File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14765810824).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

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es you to fix a hookor volsella into the cervix, and pull it down so asto inspect it thoroughly. But you cannot do thiswithout an assistant. You also need a table, and, toget the utmost advantage from it, a special table, suchas Daggetts, which can be raised at the end on whichthe patients pelvis lies, and on the side towards whichher back is directed. The patient is placed on this withher hips close to its edge. Her left arm is placed behindher back. Her left thigh and knee are slightly bent, herright thigh is much bent, so that her knee goes against araised padded side which prevents her from slipping off.The right buttock is held up by the assistant (Fig. 8). METHOD OF INVESTIGATION. 63 The speculum lifts the posterior vaginal wall away from theanterior, so that you then see the cervix and the anteriorvaginal wall in their natural relation to one another. This isexcellent for hospital practice, but inconvenient and seldomnecessary in private. In a few cases—such, for instance, as
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1 Fig. 8.—Position of Patient for examination with Duckbill Speculum. doubtful cancer—this is an advantage; but the cases in whichthe duckbill speculum gives you information of value in diag-nosis and treatment which you cannot get without it, are rare. The volsella.—Two kinds of volselke are sold, one withsharp teeth which stick into the cervix, and one with bluntteeth, which hold the cervix by compressing it. It shouldfasten with a clip (Fig. 9). The sharp-toothed instrumentgives the securer hold, and hurts the patient less, but itspoints may scratch the vagina or your finger while it isbeing applied. The blunt volsella cannot do this, but thecompression of the cervix is painful. In buying one, seethat the teeth fit nicely into one another when the instru-ment is closed. A tenaculum is sometimes used; it is easierto apply, but holds less firmly than the volsella (Fig. 10).The use of the volsella is to pull the cervix down that itmay be seen, and that the sound may be more easi

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