The principles of midwifery : including the diseases of women and children / by John Burns.

  • Burns, John, 1774-1850.
Date:
1811
Catalogue details

Licence: Public Domain Mark

Credit: The principles of midwifery : including the diseases of women and children / by John Burns. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    57/648 (page 35)
    -65 carried on for an inch and a half farther, would touch the second bone of the sacrum. The uterus being much con- nected with the bladder at its lower part, it follows, that when it rises up in pregnancy, the bladder will also be some- what raised, and pressed rather more forwards; and the Va- gina being elongated, the urethra^ -which is attached to it, is alsp carried a little higher, and, in its course, is brought nearer the inside of the symphysis pubis. In those women who, from deformity of the pelvis, or other causes, have a very pendulous belly, the bladder, during pregnancy, is sometimes turned over the pubis, the urethra curved a little, and its opening somewhat retracted within the orifice of the vagina. When it is necessary to pass the catheter, it is of great consequence to be able to do it readily, and this is by no means difficult to do. The woman ought to be placed on her back, with her thighs separated, and the knees drawn a little up : A bason is then to be placed betwixt the thighs, or a bladder may be tied firmly to the extremity of the ca- theter, to receive the urine. The instrument is then to be conveyed under the thigh, and the labia separated with the finger. The clitoris is next to be touched, and the finger run gently down the fossa that leads to the orifice of the urethra, which is easily distinguished, by its resemblance to an irregular dimple, situated just above the entrance to the vagina. The point of the instrument is to be moved light- ly down the fossa after the finger, and it will readily slip into the urethra. It is then to be carried on in the direc- tion of the axis of the outlet of the pelvis, and the urine drawn off. This operation ought always to be performed in bed, and the patient is never to be exposed. In cases of fractures, bruises, Sec. where the woman cannot turn from ber side to her back, the catheter may be introduced from behind, without moving her. When the bladder is turned, over the pubis, as happens in cases of great deformity of the pelvis, it is sometimes requisite to use either a flexible cathe- ter, or a male catheter, with its concavity directed forward. When the uterus is tetroverted, if we cannot use a female catheter, we may employ a male catheter, directinj the can-