Gynaecology for students and practitioners . gers, the hymen, carunculse myrtiformes, vestibule, meatusurinarius, and fossa navicularis should be examined in turn ; then,with the tip of the index finger introduced through the ostiumvaginae, pressure should be made upon the floor of the urethra towardsthe meatus, so as to reveal the presence, if any, of urethral discharge ;flnally, the openings of the Bartholinian ducts may be inspected andthe glands may be palpated, when enlarged, by taking the tissuesat the base of each labium ma jus between the finger in the vaginaand the thumb externally. G
Gynaecology for students and practitioners . gers, the hymen, carunculse myrtiformes, vestibule, meatusurinarius, and fossa navicularis should be examined in turn ; then,with the tip of the index finger introduced through the ostiumvaginae, pressure should be made upon the floor of the urethra towardsthe meatus, so as to reveal the presence, if any, of urethral discharge ;flnally, the openings of the Bartholinian ducts may be inspected andthe glands may be palpated, when enlarged, by taking the tissuesat the base of each labium ma jus between the finger in the vaginaand the thumb externally. Generally the mucous surfaces of thevulva are moist, but there is no visible discharge ; sometimes whitecurdy secretion or a thin opalescent fiuid is present ; neither isabnormal. The next step is the digital examination of the vagina, which isusually made with the index finger, or in a parous woman the indexand middle fingers, of the right hand. It is a great convenience tolearn to use either hand indifferently for the internal Fig. 73. Double Rubber Finger-stall forUse in making Vaginal Examination. VAGINAL EXAMINATION 119 In introducing the fingers it will be remembered that the vulvapresents an antero-posterior slit, while the lumen of the vagina istransverse ; the hand will therefore be rotated through a right angleas the fingers pass upwards towards the cervix. The condition of the vaginal walls is the first point to be observed ;the transverse rugse {see p. 30) can usually be felt on the anterior wall,but in women who have borne several children, or in cases of prolapse,they are often absent. The educated finger will at once detect suchconditions as abnormal laxity of the walls (in prolapse), constrictions,cicatrices, warty excrescences, and new growths, either cystic orsolid. The vaginal j^ortion of the cervix must next be defined. Itlies usually about the centre of the pelvic cavity, the os correspondingto the level of the ischial spine ; departure from th
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
