A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
=Examination of External Genitals and Pelvic Structures.=--To examine
the external organs of generation and the pelvic viscera the woman
should be placed upon a table. In some cases the physician may be
obliged, for want of proper facilities or on account of the physical
condition of the patient, to make his examination upon a bed. Such
an examination, however, is never so satisfactory or so thorough as
the examination made with the woman upon the examining-table. A great
number of gynecological tables have been introduced. The one which
seems to the writer the best, on account of its simplicity and the
perfect relaxation of the abdominal muscles furnished by it, is shown
in the accompanying illustration (Fig. 1). It is a plain wooden table,
at the foot of which are attached the upright supports for holding the
stirrups for the feet, such as have been devised by Dr. Edebohls. By
this arrangement the feet and legs are supported without any effort on
the part of the woman; when the buttocks are drawn well down to the
foot of the table there is a certain amount of flexion of the pelvis
upon the trunk, and the most complete attainable relaxation of the
abdominal muscles is secured.
When the woman has been placed in this position the examiner should
investigate thoroughly, and in order, the following structures: The
anus, the perineum, the labia majora, the nymphæ, the fourchette, the
orifices of the ducts of the vulvo-vaginal glands, the hymen or its
remains, the vestibule and the small glands of the vestibule, the
external urinary meatus, and the clitoris.
To determine any pathological condition of these structures it is
necessary that the physician should be familiar with the appearance in
the normal woman, and to gain such essential knowledge we should avail
ourselves of every opportunity offered to make a critical examination
of the external genitals of women, going over all the different
structures in order.
[Illustration: FIG. 1.--Woman in the dorsal position with feet
supported in Edebohls’ stirrups.]
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