Gynecological diagnosis . meter of the abdomen as measured with the pelvimeter, thepatient standing, one point of the pelvimeter being placed overthe most prominent portion of the abdomen, and the other overthe spinous process of some definite counted sacral vertebra. Dr. Howard A. Kelly ( Medical Gynecology, p. 17) has deviseda method for making permanent gauze records of abdominaltumors and displaced viscera. The patient being in the dorsalposition, the physician outlines the tumor and the landmarks,such as anterior superior spines of the ilia, margins of the ribs,symphysis, and umbilicus, o
Gynecological diagnosis . meter of the abdomen as measured with the pelvimeter, thepatient standing, one point of the pelvimeter being placed overthe most prominent portion of the abdomen, and the other overthe spinous process of some definite counted sacral vertebra. Dr. Howard A. Kelly ( Medical Gynecology, p. 17) has deviseda method for making permanent gauze records of abdominaltumors and displaced viscera. The patient being in the dorsalposition, the physician outlines the tumor and the landmarks,such as anterior superior spines of the ilia, margins of the ribs,symphysis, and umbilicus, on the skin of the abdomen with ananiline pencil. If the skin does not take the pencil marks well,wet it with a little alcohol. Lay a plate of glass over the abdomenand on it place a piece of stiffened gauze (suisse, nainsook, or organ-die). The skin markings are visible through the glass. Reproducethem with a crayon pencil on the gauze. File away the gauze,labeled with the patients name and the date, for future Fig. 20.—A Permanent Gauze Record of an Abdominal Tumor. (Kelly.) 75 76 PHYSICAL EXAMINATION The X-rays in Diagnosis.—The X-rays are of supplementarydiagnostic value in detecting stone in the ureter or kidney, and indetermining ptosis of the stomach and intestines when these organsare filled with bismuth in suspension, also the presence of bone intumors,—conditions important for the gynecologist to skilled in the use of the Roentgen rays should be called in, asthe neophyte is apt to be misled by the appearances seen in thephotographic plates, and to put a wrong interpretation on theirshowings. CHAPTER VII THE PHYSICAL EXAMINATION (Concluded) III. The examination {concluded): 9. Instruments and their use indiagnosis, p. 77: General remarks, p. 77. The uterine sound, p. 78: Whento pass it, p. 78; Methods of passing, p. 79; Facts to be determined by theuse of the sound, p. 80; Cautions, p. 82. The uterine probe, p. 82. Theuterine dressing for
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