File:The diagnosis and treatment of diseases of women (1907) (14781249081).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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mall(virgin), medium and large. The cervix is easier exposed in most cases if the an-terior blade of the speculum is somewhat shorter than the posterior. Some specula are made with three blades, instead of two, constituting a tri-valve speculum. They are made on the same general principles as the bivalvebut the mechanism is more complicated and, usually, without correspondingbenefit. The bivalve speculum is used with the patient in the dorsal posture (Fig. 41).For sterihzation of specula and other instruments, see Preparations for Exami-nation, at the end of this chapter. THE BIVALVE SPECULUM 79 The uterine dressing=fcreeps (Fig. 90-b) is a long strong forceps for sponging outthe vagina and for making vaginal applications. It may be straight or curvedas preferred. I find the forceps with a straight shank and a slight curve near theend more convenient than the much curved instrument. A vaginal depressor forpushing the vaginal wall out of the way is usually mentioned in an examining set
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Fig. 91. Bivalve Speculum in place. Sectional view, showingthe cervix and vaginal vault by opening the blades. relations of speculum and exposure of but it is generally not necessary, as the vaginal wall may be pushed aside sufficientlywith the dressing-forceps. The uterine tenaculum=forceps is needed for catching the cervix and bringing allparts of it into view. It should be light but strong, especially about the lock,where it is likely to work loose (Fig. 90-c). 80 THE PHYSICAL EXAMINATION The Specimen scissors are for clipping out a small piece of tissue from the cervix,in cases presenting an appearance suspicious of malignant disease. The one shownin Fig. 90-d I have found very convenient and satisfactory. It presents at theend a small sharp hawk-bill which cuts through the firmest tissue, clipping outa small piece with but httle pain or bleeding. I appropriated it from the throatspecialists armamentarium, where it is catalogued as the Miles tonsil punch. Steps in the Regular Spec

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