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 . e knees touching the tho-rax; the lithotomy, with the shoulders elevated, so as to approach thepelvis. The dorsal position, with legs extended, I have not thought necessaryto enumerate among the positions for a vaginal examination, as this pro-cedure can only be very imperfectly performed in that position. The ne-cessity for examining in that position will occur only in cases where ab-solute immobility of the body is
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 . e knees touching the tho-rax; the lithotomy, with the shoulders elevated, so as to approach thepelvis. The dorsal position, with legs extended, I have not thought necessaryto enumerate among the positions for a vaginal examination, as this pro-cedure can only be very imperfectly performed in that position. The ne-cessity for examining in that position will occur only in cases where ab-solute immobility of the body is imperative (as hemorrhage, violent peri-tonitis), or where the knees or hips are anchylosed. Under all other cir-cumstances, no matter how inconvenient, the patient can at least flex theknees as in the regular position about to be described. The differenceof position of the pelvis and sexual organs is seen by comparing figures1 and 2. GYNECOLOGICAL EXAMINATION. 19 For purposes of digital and bimanual examination the ordinary leveldorsal position with flexed knees is the most convenient. Its employmentby far the larger majority of gynecologists proves this statement. In it. Fig. 1.—Dorsal recumbent position, with extended legs. (Hegar and Kaltenbach.) the pelvic and abdominal viscera are at rest, and occupy as nearly as pos-sible a horizontal position, gravitating neither downward, nor laterally,nor upward; the diaphragm exercises a minimum of displacing power on
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