Identifier: treatiseongync00pozz (find matches)
Title: Treatise on gynæcology : medical and surgical
Year: 1891 (1890s)
Authors: Pozzi, S. (Samuel Jean), 1846-1918 Wells, Brooks H. (Brooks Hughes), b. 1859
Subjects: Gynecology Genital Diseases, Female
Publisher: New York : W. Wood
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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proved its exactnessevery day at the hospital for twenty-five years, demonstrating it atthe bedside to any one who desired it. It thus becomes plain that Hegar is wrong in claiming the honorof its discovery for von Schultze, Hoist, and Yeit. The subject hasbeen well treated by L. Guernes (De lHemato-salping., These deParis, 1888, No. 178). METHODS OF GYNECOLOGICAL EXAMINATION. 99 For the employment of the method the patient is placed in simpledorsal decubitus, or, if that position offers any difficulty, as for lithot-omy; while the index of the right hand practises the touch, as de-scribed, the left hand is laid above the pubis, and the fingers sunkinward with gentle, even pressure, thus driving the pelvic contentstoward the vaginal finger. To make clear the exact position of theuterus, this procedure is carried out in the hypogastric region, then inthe inguinal, and lastly the lumbar should be examined, the vaginalfinger exploring the depths of the culs-de-sac toward the other hand;
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Fig. 70.—Bimanual Exploration. Sectional view (Davenport). thus the bases of the broad ligaments and the uterine adnexa areeasily examined for abnormal enlargements. At the same time accountshould be taken of the sensitiveness of the parts; in the healthy con-dition, pressure over the adnexa, as also elevation and tossing (balotte-ment) of the uterus, are free from pain. Bimanual palpation should then be made by rectum and abdomen(Hoist); it is particularly advisable in disease of the adnexa. By the combined method one can palpate the ovaries, with specialfacility if the patient is anaesthetized, but even without such aid.It is well, as Hegar advises, to have the uterus gently pulled downby an assistant, the cervix being fixed with a (tenaculum) forceps 100 CLINICAL AXD OPERATIVE GYNAECOLOGY. while the surgeon palpates the abdomen and passes the index of theother hand by turns into vagina or rectum; the ovary is felt to glidebetween the fingers like a small testicle. The left ovary

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