Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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var outlet. The body of theuterus lies within the pelvis, but at a lower level than normal. The depth of the uterinecavity measured by a sound is five inches. lapsed. A positive diagnosis can only be made by locating thefundus of the uterus in a bimanual examination. The patientbeing under ansesthesia, firm traction upon the cervix with thevulsella forceps will determine the exact extent of the displacement(Fig. 75). The finding of the cervix at a lower level than is normalwill not suffice for a diagnosis. Such a finding is not seldom dueto an elongation of the cervix, either with or without a descent of 228 SPECIAL DIAGNOSIS the uterus. Without having located the fundus it cannot be saidthat the uterus, as a whole, has descended. By a rectal examina-tion it is often possible to locate the point of juncture of the cervixand uterine body, and estimate with some degree of accuracy thelength of the cervix. Measuring the depth of the uterus by thesound will give exact information. Fig. 76
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Prolapsus uteri. The external os is lacerated and eroded. On the side of the prolapseduterus is a decubitus ulcer. (Case of J. C. Websters.) It is more difficult to determine whether it is the supravaginal orinfra vaginal portion of the cervix that is elongated. This is ascer-tained by noting the depth of the vault of the vagina. If decreasedin depth, the supravaginal portion of the cervix is elongated; if itremains at the normal level, the infravaginal portion of the cervixis elongated. Both the infravaginal and supravaginal portions of DIAGNOSIS OF MALPOSITIONS OF THE UTERUS 229 the cervix may be increased in length, in which event there will belittle change in the depth of the vault of the vagina. When the uterus is completely prolapsed it is possible to approx-imate the hands over and above the body of the uterus, havingmerely the vaginal walls and bladder between the fingers. Byso doing it is possible to absolutely exclude all other conditions(Fig. 77). Can the displacement of th

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