File:Gynecological diagnosis (1910) (14591538457).jpg

Identifier: gynecologicaldia00burr (find matches)
Title: Gynecological diagnosis
Year: 1910 (1910s)
Authors: Burrage, Walter L. (Walter Lincoln), 1860-1935
Subjects: Women
Publisher: New York, London, D. Appleton and Company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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to expand and contract, the spurts beingmore forcible and more frequent with greateractivity of the kidneys, the normal rate beingall the way from one spurt every ten secondsto a spurt every sixty seconds. Observations have been recorded which tend toprove that the movements of the orifice are lessfrequent when the kidney on that side is func-tionally inactive. Infectiontravels from the bladder upthe ureter only when thevalve-like arrangement atthe orifice in the bladderhas been destroyed, orwhen infective materialhas been introduced intothe ureter, as on a ureteralcatheter Or bougie. FlG# 50.-Alligato7Bladder Forceps. 106 THE URETHRA, BLADDER, AND URETERS THE EXAMINATION Suppose a woman presents herself complaining of marked painor difficulty with urination, or she has noticed pus or blood in theurine. The examination is conducted as follows: The patientis instructed not to pass her urine, if she is able to hold it. She isplaced on the table in the dorsal position (see page 33). The
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Fig. 51.—The Normal Bladder, Laid Open from the Front. (Kelly.) external genitals are inspected and a sharp lookout is exercised forevidences of gonorrhea, for eczematous skin lesions, or abnormali-ties of the meatus. Redness about the meatus and the orifices of the glands ofSkene and Bartholin, with the possibility of expressing a dropor two of pus from the urethra by stroking its course through THE EXAMINATION 107 the wall of the vagina, makes gonorrhea most probable. Gon-orrhea being suspected, no instrument should be passed beyondthe bladder neck for fear of carrying infection into that organ. Inspection shows whether the labia urethrse, which normallyclose the meatus in virgins, are in apposition or separated; showsthe presence of a urethral caruncle or prolapse of the mucousmembrane of the urethra or a tumor in the urethra projectingthrough the meatus. Inspection also shows eczema of the vulvacaused by the urine of diabetes mellitus. Palpation by the left forefinger in the vag

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