Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
ise of temperature. A foul-smelling vaginal dischargeindicates the sloughing of the vaginal wall, and this is soon fol-lowed by a dribbling of urine into the vagina. The vagina, vulva,perineum, and inner aspect of the thighs soon show the irritatingeffect of the urine in the form of vulvovaginitis and local dermatitis.The distress and inconvenience of the dribbling lowers the vitality DIAGNOSIS OF DISEASES OF URETHRA AND BLADDER 521 of the patient, and she may become extremely weak and emaciated.Such individuals are almost invariably sterile. Menstruation maybe absent, irregular, or painful, but may also be perfectly normal.When the fistula is high up and small, the disturbance may beslight and the general health unimpaired. Difficulty in voiding urine, following labor, should always suggestthe possible development of a urinary fistula. Under such circum-stances it is well to avoid vigorous manipulation for fear of creatingor extending a fistula in tissue already devitalized. Fig. 218
Text Appearing After Image:
Vesicouterine fistula. A communication is established between the fundus of the bladderand the uterus at about the level of the internal os. Palpation of the fistula seldom affords satisfactory informationwhen the tissues about the fistula are soft and necrotic. This isparticularly true of a small opening. In long-standing cases thepuckered scar tissue and an opening possibly filled with soft mucousmembrane may often be recognized. A sound placed in the bladder and the index finger of the oppo-site hand in the vagina may be brought together through a fistulousopening. Inspection will give positive information as to the location andsize of the fistula. A Sims speculum introduced into the vaginawill expose the fistula if large enough. Sterilized milk or some 522 DIAGNOSIS OF DISEASES OF THE URINARY SYSTEM colored aseptic fluid injected into the bladder may be seen to flowthrough the fistula. The cystoscope will expose the opening fromthe vesical side and at the same time afford informat

Note About Images