. Clinical gyncology, medical and surgical. ometimes cause considerable difficulty to theentrance of the finger, turning the palmar surface of the finger downwardand making firm pressure on the perineal body will so inhibit the action ofthe constricting muscle that the finger will easily pass in. The position in which the other fingers of the hand are held is im-portant. Most text-books on gynaecology describe and figure the remainingfingers as folded upon the palm, but a very little consideration will show The broad surface of the foldedfingers is opposed to the peri-neum and the projecting f
. Clinical gyncology, medical and surgical. ometimes cause considerable difficulty to theentrance of the finger, turning the palmar surface of the finger downwardand making firm pressure on the perineal body will so inhibit the action ofthe constricting muscle that the finger will easily pass in. The position in which the other fingers of the hand are held is im-portant. Most text-books on gynaecology describe and figure the remainingfingers as folded upon the palm, but a very little consideration will show The broad surface of the foldedfingers is opposed to the peri-neum and the projecting foldsof the buttocks, and it is im-possible that the forefingershould reach as high in thevagina as it ought. If, how-ever, the fingers are extendeddownward along the cleft ofthe nates, over the anus, thenonly the web between the indexand middle fingers is opposedto the perineum, and the fingercan be pushed up to its fullestextent. (Fig. 3.) In this way considerable isgained in the length of the that this arrangement is not the best Fig. examining finger. At first thought it might seem as ifwith this arrangement the sideof the forefinger would be op-posed to the cervix, and thepart of the pelvis reached byits sensitive tip be limited to the left side. But, using the buttock asa point of resistance, the finger can be so rotated that its palmar surface Position of examining hand. METHODS OF GYNAECOLOGICAL EXAMINATION. 37 will be directed upward and the whole vaginal vault can be reached andpalpated, even the right side, though naturally less perfectly than the reversing the hands, as will be spoken of later, the examination canbe made thorough. Practice will so increase the flexibility of the indexfinger at the metacarpophalangeal joint that this method will become moreand more easy. Certain facts can be ascertained by the examining finger alone. Thecondition of the perineum can be told in a general way, though its exactstatus can be determined only by visual inspectio
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