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
Neglect during menstruation, especially in the young girl, is a
frequent cause of subsequent suffering. The effect of menstruation upon
the whole system is remarkable. The nervous, vascular, and digestive
systems all share in the menstrual function. The usual work of the girl
at school or other employment should be altered to suit the altered
conditions of her body at the menstrual period. Long school hours and
close mental application or active exercise are too often continued at
this time.
Celibacy is an unnatural state and a common cause of disease. Certain
forms of fibroid tumors of the uterus are more common in single than in
married women, and more common in sterile than in childbearing women.
And the painful cirrhotic ovaries of the old maid are the result of
the unceasing menstrual congestions never relieved by pregnancy and
lactation.
CHAPTER II.
METHODS OF EXAMINATION.
In order to make a complete gynecological examination, we must examine
the abdomen, the external organs of generation, and the pelvic
structures.
=Examination of the Abdomen.=--In order to make a perfectly
satisfactory examination of the abdomen, the woman should be in bed,
with all clothing removed except the undershirt and the night-dress,
which should be drawn well up above the costal margin. Examination
made with any constricting clothing about the waist or about the lower
thorax is most unsatisfactory.
The abdomen is examined by inspection, palpation, percussion, and
auscultation.
The woman should lie flat upon her back, and the abdomen should be
thoroughly exposed. We can then determine by _inspection_ the presence
of dilated veins or of lineæ albicantes, the general size and form of
the abdomen, the occurrence of any abdominal movement, and the presence
of any asymmetry in the abdominal contour, such as would be made by the
bulge of a tumor or the displacement of an abdominal organ. The shape
of the abdomen, even though symmetrical, is often diagnostic of certain
intra-abdominal conditions. Thus, an abdominal enlargement that is due
merely to fat presents a different contour from the enlargement caused
by tympanitic distention of the intestine. The enlargement due to
ascites, or free fluid in the peritoneum, differs in contour from that
caused by an encysted collection of fluid.
It should be remembered that lineæ albicantes are not always the result
of pregnancy, but that they may have been caused by distention of the
abdomen from some other cause.
_Palpation._--We can determine most by palpation of the abdomen. The
examiner should always remember that it is most important to secure the
patient’s confidence, and to proceed so gently, slowly, and gradually
in performing palpation that no voluntary or reflex contraction of the
abdominal muscles may impede his manipulations.
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