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 . , when we consider thatthe distance from that point to the fundus is only 1£, and that the suddenforcible passage of the apparent obstruction might result in the tip beingdriven sharply against the sensitive fundus, and perhaps through it. Infact, the less the fundus is irritated by the sound after it has once beentouched, the better. The fundus thus reached, and the patency of theuterine canal, and the tenderness of
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 . , when we consider thatthe distance from that point to the fundus is only 1£, and that the suddenforcible passage of the apparent obstruction might result in the tip beingdriven sharply against the sensitive fundus, and perhaps through it. Infact, the less the fundus is irritated by the sound after it has once beentouched, the better. The fundus thus reached, and the patency of theuterine canal, and the tenderness of the internal os and fundus noted, theinternal finger, which all this time has retained its position against the cer-vix, is pressed firmly against the sound at the spot where it issues fromthe os, and the sound is withdrawn with the finger in that position; the GYNECOLO&ICAL EXAMINATION. 97 point thus marked on the sound will indicate the length of the uterinecavity. In a normal uterus the finger will be arrested at the small knobwith which every Simpson sound is provided at a distance of 2£ fromthe tip. The approach of this knob should indeed be used as an alarm to. Fib. 87.—Manner of introducing the sound In anteflexion. (P. F. M.) the internal finger that the tip of the sound is near, or at the character of the secretion attached to the sound and finger, if any,should be noted. When the uterus occupies the normal position, and the external andinternal os, and whole uterine canal arewidely patent, and the latter devoid ofentangling rugosities, the passage of thesound is an easy matter, even to the be-ginner. But, when the cervix is turnedfar back, or curled up anteriorly, when theexternal os is scarcely perceptible, or thereis a sharp flexion, particularly anteflexion,of the body of the uterus, even the expertmay fail at the first attempt. In a verysmall, or soft, or conical cervix, the exter-nal os may be hardly larger than a pinshead at the very apex of the c
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
