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 . are none but beneficial when it is employedfor therapeutical purposes (as for the cure of fissure of the anus, for whichit is a specific) and innocuous when used as a means of diagnosis; the in-continence following it rarely lasts longer than a few days. The field ofvision opened by this hyperdilatation may render a further specular exami-nation unnecessary; but generally the mucous membrane falls forward soas to obsc
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 . are none but beneficial when it is employedfor therapeutical purposes (as for the cure of fissure of the anus, for whichit is a specific) and innocuous when used as a means of diagnosis; the in-continence following it rarely lasts longer than a few days. The field ofvision opened by this hyperdilatation may render a further specular exami-nation unnecessary; but generally the mucous membrane falls forward soas to obscure the unobstructed view, and a speculum or retractors are re-quired to separate the walls. A large-sized cylinder will now afford a good view, which can likewisebe obtained through two Sims specula, one retracting the posterior,, andthe other the anterior wall of the rectum. To view successively the wholecircumference of the rectal tube without obstruction by the blade of aspeculum, a cylinder is perhaps preferable to the two Sims. It should be noted that the mucous membrane of the rectum is of abright red color, not pale pink like the vagina. If it has a bluish or dark. Fig. 94.—Thebauds sphincter ani dilator for forcible dilatation. GYNECOLOGICAL EXAMINATION. 107 red color, however, it is congested or inflamed, and in need of treatment;so, also, if it is coated with thick, stringy mucus. Applications of fluid medicinal substances may be made either throughthe cylindrical or double Sims specula. If the cylinder is used, the fluidmay be poured into the speculum and brought in contact with the interiorof the rectum by withdrawing the speculum or mopping it on the mu-cous membrane with a sponge on a holder, or cotton on a whalebone stick;the latter is also the method of applying fluid agents through the (iodoform, bismuth, etc.), may likewise be applied in this way,or by insufflation. Solid substances, such as the stick of silver nitrate todistinct spots, as ulce
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
