File:The diagnosis of diseases of women (1905) (14760338871).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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size of the speculum shouldvary from No. 7 to No. 12, according to the case. When the urethrais small and sensitive, No. 7 or No. 8 may best answer the purpose.W^ith experience a No. 10 will be satisfactory in the majority of cases.The urethral orifice is cleansed with boric acid, an assistant holdsthe labia and buttocks apart, while the operator grasps the specu-lum, as shown in Fig. 213, and gently forces it through the urethrainto the bladder. The obturator is held in place by the thumbuntil the cystoscope has entered the bladder, when it is withdrawn.A head mirror reflects the light from an electric drop lamp. DIAGNOSIS OF DISEASES OF URETHRA AND BLADDER 509 The interior of the bladder should be explored systematically,moving the speculum from side to side and up and down as theoccasion requires. The Segregator. By this ingenious instrument, first introducedby Harris, and modified by Downes, the urine is separately collectedfrom each ureter as it passes into the bladder. Fig. 216
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Kelly-Pawlik method of cystoscopy. The hips are elevated, the bladder is distended withair, the cystoscope is inserted into the bladder, and artificial light is directed through thecystoscope into the bladder. Two catheters are arranged side by side within a flattened tube,each separate and movable on its longitudinal axis. When intro-duced into the bladder the catheters are rotated outward on theirlong axes and separated at the bladder end. A metalUc leverintroduced into the vagina of the female and into the rectum ofthe male provides a water-shed in the bladder, on either side ofwhich the urine is collected from the corresponding kidney. Theurine flows through the catheters into bottles. The application of 510 DIAGNOSIS OF DISEASES OF THE URINARY SYSTEM the segregator is simple and has the great advantage of collectingthe urine from either kidney separately without catheterizing theureters. However, it has not proven of universal value. MALFORMATIONS AND DISEASES OF THE FEMALE URETH

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