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 . into the endocervicalmucous membrane from within outward, and by which the os may beopened, and the whole uterus drawn down. If the physician is obliged to examine his patient without the assist-ance of a nurse, his left hand is used to separate the labia, and then seizesthe speculum, and gives it the utmost upward twist possible, while theright hand sharply separates the anterior vaginal wall with the bo
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 . into the endocervicalmucous membrane from within outward, and by which the os may beopened, and the whole uterus drawn down. If the physician is obliged to examine his patient without the assist-ance of a nurse, his left hand is used to separate the labia, and then seizesthe speculum, and gives it the utmost upward twist possible, while theright hand sharply separates the anterior vaginal wall with the bowing the head, the eye may generally succeed in reaching the cer-vix, and getting a fair glimpse of it. The overhanging of the superiorbuttock, however, usually interferes with vision; and to obviate this, theflanged speculum shown in Fig. 47, should prove useful. If the patientlies very thoroughly on her side and, particularly, if the table has the lon-gitudinal and lateral tip described on page 29, the expansion of the vaginawill often be sufficient to enable the physician unaided to obtain a goodview of the parts, and, dispensing with depressor or tenaculum, introduce. Fig. 60.—Correct position of patient for examination with Sims1 speculum. (P. F. M.) the probe, or sound, or applicator. The introduction of vaginal tampons,and the application of tincture of iodine, or other agents to the vaginaand cervix, is thus perfectly feasible. The whole vagina, except the posterior wall, and the cervix in its to-tality are exposed freely to view through Sims speculum, an advantageoffered by no other form of speculum, and not to be undervalued. Thecervix, being visible in its whole periphery, it is much easier, perhaps pos-sible only, to recognize deformities and injuries of that organ throughthis speculum. Thus, for instance, laceration of the cervix is easily rec-ognized, and its extent and curability determined only through this instru-ment. This is done by seizing each lip with a
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
