File:Clinical gyncology, medical and surgical (1895) (14598129207).jpg

Identifier: clinicalgyncolog00keat (find matches)
Title: Clinical gyncology, medical and surgical
Year: 1895 (1890s)
Authors: Keating, John M. (John Marie), 1852-1893 Coe, Henry Clark, 1856-
Subjects: Women Gynecology
Publisher: Philadelphia, Lippincott
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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k, where they are most commonly found, may be determined by the pas-sive of a sound. While the urethra is normally sensitive to the passage ofany instrument, yet the pain on reaching any inflamed spot, or touching afissure at the neck, is so much more acute that this sign is fairly reliable.The passage of a sound or catheter will also determine the presence of astricture, a condition which, though rare in comparison to its occurrence inthe male, is yet occasionally met with. For the determination of the exact condition of the lining membraneof the urethra the endoscope is necessary. This, as its name implies, is aninstrument which enables us to see the mucous membrane either directly orreflected in a mirror. As the urethra can be stretched without undue vio-lence so as to admit the average-sized forefinger, a simple tube may serveas an endoscope. The urethra can be gradually dilated with Simons plugs(Fig. 38), for instance, the inner plug withdrawn, and the tube left in situ. Fig. 38.
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Simons urethral plugs. Through this the whole urethra may be inspected, the field being illuminatedby lighl thrown Iri.m a head-mirror. The neck of the bladder being placedin the Held fust, the tube may be slowly withdrawn, and each successivepart examined as it rolls into view. Such a thorough examination, ofcourse, presupposes that the patient is under ether. 68 METHODS OF GYNAECOLOGICAL EXAMINATION. Fia. 39.

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