A system of gynecology . obvious, although not always suf-ficient, cause as hemorrhoids. The specula of utility are either tubularor valvular. For general purposes the blade of a small Simss willsuffice for diagnosis, although a much more convenient instrument,when the examiner is without an assistant, is that devised by Kelsey of New York. The specialadvantage of this instru-ment is the fact that alarge surface of the rectalmucous membrane may beinspected through it with-out the anus being stretch-ed to any great the form of in-strument used, either re-flected light, or that f
A system of gynecology . obvious, although not always suf-ficient, cause as hemorrhoids. The specula of utility are either tubularor valvular. For general purposes the blade of a small Simss willsuffice for diagnosis, although a much more convenient instrument,when the examiner is without an assistant, is that devised by Kelsey of New York. The specialadvantage of this instru-ment is the fact that alarge surface of the rectalmucous membrane may beinspected through it with-out the anus being stretch-ed to any great the form of in-strument used, either re-flected light, or that fromone or another of the port-able electric light appara-tuses recently devised, isalmost a necessity for exactdiagnosis. The patientmay occupy either the dorsal or the left-lateral position, although a betterview may be obtained from the latter. The points to be noted throughthe speculum, some of which must escape the examining finger alone,are—the color and integrity of the rectal mucous membrane, erosion, Fig. Kelseys Rectal Speculum. SPECIAL INSTRUMENTAL MEANS OF DIAGNOSIS. 319 ulceration and fissure, polypi, carcinoma, and fistulous openings fromischio-rectal or pelvic abscesses. B. Dilatation of the Cervix for Diagnostic Purposes.—Inorder to explore the interior of the uterus with the finger, the cervicalcanal must first, apart from the puerperal state, be widely dilated. To Fig. 130.
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectwomen, bookyear1887
