File:The diagnosis and treatment of diseases of women (1907) (14597714098).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ATION A distinct fluid wave may l:e obtained in any large collection of fluid with a com-paratively thin wall. It is piesent in well maiked ascites, in unilocular cysts and inmultilocular cysts with one or more large cavities. Occasionally the fact that thereare different large cavities in the cyst may be surmised by a distinct difference in thefluid wave as obtained through different parts of the cyst. In a cyst with smallcavities, no fluid wave is obtained, as there is not a large enough single cavity,although fluctuation may be as clear as in a single large cyst. Also, in a cyst withthick gelatinous contents, a fluid wave may not be obtained. The tenderness of a mass as determined by palpation, is of mu(?h importance indifferential diagnosis. In acute inflammation (as in acute salpingitis or perito-nitis) or in acute irritation (as in hemorrhage from tubal pregnancy), the tender-ness is very marked. On the other hand, in uncomplicated ovarian or uterinetumors, tenderness is slight.
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Trying for a Fluid Wave across the abdomen. The mobility and attachments of a mass are determined by attempting to movethe mass in different directions. The fingers are worked in deeply about the massat various points, and it is determined just what part may be easily displaced andwhat part is fixed (Fig. 37). The fixed point of a mass usually indicates its pointof origin, i. e., the organ involved. The presence or absence of mobility helps to de-termine whether or not the mass is bound down by inflammatory exudate or is re-troperitoneal or is in the abdominal wall. Occasionally a mass is not mobile because it is so large that it fills the abdominalcavity. Some retroperitoneal masses (particularly kidney tumors) present markedmobility in certain directions. OTHER POINTS IN PALPATION 27 Fetal Movement, Uterine Contraction, Friction Rub. In late pregnancy, fetal movement, caused by the fetus changing position or kick-ing, may not infrequently be felt. Dipping the hands in cold water and

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