. Operative gynecology. arged ovary rotated highup and to the front can be distinctly palpated, while the vaginal cervix is feltbelow, the existence of an elongated uterine cavity is perfectly evident. Whennone of these landmarks can be recognized with certainty, the length and direc-tion of the cavity can be measured witli a flexible hard rubber uterine sound. Ifthe sound does not enter easily under the guidance of the finger, its introductionmay be facilitated by catching the cervix and holding it with a pair of bulletforceps. It is essential during these examinations to observe allthe indiv
. Operative gynecology. arged ovary rotated highup and to the front can be distinctly palpated, while the vaginal cervix is feltbelow, the existence of an elongated uterine cavity is perfectly evident. Whennone of these landmarks can be recognized with certainty, the length and direc-tion of the cavity can be measured witli a flexible hard rubber uterine sound. Ifthe sound does not enter easily under the guidance of the finger, its introductionmay be facilitated by catching the cervix and holding it with a pair of bulletforceps. It is essential during these examinations to observe allthe individual peculiarities of the ease, which may have an im-portant bearing upon operative treatment or for future comparison to determinewhether any changes have occurred ; for example, the size of the tumor and the 360 MYOMECTOMY—HYSTERO-MYOMECTOMY. extent to which it fills the pelvis, whether in one or all directions, should benoted, as well as the condition and size of the cervix and its position, whether in Fig. 486.—Fed Cer?? Myomata, giving a Perfect Ballottement. Anterior View. The uterus contains numerous interstitial and sessile myomata, and on its fundus are two pedunculatedtumors about the size of a childs head at seven months. The abdomen was filled with ascitic fluid justsufficient to raise the anterior wall 2 or 3 centimeters away from the tumor on the left. On giving the tumora slight blow, it disappeared at onee, to return again immediately and strike the finger a gentle blow back,perfectly imitating the ballottemeiit of pregnancy. Note the manner in which the enlarged omental vesselsplunge directly into the tumor. % natural size. the pelvis or drawn npward into the abdomen. In large tumors the abdominalenlargement should be recorded from the circular measurements of the patients PALLIATIVE TREATMENT. 351 body, and a good contour may be made with a flexible leaden tape ; the positionand size of prominent bosses are also to be described. A sound passe
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
