File:The diagnosis and treatment of diseases of women (1907) (14597843777).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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ly 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 then layingthem flat over the uterus, may cause the fetus to move. The absence of fetal movements is of no diagnostic significance, but the presenceof them is of course certain evidence of existing pregnancy and consequently wellworth trying for in a doubtful case.
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Fig. 36. Differentiating a Fat-wave from a Fluid-wave. The Fat-wave is stopped by the pressure inthe median line. The same may be said of the intermittent contraction and relaxation of the preg-nant uterus. In some cases, alternate hardening and softening of the uterus maybe very distinct, and is positive evidence of the character of the mass under thehands. A friction rub may sometimes be felt in a case of active peritonitis, particularlyin the local plastic or irritative peritonitis that not infrequently takes place when atumor lies against the abdominal wall. The hand is pressed oA^er the mass duringforced respiration. Occasionally the friction rub may be obtained over the liver orspleen, when there is a local peritonitis there. 28 THE PHYSICAL EXAMINATION PERCUSSION OF ABDOMEN. AREAS OF DULLNESS. Percussion over the abdomen serves to confirm tlie information obtained by pal-pation, and also brings out some new facts—for example, by outlining accurate^the area of dullness it show

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