File:Gynecological diagnosis (1910) (14754995686).jpg

Identifier: gynecologicaldia00burr (find matches)
Title: Gynecological diagnosis
Year: 1910 (1910s)
Authors: Burrage, Walter L. (Walter Lincoln), 1860-1935
Subjects: Women
Publisher: New York, London, D. Appleton and Company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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the physician with her right footresting on a round of a chair eight or ten inches from the floor.The physician kneels on his left knee in front of her, or sits in alow chair resting his left elbow on his left knee. He anoints hisleft forefinger, and steadying himself with his right hand on herleft hip, finds the vulva by sweeping the anointed middle fingerof his left hand over the anal region, and then introduces the fore-finger, just as in the vaginal examination in the case of the dorsalposition. Having the patient bear down or cough gives an ideaas to the excursion of the uterus with forced expiration. 60 PHYSICAL EXAMINATION 4. Odor as a Diagnostic Sign The sense of smell is sometimes an aid to diagnosis, as in detect-ing the characteristic odor of the vaginal discharge from uterinecancer, and the odor of urine or feces in the vaginal discharges inthe case of urinary or fecal fistula?. Menstrual blood has a differentodor from other blood. Certain vaginal discharges have a pecul-
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Fig. 17.—The Standing Position. iarly foul odor. The odor exhaled by a patient suffering withsepticemia is characteristic, although, like other odors, not capableof definite description. Diabetic urine has a sweet smell andurine may be distinguished from other discharges by administeringspirits of turpentine or asparagus to the patient by the month andnoting the odor of violets or asparagin in the urine. COLLECTION OF DISCHARGES AND TISSUES 61 Acetonemia, a form of intoxication with acetone occurring indiabetes, in infectious fevers, in intestinal fermentation, in gen-eral sepsis, and sometimes following gynecological operations,may be distinguished by the sweetish odor of the breath,described as like that of a pippin apple. 5. The Collection of the Discharges and Tissues forMicroscopic Examination Materials Needed.—1. Half a dozen absolutely clean coverglasses. 2. A few culture tubes of hydrocele agar or blood serum(furnished by the pathologist). 3. Platinum wire loop. 4. Alcohol

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