File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14745167116).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
or increased resistance behind or on either side of the uterus. Uterine enlargement from subinvolution is distinguishedfrom that due to fibroid tumours by the fact that the uterus,though large, is normal in shape ; there are no bosses ornodules, nor is there disproportionate thickening of the uterusin any one diameter (Fig. 17). If the patient be irregular in menstruation, and hasgone over her time without seeing anything, it may bedifficult, and, from one examination, impossible, to saywhether she is pregnant or not. If the patient thinks she hasgone two months, it is easy to form a judgment which willprobably be correct. In pregnancy which has reached this 96 DISEASES OF WOMEN. date the body of the uterus is enlarged from before backwardsto an extent not found in subinvolution. If the pregnancyhas not reached two months, diagnosis is impossible ; there-fore postpone an opinion, and ask leave to examine again in amonths time. In the foregoing paragraphs the difficulties explained are
Text Appearing After Image:
Fig. 17.—Diagram showing the difference between the normal uterus (inner outline)and one enlarged (outer outline) from subinvolution. (After Simpson.) those of distinguishing between an enlarged and tender uterusand other pelvic conditions. But this is not the chiefdifficulty in practice. To diagnose an enlarged uterus iseasy : to judge rightly of its importance is not. The question in practice.—Some writers have said thatchronic metritis is the commonest of female diseases. Ithink that it is comparatively rare, and that its frequencyhas been over-estimated, for two reasons. (1) Persons unaccustomed to make bimanual examinations CHRONIC UTERINE PAIN. 97 often do not notice slight physical signs indicating chronic in-flammation of the pelvic peritoneum and uterine appendages,and they consequently attribute to chronic metritis pain reallydue to perimetritis, a disease which in the puerperal, statecauses subinvolution. Gooch described chronic metritis asa common disease, under the na

Note About Images