. The diagnosis and treatment of diseases of women. , and the knees are drawn up to relax the ab-dominal muscles (Fig. 112). The abdomen is then examined by the various me-thods previously explained. The vaginal and vagino-abdominal examinations, with deep bimanual palpation,may be conveniently and satisfactorily conducted with but little disturbance tothe patient by observing the following directions, some of which were partiallycarried out in arranging for the abdominal examination: METHOD OF EXAMINATION ON BED 109 1. Direct the patient to move close to the left edge of the bed. There is but
. The diagnosis and treatment of diseases of women. , and the knees are drawn up to relax the ab-dominal muscles (Fig. 112). The abdomen is then examined by the various me-thods previously explained. The vaginal and vagino-abdominal examinations, with deep bimanual palpation,may be conveniently and satisfactorily conducted with but little disturbance tothe patient by observing the following directions, some of which were partiallycarried out in arranging for the abdominal examination: METHOD OF EXAMINATION ON BED 109 1. Direct the patient to move close to the left edge of the bed. There is butlittle disturbance — she lies just as she is in the bed, except nearer the left edge(or the right edge, if the examiner uses the right hand for the internal palpa-tion). A patient seriously sick, even with peritonitis, may usually be moved oversufficiently without much pain. 2. Remove the heavy bed-clothing, all except the sheet with perhaps a lightblanket, and have the patient draw up both knees so that the feet are near thebuttocks (Fig. 113).. Fig. 117. Another method of arranging a bed-patient for examination of external genitals. Tliis is usefulwhen the patient is very sick or when movement is painful. The hips are simply slipped to the edge of thebed and one foot placed on a chair. 3. Sit on the bed, or on a chair placed at the side of the bed, against the patientsleft foot and direct the patient to separate the knees widely. The sheet is thenraised sufficiently to permit the examining hand (with the index and middle fingerswell lubricated) to be passed between the patients thighs (Fig. 114)—not underone thigh, as ordinarily directed. The hand is carried to the perineum and theexamining fingers are introduced deeply into the vagina, taking care to depress theperineum sufficiently to allow their introduction without pain. 4. After the simple vaginal examination is completed, then the right hand,passed under the sheet, is made to depress the abdominal wall into the pelv
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Keywords: ., bookcentury1900, bookdecade1900, booksubje, booksubjectgynecology
