. Clinical gyncology, medical and surgical. .) METHODS OF GYNAECOLOGICAL EXAMINATION. 51 A good light is most essential. A north exposure is best, for the sun-light is so dazzling as to obscure the view, and the window should be highenough to allow the light to fall over the operators shoulders. A bay-window is bad, as it gives cross-lights. Where good daylight cannot be secured, artificial light serves admirably;any apparatus for illuminating, whether by oil, or gas, or electricity, can beused, provided only that it is so arranged as to be adjustable. It should becapable of being raised or lo
. Clinical gyncology, medical and surgical. .) METHODS OF GYNAECOLOGICAL EXAMINATION. 51 A good light is most essential. A north exposure is best, for the sun-light is so dazzling as to obscure the view, and the window should be highenough to allow the light to fall over the operators shoulders. A bay-window is bad, as it gives cross-lights. Where good daylight cannot be secured, artificial light serves admirably;any apparatus for illuminating, whether by oil, or gas, or electricity, can beused, provided only that it is so arranged as to be adjustable. It should becapable of being raised or lowered, or of being moved to the right or left,to suit different patients. When the patient has been placed in a good position, with the towelsarranged, the nurse should take her place at the patients back, facing thephysician, her left arm resting on the patients thigh and the hand raisingthe right buttock. To do this helpfully, she should carry the hand wellover, so as to hold up the labium majus and the hair and expose thehymen. Fio. ,^J& \ ~-. Method of introducing speculum. Having warmed and well anointed the speculum so that it will easilyslip in, the physician should hold it with the left hand by one blade, andgently insert the forefinger of the right hand into the vagina just farenough for the first joint to be within the hymen. This will protectthe sensitive parts of the vulva from being pressed upon, and at the sametime serve as an entering wedge for the speculum. The beak of the bladeof the speculum should then be carried in on the finger, gentle pressurebeing made on the heel of the blade by the thumb. (Fig. 17.) Slighttraction is to be made backward, so as to depress the perineum, it beingremembered that only in this way can room be gained. The speculum 52 METHODS OF GYNAECOLOGICAL EXAMINATION. should hug the posterior vaginal wall, and it should be borne in mind thatthe direction of the vagina at first is backward towards the promontory, oreven the hollow, of
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