Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . normal to the patient, but it is generally dueto reflex action produced by fear,and the first touch of the specu-lum. I have a patient, whose ca-pacity readily admits the largestsize (2 ), but whose perineal andlevator ani muscles contract soforcibly at every examination,that even the finger meets withopposition, and every specularexamination (with whatever formof speculum it is made) causesdecided expressions of pain
Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . normal to the patient, but it is generally dueto reflex action produced by fear,and the first touch of the specu-lum. I have a patient, whose ca-pacity readily admits the largestsize (2 ), but whose perineal andlevator ani muscles contract soforcibly at every examination,that even the finger meets withopposition, and every specularexamination (with whatever formof speculum it is made) causesdecided expressions of pain onthe part of the patient. Thepresence of a urethral caruncle,which has been inadvertentlytouched by the operator, mayalso give rise to the same reflexspasm. Pendulous nymphae oc-casionally form a momentary ob-stacle to the insertion of thespeculum. The cervix once engaged inthe speculum, one of the first points to notice is the presence and char-acter of discharge from the os, whether it is thin, glairy, purulent, discolor-ed. Attention should then be paid to the size and color of the cervix (nor-mal, pale pink, or purple or mottled), the size of the os (normal, round,. Fig. 37.—Hunters speculum. GYNECOLOGICAL EXAMINATION. 67 transverse, or patulous), the nature of its edges (smooth or fissured). Apurple color of the cervix may mean pregnancy, or may only indicate the
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
