File:The diagnosis of diseases of women (1905) (14763032992).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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Fig. 108.—Atresia of the os internum, producing hsematometra. Fallopian tubes maybecome distended later. (Sutton and Giles.) Fig. 109.—Atresia of the vulva on one side of a double uterus and vagina, causing ahaematocolpos on the affected side. (Sutton and Giles.) DIAGNOSIS OF DISEASES OF THE VAGINA 271 or cervix is suspected. If, in addition, a pelvic tumor develops anddistinctly fluctuates, the diagnosis is highly probable, but mustbe confirmed by a vaginal examination. Vicarious menstruationrarely occurs. In an attempt to make a digital examination ofthe vagina the finger will meet the obstruction. The extent of theclosure is best determined by the finger in the rectum. If theobstruction lies high in the vagina and does not bulge downwardit is not likely that there is any considerable secretion pent upabove the point of obstruction (Fig. 110). Fig. 110
Text Appearing After Image:
Vaginal septum. The index finger inserted into the urethra and the thumb in the rectumare approximated, and by so doing the atresic vagina is demonstrated. Hsematometra is not easy to demonstrate, because of the difficultyin palpating the elevated uterus through the rectum. The uterususually lies near the median line, and is rounded, tense, possiblyfluctuating, and somewhat increased in size. 272 SPECIAL DIAGNOSIS Double vagina is the result of failure on the part of the Mullerianducts to perfectly fuse. From this cause a septum divides thevagina in part or throughout. The vaginal canals usually lie sideby side, the septum running anteroposteriorly. The canals may beunequal in size. The septum rarely runs transversely, so dividingthe vagina that one lies in front of the other—this can only beaccounted for on the supposition that the Mullerian ducts hadrotated prior to their fusion. All degrees of development may beobserved in the septum, from a slight ridge to a complete partitionco

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