File:Pathology and treatment of diseases of women (1912) (14781159812).jpg

Identifier: pathologytreatme00mart (find matches)
Title: Pathology and treatment of diseases of women
Year: 1912 (1910s)
Authors: Martin, August Eduard, 1847- Jung, Ph. (Philipp Jacob), 1870-1918
Subjects: Gynecology Gynecology
Publisher: New York : Rebman company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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lvis. Besides, pressure upon afilled bladder is painful to the patient. The gynecologic examination can be only a combined bimanual one,that is, a palpation of the internal genital organs by one or more fingersintroduced into the vagina, with a simultaneous counterpressure on the 20 DISEASES OF WOMEN organs through the abdominal wall by the other hand. In this way, only,is it possible to form a clear judgment as to the relative position of theorgans to each other, their size, form, and consistency. To perform themethod of combined examination we should from the beginning accus-tom ourselves to place the patient always in the same definite posture.A great number of examining tables and chairs have been recom-mended for this purpose whose various advantages cannot be disputed.The essential requirement of an examining table is that the woman canbe placed, with relaxed abdominal walls that is in a dorsal position withelevated legs, at such a height that the examiner can easily execute the
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Fig. 15. —Examination Table, after A. Martin. external palpation as well as the combined bimanual method. We use aplain table of the height of a common kitchen table, the top of which iscut off transversely at one end. The cut off larger end can be folded upto any desirable height. The table is covered with a blanket, a bolsterfor the head and a roll for the small of the back. The feet are placedupon a high footstool. We usually make all our examinations on a tablearranged in this manner. It can be easily imitated in practice. For clinical purposes these tables have been made of iron and glass,to insure and facilitate thorough cleanliness. They have been furnishedwith stirrups and legholders, and a pan arranged like a drawer for thereception of irrigation fluids, used tampons and sponges, etc. (Fig. 15). If such an examining table is not at hand then a couch, sofa, or bed GYNECOLOGIC EXAMINATIONS 21 may suffice for this purpose. It is only necessary to elevate the buttockssufficient

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