Operative gynecology : . and Littres acinousglands, appear as fine points, often in groups disposed longitudinally, or aslarger yellowish spots; they can be better seen by changing the position of the 354 AFFECTIONS OF THE URETHRA AND BLADDER. speculum so as to displace the central figure and bring one side of the urethralwall flat against its end. One of the best methods of examining the outer portion of the ureter,and especially the orifices of Skenes glands, is by bending two hairpins asshown in the figure (Fig. 213), and grasping them with forceps and usingthem to draw the labia and walls
Operative gynecology : . and Littres acinousglands, appear as fine points, often in groups disposed longitudinally, or aslarger yellowish spots; they can be better seen by changing the position of the 354 AFFECTIONS OF THE URETHRA AND BLADDER. speculum so as to displace the central figure and bring one side of the urethralwall flat against its end. One of the best methods of examining the outer portion of the ureter,and especially the orifices of Skenes glands, is by bending two hairpins asshown in the figure (Fig. 213), and grasping them with forceps and usingthem to draw the labia and walls of the urethra apart. Cystoscopy.—The fundamental principles of a cystoscopic examination are: 1. The introduction of a simple cylindrical speculum into the bladder. 2. The atmospheric distention of the bladder induced solely by posture. 3. The illumination and inspection of the vesical mucosa, either by meansof a direct light, such as a little electric lamp attached to the forehead or the mouth of the speculum, or by. means of a strong light re- \ fleeted by a head mirror. The view of the bladder ob-tained in this way is a directone; and the open speculumallows the operator to touchany part of the bladder with asound, and to introduce variousinstruments with ease. The Instruments Used.—-The necessary instrumentsare the following: A stronglight, a head mirror, vesicalspecula with obturators, a ure-thral calibrator and dilator, anevacuator for removing urine,long mouse-toothed forceps,and a ureteral searcher. In case of emergency theinstruments absolutely neces-sary for an examination arefew and simple. The light isalways easily obtained, andevery physician owns a throatmirror. An evacuator can bemade by attaching a piece ofrubber tubing to the end of asyringe; and the dilator, for-ceps, and searcher can be dis-pensed with, so that the vesical speculum is really the only novel indispensableinstrument, and even that could be extemporized from a piece of tin or a bit ofcardboa
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
