File:The diagnosis of diseases of women (1905) (14576565630).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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ry much.They do not even prove that the pregnancy, if present, is ectopic,or that, whether it is or not, it has anything to do with causing thepresent illness. All that can be said is that when symptoms arepresent that suggest the possibility of a ruptured ectopic gestationthese signs of pregnancy serve to confirm the suspicion. These are, so far as I have been able to observe, the main helpsto a correct diagnosis. There still remains to be considered one or two other points ofdiagnosis of less importance than those just indicated. It is frequently stated in text-books that when there is intra-abdominal hemorrhage there will be the usual signs of the presenceof free fluid in the peritoneal cavity. In a case of very extensiveeffusion, and in a patient without much fat in the abdominal wall,it may be possible to obtain evidence of fluctuation and of dulnessin the flanks, shifting on change of posture, but such evidence is notusually forthcoming. ..»^ PLATE XXIL -;,-Vfil&Fic^^Sfe-..
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V- Tubal Pregnancy. The ■wall of the tube is thickened. The villi are vascular anidnear the centre of the lumen. Entangled in the meshes of the villiis an irregular blood clot containing numerous syncytial cells—thisrepresents the fetal remains. THE DIAGNOSIS OF ECTOPIC PREGNANCY I65 Lastly, a word must be said as to the evidence obtainable byvaginal examination. Here, again, the signs are not very definite.There is no distinct circumscribed swelling to be felt, as in the caseof encysted effusions (pelvic hsematocele). All that can be madeout is, in the words of my friend Mr. John W. Taylor, ^a full andboggy condition of the pouch of Douglas, suggestive, to the expe-rienced finger, ^of the presence of fluid or semiclotted blood withinthe pelvis, but, as he goes on to say, the symptoms denoting thata lethal hemorrhage is actually taking place are of chief importance. There is very often a slight hemorrhage going on from thevagina, generally regarded by the patient either as due to

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