File:The diagnosis of diseases of women (1905) (14576679338).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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elargely the result of disturbance in circulation, of exposure to theinfluence of air and of friction of the thighs. There is first conges-tion and oedematous infiltration, and this is followed by induration(hyperplasia) of the tissues. Decubitus ulcers, slow in healing,may form on exposed surfaces. Where the lips of the cervix areretracted, the exposed mucous membrane of the cervix may betransformed into stratified epithelium. Clinical Diagnosis. The diagnosis of descensus and prolapsusuteri is seldom diflficult. It is very unusual to find a prolapsed DIAGNOSIS OF MALPOSITIONS OF THE UTERUS 227 uterus in a nullipara. Beyea estimates that prolapsus uteri innulliparae occurs in not more than 1 per cent, of all cases. Hereported two cases and found sixty-two others in the literature. When upon physical examination the pelvic floor is found relaxedor lacerated, and there is also found a rectocele and vesicocele, it ishighly probable that the uterus will be found more or less pro- FiG. 75
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Elongation of the cervix with prolapsus uteri. Traction made upon the cervix by avulsellum forceps pulls the cervix two inches beyond the vulvar outlet. The body of theuterus lies within the pelvis, but at a lower level than normal. The depth of the uterinecavity measured by a sound is five inches. lapsed. A positive diagnosis can only be made by locating thefundus of the uterus in a bimanual examination. The patientbeing under ansesthesia, firm traction upon the cervix with thevulsella forceps will determine the exact extent of the displacement(Fig. 75). The finding of the cervix at a lower level than is normalwill not suffice for a diagnosis. Such a finding is not seldom dueto an elongation of the cervix, either with or without a descent of 228 SPECIAL DIAGNOSIS the uterus. Without having located the fundus it cannot be saidthat the uterus, as a whole, has descended. By a rectal examina-tion it is often possible to locate the point of juncture of the cervixand uterine body, and esti

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