Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ick perception will gain sometimes in-stantaneously the required information in this way. During the exam-ination the patient should keep the mouth open. If the uterus and its appendages are sensitive, or fixed by adhesions,the attempt to force them up toward the outside hand may be futile oreven dangerous. Deep palpation behind the pubes is then necessary.One should remember, however, that even a little force injudiciouslyapplied by either hand may rupture a pus-pocket or tube, and therebylead to serious results. DIAGNOSIS. 57 Bininimal )):i1)KitI(>ii ciiahlcs one to jiidoe of the f()ll<)\viii<z; coiuli-tioiis : tln size, torin, location, position, consistfiicc, and iiiol)ility oithe utorus, the proseiioe or absence of a pelvic tiiiiini-. If tlic nterusis displaced, is it replaceal)le, or is it bound by adhesions, and there-fore irrcplaeeable? If there is a tumor in the pelvis, is it a neoplasmor an inllanunatory swell inn? If the former, it is not sensitive!; if Kidiio: II.
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Vaginal touch, conjoined examination. the latter, it is tender on pressure. Is it connected with the uterus,or the Fallopian tube, or the broad lio:ament, or the ovary ? Is itcystic or solid, malignant or benign? Does it originate in the pelvis,or in the abdominal cavity, and, above all, is it possibly due to preg-nancy? These questions will come up again under the diagnosis ofspecial jiisorders. 58 GENERAL PBINCIPLES. Conjoined Rectal Examination.—Conjoined examination by rec-tal instead of vaginal touch may confirm, disprove, or supplement theprevious observations and impressions. Figure 12. Rectal touch,whether digital or conjoined, may be impeded by coils of intestine inthe pelvis interposed between the finger and the viscera to be palpated. Fif4mE 12.

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