Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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uterus is increased, but not mate-rially increased by the presence of ovarian and other extra-uterinetumors. The case, however, is rather exceptional in which the soundor probe is a necessary means of diagnosis. The more experience onehas, the more educated ones touch, the less one will need to use theseinstruments for diagnostic purposes. DTAGNOSTS. 73 Uterine Dilatation may ho accompli shod in tlio followiiiii^ svavs : 1. \)y t;ra(liiatc(l bougies, or sounds, after the method of dilatationof the mal(! urethra. 2. l>y instruments ofdiveriiing l)lades eonstrueled on the ))rinei()leof the iilove-streteher. 3. )>y water dilators. 4. )W tents. The object of diagnostic dilatation is to open the endometrium inorder that by means of the curette a specimen may bo removcnl formicroscopical examination, or in order that the finger may be used forintra-uterine digital touch. Dihitation is required more frequentlyfor therapeutic than for diagnostic purposes. The technique is the Figure 27.
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Passing sound ; second step : patient in dorsal position without speculum. As sound passes fromOS externum to fundus index-finger is moved from os externum to posterior vaginal fornix. same for diagnostic as for therapeutic dilatation. See, therefore, adescri))tion of the latter in Chapter \., on Minor Operations. Diagnostic Curettage.—The object of diagnostic curettage is toremove enough diseased tissue for microscopical or other examination.If the curette is small, and the os patulous, curettage is sometimespossible without anaesthesia or previous dilatation. Usually, however,the procedure requires both. Microscopical examination of the scrap-ings is frequently the only means of differentiation between hemor-rhagic endometritis, the remains of abortion, post-abortum endome-tritis, carcinoma, and sarcoma. The technique of curettage is describedin Cha)>ter V. The Exploratory Needle and Aspirator have the same diagnosticand therapeutic significance in gynecology as in other depart

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