should be washed, before making a biman- ual examination. The examiner should always clean the external genitals of all discharges before introducing the vaginal finger. In this way we avoid the danger of