Manual of gynecology . rvix normalin size (Fig. 13) ; os uteri felt like a dimple, looking downwards andbackwards. No bodies are felt through the lateral and posterior fornices,which are concave on their vaginal aspects and have the feeling, on press-ure, of the angle of ones mouth. In the anterior fornix a body is felt, 104 MANUAL OF GYNECOLOGY. which on bimanual examination is discovered to be the uterus lying tothe front and not enlarged. The fundus and cervix meet at a very largeangle. Bimanual exploration of the fornices reveals nothing The patient complains of no pai
Manual of gynecology . rvix normalin size (Fig. 13) ; os uteri felt like a dimple, looking downwards andbackwards. No bodies are felt through the lateral and posterior fornices,which are concave on their vaginal aspects and have the feeling, on press-ure, of the angle of ones mouth. In the anterior fornix a body is felt, 104 MANUAL OF GYNECOLOGY. which on bimanual examination is discovered to be the uterus lying tothe front and not enlarged. The fundus and cervix meet at a very largeangle. Bimanual exploration of the fornices reveals nothing The patient complains of no pain during the whole examina-tion, and has no symptoms referable to the pelvis. Cases where the Bimanual is difficult.—The student will soon find thatthe bimanual can be performed in certain cases with great facility andaccuracy, while in other women it is exceedingly unsatisfactory. The best case for a bimanual is a woman a fortnight or three weeksafter delivery. The reasons for this are evident. A puerperal woman has. Fig. of pelvic floor segments and abdominal wall in bimanual (Hart). had the ostium vaginae and vaginal walls relaxed by the childs head; thepubic segment has been drawn up and its attachments slackened; theabdominal walls have had their elasticity diminished by the full timeuterus, and the uterus itself is not involuted to its normal size. In such acase there are evidently all the requisites for a good bimanual. Difficult bimanual cases are found in stout nulliparous women, and incases of pelvic inflammation. In such, the rectal examination, with orwithout the use of the volsella, is indicated. One practised in the bimanual can feel the normal ovaries. EXAMINATION OF THE FEMALE PELVIC ORGANS. 105 Students at first find their bimanual unsatisfactory. By perseverance,however, they will obtain by means of it an accuracy in diagnosis whichis astonishing. It is not only the best means of investigation, but onefrom which no possible harm can arise. In
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