File:The diagnosis and treatment of diseases of women (1907) (14781225021).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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vagina. If the vagina isroughened and tender, the discharge probably originates there. Whether or not itreally does originate there, is determined in the speculum examination. induration or a hard place felt at some part of the vaginal wall, may be due to in-filtration of the wall itself (inflammation, scar tissue, small cyst, malignant disease)or to some trouble back of the wall. WHAT TO PALPATE FOR 43 A swelling or mass in the vaginal wall or bulging into the vagina from any direc-tion, may be due to any one of a number of conditions which are mentioned in detailin chapter ii. A stricture (narrowing) or atresia (occlusion) of the vaginal canal may be a con-genital malformation or may be an acquired condition resulting from injuries, inlabor or otherwise, or from severe or protracted inflammation, as in the adhesive orobliterative vaginitis seen frequently in aged patients. The narrowing of the canalmay be due also to pressure of a tumor or of an inflammatory mass around the vagina.
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Fig, 55. The bony arch, which bounds the vaginal opening above. BASE OF BLADDER. TENDERNESS, INDURATION. The base of the bladder lies directly beneath the central part of the anterior va-ginal wall and is readily palpated. In cystitis or other painful affection involvingthe base of the bladder, tenderness is found. When induration or almormal hard-ening or thickening is found, ascertain whether it is a distinct mass with definite out-lines (foreign body or tumor of the bladder), or a diffuse infiltration (inflammatory,tubercular, maUgnant) of the bladder wall or of the vesico-vaginal septum. 44 THE PHYSICAL EXAMINATION URETHRA. TENDERNESS, INDURATION, DISCHARGE. The urethra, as it extends from the bhT,dder forward under the pubic arch, is easilypalpated through the anterior vaginal wall, immediately beneath which it lies. Ininflammation of the urethra, there is usually considerable tenderness, and, in manycases, decided induration or thickening. A thickening due to a new growth may be

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