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Google Book Search helps readers discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web at|http: //books .google .com/I I^IBRARY OF Cooper Medical College DATE NO. CLASS GIFT OF ( 1 i '1 FOR PRACTITIONERS AND STUDENTS BY WILLIAM EASTERLY ASHTON, M.D., LLD. HKI.LOW OF TMK AMKRICAN GYNECOLOGICAL SOCIKTY; PROKKSSOK OK GYNECOLfXiY IN THK MKDICO-CHIRURGICAL COLLKGt, AND GYNKCOLOGIST TO THK MKOICO-CHIRTRGICAL HOSPITAL. PHILADELPHIA ; Ft'RMKKLY LKCTl'RER ON <;YNRC(>L0GY IN THE JKFKKRSON MEDICAL COLLKCK, PHII.ADKI.PHIA ; ONK <^K THE KOL'NDKRS OF THK CONGR^S INTERNATIONAL DK GYNlicOL<K;iR ET O'OBST^TRIQL'K ; MEMBER OF THE AMKRICAN MEDICAL ASSOCIATION, ETC. ^ • • • < • • • WITH JEN HUNDRED AND FORTY-SIX NEIV UNE DRAIVINGS IUUS7RA7ING THE TEXT BY JOHN V. ALTENEDER Copyright, 1905, by W. B. Saunders & Company. H2. 0\ THIS BOOK IS DEDICATED TO MY WIFE ALICE ASHTON AS A TOKEN OF LOVE AND IN APPRECIATION OF HER CONSTANT AND LOYAL COMPANIONSHIP DURING THE YEARS THAT HAVE GONE BY CONTENTS. CHAPTER I. PAGE Gexeral Technic of Gynecologic Examinations 17 chapter ii. Microscopic and Bacteriologic Examinations 37 CHAPTER m. The Blood in Relation to Surgery 50 chapter iv. Examination of the Abdomen 57 chapter v. Examination of the Rectum 68 chapter vi. The X-rays in Gynecology 75 CHAPTER vn. Hydrotherapy 77 chapter viii. Constipation 102 CHAPTKR IX. \)n.T 106 CHAPTKR X. I\iMM)R Exercises 117 CHAPTER XL >\LINK InJE(TI()\S 12(1 CHAPTER XII. Thi V VISES OF Diseases Peculiar to Women 1 ;6 chapter XIII. ni-ri>Rv Takinc; 144 chapter XIV. r»:J XlLVA Is2 14 contents. chapter xv. The Vagina chapter xvi. The Uterus chapter xvii. Examination of the Fallopian Tubes, the Ovaries, and t Uterine Ligaments chapter xviii. The Fallopian Tubes chapter xix. The Ovaries chapter xx. Diseases of the Broad Ligaments chapter xxi. Tumors of the Ovarian Ligaments chapter xxh. Tumors of the Round Ligaments chapter xxiii. Suppuration of the Pelvic Connective Tissue chapter xxiv. EcHiNOCOCCus Disease of the Pelvis chapter xxv. Ectopic Gestation chapter xxvi. Hysterectomy for Diseased Appendages chapter xxmi. Effects of the Removal of the Uterine Appendages chapter xxviii. Conservative Operations on the Uterine Appendages chapter xxix. The Urethra chapter XXX. The Bladder CONTENTS. IS CHAPTER XXXI. paoi The Ureters 657 CHAPTER XXXn. Physiology 692 CHAPTER XXXni. IXTKSTINAL DISORDERS 698 CHAPTER XXXIV. ' COCCYOODYNIA 73O CHAPTER XXXV. TrBERCULOSIS OF THE GeNITAL OrGANS 738 chapter xxxvi. Genital Fistulas 750 chapter xxxvii. Sterility 775 chapter xxxviii. The Pelvic Floor 781 chapter xxxix. .\.\TisEPsis IN Hospitals 807 CHAPTER XL. TFrirvir of Minor Operations 830 CHAPTER XLI. TFrHNir OF Abdominal and Pelvic Operations 834 chapter xlii. Antisi.p^is in Private Houses 944 chapter xliii. Tm H\i( oi' Special Operations 955 chapter xliv. Al'ITNDK ITIS IOI3 chapter xlv. M'»\ \IlI.E KlDNFY 1028 Im»i.x 1043 THE EXAMINING I Fic. iS. — Pose or tve Fmcui ih Madhc ah Ihthhai ExAUiHAnoH it the Fitn Mettod (a ud H. GYNECOLOGIC POSTURES. 33 The physician then kneels on one knee in front of the patient and passes his hand under the sheet and clothing (Fig. 33). FlO. 30. — DOKSOSACBAL ELEVATED POSITION. O- F;', II — Etrrr PfwrnoN with thk Right F(»ot Rfst- iNi, «»N thf Rovnd of a Chaik. Fu;. V- Krkt Position with thk Ha( K Ar.AIN>.T THK WaI.L AND THK Fkkt Skpakatki). s GYNECOLOGIC POSTURES. Arrangement of the Sheet and Clothing. — The patient is protected from eitposure by throwing a sheet over the hips and back and sep>arating it at the gluteal cleft to bring the i-ulva into view. If the examination is made at the Fus. j5. — KHiE-cam PosmoK with the Sensi Rurao n> Exposi mt Vulva. phvsidan's office, the skirts are drawn up over the patient's hips after the sheet has been thrown over her. (a) Knce-cbest Elevated Position. — The patient is placed in the ordinary kwt-chest posiiii>n and the pelvis is then niiscd higher by placing pillows under I be knees. Itateral-prone Position. — This position is uUo known as Sims's or ihc *mi. prune position. GYNECOLOGIC POSTURES. 37 Horhsontal Recumbent Position. — Position of the Patient. — The patient lies flat upon her back with the head resting on a pillow and the arms Fxc. 40.— Horizontal Rxcuicbent Position. at the side of the chest. The lower extremities are extended in a direct line with the long axis of the body and the heels placed in contact with each other. Fir.. 41.— Horizontal Recxmbent Position with the Sheet Draped to Expose the Abdomen. Arrangement of the Sheets and Clothing. — A sheet is thrown over the <he>t and another placed over the abdomen and lower extremities. The cloth- ini: i^ then drawn up to the chest and the upy)er edge of the lower sheet is tucked arr»und the hips so as to leave the surface of the abdomen exposed to view. CHAPTER II. HICROSCOPIC AND BACTERIOLOGIC EXAMINATIONS. It is often impossible for the surgeon to make a positive diagnosis in cases in which malignancy' is su.^j)ected or to determine the variety of an infection or t'f ri-certain the nature of a growth removed by an oj)eration without the co-op- fr.iiiun of the pathologi.<t. In seeking his aid, however, the clinician must bear in mind that the microscope and the culture-tube are but adjuncts to the diag- nostician's resources, and that thev mav not alwavs be conclusive in their evi- <lencc. DIKECT INSPECTION. Fic. >].— ExnMTHi tBi Amn wn S»ai. : Ir— DrerTii Eimiioii ENEMATA. 10$ constip>ation be attended with bleeding hemorrhoids, the daily injection of half an ounce of the distilled extract of witch-hazel or a pint of cold water will usually be of benefit. When a more stimulating enema is desired, the following, sometimes called the '*ox-gair^ enema, will often give the wished-for result: Powdered ox-gall, e-. xx Glycerin, f 5 j Water and soapsuds ( 105° F.) Oj Rub up the ox-gall powder with the glycerin, adding the latter very gradually until a perfectly smooth paste is made, and then thoroughly mix it with the water and soapsuds. The mixture at a temperature of loo® F. is then injected into the bowel through a large-sized rubber catheter, or, better, through a flexible colon tube passed as far in as possible, the patient lying uj)on the left side or in the knee- chest jx>sition. In this way the injection is given high in the bowel, where it should be allowed to remain for two or three hours before the bowels are moved. For obstinate constipation good results may be obtained by the use of oil, as f< ill* >ws : Castor oil or olive oil, f 5 j Castile soapsuds ( 100** F.), Oij These should be mixed as thoroughly as possible and one drachm of spirits of turp>entine beaten up with the yolk of an egg added. A plain enema of soapsuds is best made of brown soap and from one to two quarts of hot water; its efl&ciency may be augmented by the addition of one ounce of glycerin and a drachm of spirits of turpentine. A useful enema will be found in the following: Sulphate of Magnesia Sij Glycerin, f 5ij Spirits of Turpentine, f 3 j Hot ^-ater ( 100° F.) Oj An ounce of glycerin injected into the rectum with a small hard-rubber -yrinsre is usually followe<l by prompt results; it should he used in preference to the -uppr)sitones, which are not so certain in their action. The following enema is useful in obstinate constipation: Six ounces of olive "il at a temperature of 100° F. The injection should be given through a rectal 'vuW high in the bowel with the patient in the left lateral-prone or knee-chest Shttuiii constipation be associated with excessive tympanites, the injection of a ! -''t < f milk of asafetida will be beneficial. SQDATTINC — TRUNK RAISING. EKEinii No. 8. S<tu:(i; INDEX. Abdomen, aiisnxltation, 68 diagnostic value of appearance, 60 examination, 57 inspection, 59 mensuration, 67 movements of abdominal walls, 60 palpation, 60 percussion, 65 regions, 57 shape of, in ascites, 59 in fat abdominal walls, 59 in pelvic enlargements, 59 in tumors, 59 skin of, in disease, 60 Abdominal adhesions, 910 and pelvic drainage, 893 glass tubes, 895 gauze, 901 indications, 893 rubber tubes, 903 varieties, 895 bandage, 850 dressings, 827 hysterectomy, complete, 996 incomplete, 984 irrigator, 823 myomectomy, 10 10 definition, loio number of assistants, loio operation, loio position of patient, 10 10 operations, after-treatment of, 843 in private houses, 945 wound, dressing, 905 closing, 904 Abnormal implantation of orifices of ters, 672 Abscess in abdominal wound, 876 Absence of bladder, 626 of clitoris, 155 of Fallopian tubes, 483 of hymen, 159 of labia majora, 158 ure Absence of labia minora, 156 'of ovaries, 504 of urethra, 590 of uterus, 313 of vagina, 236 of vulva, 154 Accessory Fallopian tubes, 484 ovaries, 504 Accidental ligation of ureters, 678 Accidents in opening abdomen, 908 hemorrhage, 908 injuries of bladder, 908 peeling off parietal peritoneum, 908 wounding intestines or underlying g^wth, 909 Acne of vulva, 216 ac-rays in, 77 Acquired atresia of cervix, 473 causes, 473 definition, 473 diagnosis, 474 differential diagnosis, 475 pathologic changes, 473 prognosis, 475 symptoms, 474 treatment, 475 atrophy of uterus, 446 stenosis and atresia of vagina, 242 causes, 242 diagnosis, 243 prognosis, 243 s3anptoms, 242 treatment, 243 of cervix, 477 causes, 477 definition, 477 diagnosis, 477 pathologic changes, 477 prognosis, 478 treatment, 478 Acute ovaritis, 505 causes, 505 diagnosis, 506 1043 if INDEX. 1047 Calcification in uterine fibroids, 372 Calculi of ureters, 682 causes, 682 description, 682 diagnosis, 683 results, 682 situation, 682 symptoms, 682 treatment, 684 Canal of Nuck, 193 in anterior hernia of vulva, 194 in hydrocele, 193 in inguino-labial hernia, 194 Cancer of body of uterus, 391 causes, 391 causes of death, 395 diagnosis, 393 differential diagnosis, 394 extension, 391 pathology, 391 prognosis, 395 recognition of involvement of peri- uterine tissues, 395 symptoms, 392 treatment, 395 3c-rays in, 75 of cervix, 396 causes, 396 causes of death, 400 complicating pregnancy, 406 diagnosis, 400 differential diagnosis, 403 extension, 397 pathology, 396 prognosis, 407 recognition of involvement of peri- uterine tissues, 405 recurrence after operation, 413 symptoms, 399 treatment, 407 3f-rays in, 75 of Fallopian tubes, 503 of uterus, jc-rays in, 75 of vagina, 287 causes, 287 diagnosis, 288 differential diagnosis, 289 prognosis, 289 symptoms, 288 treatment, 289 jc-rays in, 76 of vulva, 196 causes, 196 Cancer of vulva, course, 198 diagnosis, 197 prognosis, 198 situation, 196 symptoms, 197 treatment, 198 varieties, 196 af-rays in, 76 Carcinoma of bladder, 650 of broad ligaments, 550 in connection with uterine fibroids, 373 of ovaries, 518 of urethra, 614 Caruncle of urethra, 613 description, 613 diagnosis, 614 pathologic anatomy, 613 prognosis, 614 symptoms, 614 synonyms, 613 treatment, 614 Catarrhal salpingitis, 485 causes, 485 diagnosis, 486 pathology, 485 prognosis, 486 symptoms, 485 treatment, 486 Catgut, 825 Catheter, double-current, 762 glass female, 828 reflux, 595 Catheterization of bladder, loii of ureters, 663 Cauliflower excrescences of vulva, 203 Causes of diseases peculiar to women, 136 accidental infections and trauma- tisms, 144 anatomic, 136 childbirth, 140 civilization, 137 criminal abortions, 143 different periods of life, 144 education, 137 hereditary and congenital influ- ences, 136 sexual relations, 142 social condition, 137 unhygienic conditions, 138 venereal diseases, 143 Cautery, Paquelin, 829 Cervical cancer, 396 catarrh, 440 INDEX. 1053 Displacements of uterus, torsion, 321 Distilled water, 100 still for making, 100 use, 100 Divided bladder, 626 Dorsal elevated position, 30 position, 30 arrangement of sheet and clothing, 30 position of patient, 30 Dorsosacral elevated position, 32 position, 30 arrangement of sheet and clothing, 31 position of patient, 30 Double-current female catheter, 762 OS uteri, 313 uterus, 310 vagina, 234 vulva, 155 Douche, intrauterine, 94 vaginal, 91 Drainage, abdominal and pelvic, 893 gauze, 901 glass. 895 in ureteral operations, 679 rubber tubes, 903 syringe, 824 Dress in relation to disease, 139 Dressing abdominal wound, 905 Dressings, abdominal, 827 Dropsical Graafian follicles, 520 Duplication of ureters, 672 Dysmenorrhea, 718 causes, 718 definition, 718 diagnosis, 721 membranous, 719 prognosis, 722 symptoms, 719 treatment, 722 EcraNOCOCCUS disease of pelvis, 554 causes, 554 description, 554 diagnosis, 555 physical signs, 555 prognosis, 555 symptoms, 554 treatment, 556 Ectopic gestation, 556 definition, 556 ovarian, 556 Ectopic gestation, primary, 556 secondary, 556 tubal, 556 varieties, 556 Eczema of vulva, 211 causes, 211 definition, 211 diagnosis, 212 prognosis, 212 symptoms, 212 treatment, 212 varieties, 211 5:-rays in, 77 Edebohls's method of i>erforming nephror- rhaphy, 1034 Edema in uterine fibroids, 372 of vulva, 192 causes, 192 definition, 192 prognosis, 192 symptoms, 192 treatment, 192 Education as a cause of disease, 137 Effects of the removal of uterine append- ages, 570 general, 572 mind, 572 sexual appetite, 572 symptomatic results, 570 symptoms, artificial menopause, 571 Elephantiasis of vulva, 188 causes, 188 definition, 188 diagnosis, 189 prognosis, 189 symptoms, 188 treatment, 189 jc-rays in, 77 Elongation of cer^'ix (congenital), 313 Emmet's operation for tears of pelvic flDor, 802 Emollient sitz-bath, 213 Emphysema of abdominal wall, 873 treatment, 874 Emphysematous vaginitis, 274 causes, 274 definition, 274 prognosis, 275 symptoms, 274 synonym, 274 treatment, 275 Enchondroma of bladder, 649 Endocervicitis, 440 INDEX. I05S Examination of ureter, inspection, 66i locating an obstruction, 668 microscopic, 671 obtaining separate urines, 663 rectal palpation, 659 segregation of urine, 668 sounding, 663 vaginal palpation, 657 af-rays, 671 of urethra, 582 bacteriologic, 590 direct inspection, 582 indirect inspection, 585 microscopic, 590 palpation, 584 sounding, 588 urethroscopy, 585 of uterine ligaments, 479 adnexa and ligaments, 479 anesthesia, 480 artificial uterine prolapse, 483 information, 479 limitations, 479 methods, 479 position of patient, 480 preparation of patient, 479 rectovaginal touch, 483 vagino-abdominal touch, 480 of uterus, 296 artificial uterine prolapse, 306 bacteriologic, 309 indirect inspection, 296 microscopic, 309 recto-abdominal touch, 302 rectovesical touch, 305 sounding, 307 vaginal touch, 298 vagino-abdominal touch, 300 of vagina, 225 bacteriologic, 234 direct inspection, 225 indirect inspection, 227 microscopic, 234 vaginal touch, 226 of vulva, 152 bacteriologic, 153 inspection, 152 palpation, 153 microscopic, 153 Examining hand, pose of, in pelvic examin- ations, 26 external, 28 internal, 26 Excision of vulva, 963 after-treatment, 965 definition, 963 instruments, 963 number of assistants, 963 operation, 964 position of patient, 963 Exercise, effect of, upon constipation, 103 indoor, 117 in relation to disease, 139 outdoor, 117 Exfoliative cystitis, 629 endometritis, 417, 719 Exploration of peritoneal cavity. 886 illumination, 890 inspection, 887 retractors, 887 touch, 886 Trendelenburg position, 888 Exstrophy of bladder, 626 Extrauterine gestation, 556 Exudative cystitis, 629 Fallopian tubes, 483 diseases, 484 examination, 479 in imperforate hymen, 160 malformations, 483 rupture of, in imperforate hymen, 162 tuberculosis, 747 False hermaphroditism, female, 164 male, 163 Fat embolism in wounds of vulva, 166 Fatty degeneration in uterine fibroids. 372 Fecal fistula, 882 causes, 882 prognosis, 882 treatment, 882 Female false hermaphroditism, 164 Fenger's method of dividing a ureteral stricture, 680 Fermentation fever, 860 Fetal uterus, 312 Fever, effect of, upon blood-changes, 52 Fibrinous cystitis, 629 Fibroid enlargement of intravaginal cervix, treatment, 390 polypi, treatment, 387 tumors complicating pregnancy, diag- nosis, 383 treatment, 390 Fibromata of bladder, 649 i 1056 INDEX. Fibromata of broad ligaments, 550 of ovaries, 517 of round ligaments, 551 of uterus, 368 causes, 368 changes in uterus, 371 description, 368 diagnosis, 376 diagnosis of secondary changes, 381 differential diagnosis, 383 effect upon neighboring and distant organs, 371 prognosis, 375 secondary changes, 372 symptoms, 373 treatment, 384 varieties, 369 of vagina, 283 causes, 283 description, 283 diagnosis, 283 differential diagnosis, 284 prognosis, 284 results, 284 symptoms, 283 treatment, 284 Fibromyoma of Fallopian tubes, 503 Fig warts of vulva, 203 Filtered drinking-water, 100 Finger-cots, use of, in gynecologic examina- tions, 2^ Fistulas, fecal, 882 genital, 750 Flexible silk ureteral catheter, 665 Floating kidney, 1028 Follicular cysts of ovaries, 520 causes, 520 diagnosis, 521 pathology, 520 prognosis, 521 symptoms, 521 synonyms, 520 treatment, 521 vulvitis, 176 causes, 176 definition, 176 prognosis, 176 symptoms, 176 treatment, 177 Fo(xl in relation to disease, 139 Forceps, Laplace, 929 O'Hara, 932 Foreign bodies in bladder, 647 Foreign bodies in bladder, classification, 6 diagnosis, 648 prognosis, 648 symptoms, 648 treatment, 649 in ureters, 687 in uterus, 315 causes, 315 diagnosis, 316 results, 316 symptoms, 316 treatment, 316 in vagina, 244 causes, 244 diagnosis, 245 results, 245 symptoms, 244 treatment, 245 Full bath, 83 action, 83 cold, Ss hot, 83 technic, 83 tepid, 83 varieties, 83 warm, 83 Fungoid endometritis, 417 Gangrene of vulva, 172 causes, 172 definition, 172 prognosis, 172 symptoms, 172 treatment, 172 Garrulity of NTilva, 295 Gauze compresses, 826 drainage, 901 care of wound, 002 dressing wound, 902 indications, 901 introduction, Q02 objections, 901 pads, 826 sponges, 826 tampons, 826 General and local cleanliness in relation ' disease, 138 irrigating apparatus, 823 operative technic, 883 closing abdominal wound, 904 covering raw surfaces, Sgi drainage, 893 INDEX. 1057 General operative technic, dressing abdom- inal wound, 905 enteroclysis, 906 median abdominal incision, 883 threading needles, 906 toilet of peritoneum, 891 septic peritonitis, 862 diagnosis, 863 prognosis, 864 symptoms, 862 treatment, 864 Genital eminence, 154 fistulas, 750 classification, 750 definition, 750 enterovaginal, 774 fecal, 750 rectolabial, 773 rectoperineal, 772 rectovaginal, 769 uretero-uterine, 769 urethrovaginal, 768 urinary, 750 vesico-uterine, 764 vesico-uterovaginal, 766 vesicovaginal, 750 folds, 154 furrow, 154 organs, tuberculosis, 738 ridge, 154 Genito-urinary sinuses, jc-rays in treatment, 76 Glands of Skene, collecting discharges, 44 Glandular cysts of ovaries, 522 causes, 522 description, 522 synonyms, 522 endometritis, 417 Glass catheters, 829 drainage, 895 care of sinus tract, 900 care of syringe, 898 cleaning tube, 898 dressing wound, 897 indications, 895 introduction, 896 method of withdrawing tube, 900 objections, 895 when to clean tube, 900 when to withdraw tube, 900 drainage-tubes, 824 Glycerin as a lubricant, 25 Gonorrhea as a cause of disease, 143 67 ' Gonorrheal endometritis, 427 causes, 427 definition, 427 diagnosis, 428 differential diagnosis, 429 prognosis, 430 recurrence, 431 symptoms, 427 treatment, 430 macule, 179 vaginitis, 271 definition, 271 diagnosis, 272 prognosis, 272 symptoms, 272 treatment, 272 varieties, 271 \'ulvitis, 175 definition, 175 diagnosis, 175 prognosis, 175 symptoms, 175 treatment, 176 Granular vaginitis, 272 causes, 273 description, 272 diagnosis, 273 prognosis, 273 symptoms, 273 synonym. 272 treatment, 273 Gumma of Fallopian tubes, 503 of vulva, 202 Gynecologic postures, 29 arrangement of patient's clothing, 29 canton-fiannel stockings, 29 varieties, 29 Half-bath, 84 action, 84 technic, 84 Halsted's mattress suture, 923 Hand-brushes, 828 use of, in gynecologic examinations, 22 Hard soap, sterilization, 814 Harris's segregator, 671 Hcgar's uterine dilator, 598 Hematocele, pelvic, 560 Hematocolpos in double vagina, 236 in imf)erf orate hymen, 160 in partial absence of vagina, 236 Hematoma of broad ligaments, 561 INDEX. I061 ijuries during an abdominal operation, of bladder, 914 of intestines, 915 antisepsis, 919 classification, 915 continuous Lembert suture, 922 continuous through-and-through suture, 923 Cushing's right-angled suture, 922 end-to-end anastomoses, Halsted mattress suture, 924 Laplace's forceps, 928 O'Hara's forceps, 932 Murphy button, 935 general operative tcchnic, 919 Halsted's mattress suture, 923 interrupted Lembert suture, 921 intestinal anastomosis, 923 involving loss of tissue, 917 involving lumen, 916 invohing serous and muscular coats, 915 irregular tears, 916 lateral anastomosis, Halsted's mattress suture, 926 Laplace's forceps, 938 O'Hara's forceps, 940 Murphy button, 943 longitudinal tears, 916 necrotic areas, 917 needles, 919 suture material, 920 suturing, 920 treatment, 915 varieties of intestinal sutures, 921 of mesentery, 918 of rectum, 918 of ureters, 915 of body of uterus, 313 causes, 313 diagnosis, 314 prognosis, 314 treatment, 315 of ureters, 674 causes, 674 diagnosis, 674 symptoms, 674 treatment, 675 varieties, 674 ispection of abdomen, 59 of vulva, 152 istrument sterilizer, 810 Interlocking or link suture, 977 Intermediate operations for lacerations of cervix, 461 for tears of pelvic floor, 794 Intermittent angioneurotic edema of vulva, 192 Interstitial endometritis, 417 pregnancy, 558 uterine fibroids, 369 Intertrigo of vulva, 216 Intestinal anastomosis, 923 clamps, 920 needles, 919 obstruction (post-operative), 867 blood-changes, 55 causes, 867 diagnosis, 870 prognosis, 871 symptoms, 869 treatment, 871 suture material, 920 sutures, 921 suturing, 920 Intestines, injuries during an abdominal operation, 915 preparation of, for a gynecologic examina- tion, 24 Intrah'gamentous cyst, removal, 982 uterine fibroids, 370 removal, 992, 994 Intrauterine douche, 94 Intravenous saline injections, 129 antisepsis, 130 apparatus, 129 indications, 129 instruments, 130 local anesthesia, 131 operation, 131 quantity of solution, 130 rapidity, 130 temperature of solution, 130 Invagination of pelvic floor in pelvic ex- aminations, 26 Inversion of uterus, 359 causes, 359 definition, 350 diagnosis, 361 HifTcrential diagnosis, 362 pathologic anatomy, 360 prognosis, 363 symptoms, 360 treatment, 364 lodin blood -reaction in septic infection, 56 INDEX. 1063 Leukocytosis, electricity, effect upon, 53 hot baths, effect upon, 53 in infants, 53 in malignant disease, 56 in septic infection, 56 in tuberculosis, 57 massage, effect upon, 53 number of leukocytes in, 53 significance, 53 Leukopenia, significance, 53 Levator ani muscle, 782 Lichen of vulva, 216 x-T3.ys in, 77 Linen duster for visitors, 833 Lipoma of bladder, 649 of broad ligaments, 550 of Fallopian tubes, 503 of vulva, 196 Liquid diet, 106 soap as a lubricant, 24 sterilization, 814 white vaselin as a lubricant, 25 Litholapaxy, 647 Lithopedion, 562 Localized abdominal and pelvic infection, 864 diagnosis, 865 prognosis, 865 symptoms, 864 treatment, 865 Locating a ureteral obstruction, 668 Lubricants used in gynecologic examinations, 24 glycerin, use in cancer, 25 liquid soap, 24 liquid 'white vaselin, 25 advantages, 25 method of applying, 24 method of preparing, 25 tincture of green soap, 25 vaselin and oily substances, 24 Lumbar incision to expose ureter, 685 Lupus vulgaris, 739 Jf-rays in, 76 Mackenrodt's operation for vesicovaginal fistula, 763 Male false hermaphroditism, 163 Malformations of bladder, 626 absence, 626 divided, 626 exstrophy, 626 Malformations of cervix, 313 absence, 313 atresia, 313 conical shape, 313 defective development, 313 double OS uteri, 313 elongation, 313 hypertrophy, 313 pinhole os, 313 stenosis, 313 of clitoris, 155 absence, 155 adherent prepuce, 156 atrophy, 155 cleavage, 155 hypei:trophy, 155 redundant prepuce, 156 of Fallopian tubes, 483 absence, 483 accessory, 484 accessory ostia, 484 anomalies in size and shape, 483 displacements, 484 rudimentary, 483 supernumerary, 484 of hymen, 159 abnormal openings, 159 absence, 159 anomalies in structure and shape, 159 imperforate, 160 rudimentary, 159 of labia majora, 158 abnormal situation, 158 absence, 158 hypertrophy, 158 multiple, 158 rudimentary, 158 of labia minora, 156 absence, 156 adherent labia, 158 hypertrophy, 156 multiple, 158 rudimentary, 156 of ovaries, 504 absence, 504 accessory, 504 displacements, 504 rudimentary, 504 supernumerar}', 504 of ureters, 672 abnormal implantation of orifices, 673 duplication, 672 occlusion, 674 li INDEX. io6s Menstruation, recurrence of flow, 692 retarded, 699 scanty, 706 supplementary, 717 synonyms, 692 vicarious, 717 densuration of abdomen, 67 fixed points of measurement, 67 information, 67 measurements, 67 position of patient, 67 liethod of determining which ureter is injured, 679 of locating a ureteral obstruction, 668 of obtaining separate urines by catheteri- zation, 668 tfethods of sterilization, 807 boiling aqueous solution of carbonate of soda, 810 chemic, 811 high-pressure steam, 807 mechanic, 810 Metrorrhagia, 700 pathologic significance, 145 Microscopic examinations, 37 general considerations, 37 discharges, 42 antisepsis, 43 equipment and instruments, 42 glands of Skene, 44 information for pathologist, 45 method of collecting discharges, 43 method of smearing glass slides, 43 position of patient, 43 preparation of patient, 43 shipment to laboratory, 45 technic, 43 urethra, 43 uterus, 44 vagina, 44 vulva, 43 vulvovaginal glands, 44 tissues, 38 curetment, 38 collecting curet scrapings, 38 equipment, 38 information for pathologist, 39 preserving fluid, 39 shipment to laboratory, 39 technic, 38 fragment, 39 after-treatment, 41 anesthesia, 39 Microscopic examinations, tissues, fragment, final sterilization, 39 information for pathologist, 41 instruments, 40 number of assistants, 39 operation, 40 position of patient, 39 preparation of patient, 39 preserving fluid, 41 shipment to laboratory, 41 special directions, 40 technic, 39 variations in technic, 41 growth, 41 information for pathologist, 42 preserving fluid, 41 shipment to laboratory, 41 technic, 41 Minor operations in private houses, 951 Moist warts of vulva, 203 Movable kidney, 1028 after-treatment, 1041 body form, 1028 body index, 1029 causes, 1028 diagnosis, 1033 symptoms, 1030 treatment, 1033 variations in technic, 1041 Mi^cous patches of vulva, 202 Multilocular ovarian cysts, 522 Multiple labia majora, 158 minora, 158 Murphy's button, 938 intestinal clamps, 920 Muscles of [Mflvic floor, 781 bulbocavernosi, 782 ischiocavernosi, 782 levator ani, 782 sphincter ani, 782 transverse perineal, 782 Myoma of bladder, 649 of ovaries, 517 Myomectomy, abdominal, loio Myxoid cystomata, 522 Myxomatous degeneration in uterine fibroids, 373 Nausea and vomiting (post-operative), 850 treatment, 85 1 Necrobiosis in uterine fibroids, 373 Needles, intestinal, 919 INDEX. 1067 ■in as a symptom of disease, situations, 149 ainful tumors of urethra, 613 alpation of abdomen, 60 information, 60 consistence of a timior, 64 crepitation, 64 local tenderness or peritonitis, 64 presence of a tumor, 61 shape and mobility of a tumor, 63 situation and origin of a tumor, 62 position of patient, 60 technic, 61 of vulva, 153 tohysterectomy, 996 'apillary cysts, 524 causes, 524 description, 524 vaginitis, 272 'apilloma of bladder, 649 q{ Fallopian tubes, 503 1u)uelin's cautery, 829 *ftrmelee water still, 100 "arodphoritic cysts, 524 Parovarian cysts, 545 varicocele, 549 Parovarium, 545 ^artial hysterectomy, 984 ^teurized milk, 107 compared with sterilized, 107, 108 cotton batting plugs, 107 preparation, 107 sterilization of bottles, 107 Wvic connective tissue, 552 suppuration, 552 diaphragm, 781 floor, 781 anatomy, 781 mechanism, 782 puerperal injuries, 784 hematocele, 560 Percussion of abdomen, 65 information, 65 presence of a tumor, 65 shape of a tumor, 67 situation and origin of a tumor, 66 position of patient, 65 technic, 65 Mneum, 781 lacerations, 784 Mods of life as a cause of disease, 144 taitoneum, toilet, 891 Wtonitis, auscultation, 68 .crepitation, 64 Peritonitis, general septic, 862' position of patient, 60 septic, 862 traumatic, 860 Pessary, action, 352 adjustment, 350 care, 351 cup pessary, 335 external support, 335 introduction, 349 Skene's, 257 Smith-Hodge, 349 Thomas, 349 Phagedenic ulcers of vulva, 201 Phlegmasia alba dolens, 874 Pin-hole os uteri, 313 Pitchers, 825 Poland Springs water, loi analysis, loi use, loi Polypi of urethra, 615 of uterus, 370 Position of uterus, 318 Positions, gynecologic {vide postures), 29 Post-climacteric endometritis, 439 Posterior versions and flexions of uterus, 339 causes, 339 definition, 339 diagnosis, 344 difiFerential diagnosis, 345 frequency, 339 prognosis, 345 symptoms, 343 treatment, 346 Postures, gynecologic, 29 dorsal, 30 elevated, 30 dorsosacral, 30 elevated, 32 erect, 32 horizontal recumbent, 37 knee-chest, 34 elevated, 35 lateral -prone, 35 semi-prone, 35 Sims's, 35 Precocious development of vulva, 155 menstruation, 6g8 causes, 698 definition, 698 diagnosis, 699 frequency, 698 results, 698 I. I INDEX. 1069 ■eudo-hermaphroditism, 163 uberty, 691 age, 691 changes, 691 definition, 691 duration, 691 in relation to history taking, 145 management, 691 ubescent uterus, 312 uerperai atrophy of uterus, 446 injuries, pelvic floor, 784 classification, 784 intermediate operations, 794 lateral tears involving vaginal sulci, 785 median tears involving the sphincter ani, 785 primary operations, 787 secondary operations, 795 superficial median tears, 784 treatment, 787 tinctured wounds of vulva, 1 70 definition, 170 symptoms, 170 treatment, 170 *iirulent salpingitis, 487 causes, 487 diagnosis, 496 extension of infection, 491 extra-tubal results, 491 hematosalpinx, 490 hydrosalpinx, 490 p)athology, 488 prognosis, 501 pyosalpinx, 490 symptoms, 494 treatment, 501 ^trid intoxication, 433 fitting on operating gown, 816 on rubber gloves, 816 ■yocolpos in imperforate hymen, 161 ^metra in imperforate hymen, 161 yosalpinx, 490 in imperforate hymen 161 LXCTAL touch, 70 anesthesia, 70 information, 71 invagination of perineum, 70 limitations, 70 position of patient, 70 technic, 70 Rectocele, 257 causes, 257 definition, 257 diagnosis, 260 frequency, 258 prognosis, 261 results, 260 symptoms, 259 synonyms, 257 treatment, 262 Rectolabial fistula, 773 definition, 773 treatment, 773 Rectoperineal fistula, 772 definition, 772 treatment, 772 Rectovaginal fistula, 769 causes, 769 definition, 769 description, 769' diagnosis, 769 prognosis, 770 symptoms, 769 treatment, 770 Rectum, direct inspection, 68 examination, 68 indirect insj>ection, 73 in imperforate hymen, 161 preparation of, for gynecologic examina- tion, 23 probing, 71 rectal touch, 70 vaginal touch, 71 Redundant prepuce, 156 Reed's operation for varicocele of broad ligament, 550 rubber T-drainage tubes, 903 Removal of intraligamentous uterine fibroid, 992, 994 cyst, 982 operation, 982 special directions, 984 of ovarian cyst, 978 instruments, 979 number of assistants, 978 operation, 979 position of patient, 978 special directions, 982 variations in technic, 981 of uterus for diseased appendages, 569 Replacement of inverted uterus (acute), 364 (chronic), 365 of retrodisplaced uterus, 346 E 1070 Replacement of retrodisplaced ut manual, 346 knee-chest position, 349 Resection of Fallopian tubes, 579 of 0 5.579 Rest in relation ti Retarded menslruation, 699 Retentive power of abdominal cavity, 1 Rjghl hypochondriac region, < iliac region, contents, 5S lumbar region, contents, 57 Robb's leg-holder, 31 use of, in dorsosacral position, 31 Rochester sterilizer, 949 Round ligaments, 551 Mann's method of shortening, 358 tumors, 551 Wylic's method of shortening, 357 Rubber drainage, 903 tubes, 874 gloves, 8*7 in gynecologic e: Rudimentary clitoris, 15. Fallopian lubes, 483 hymen, 159 labia majora, 15S labia minora, 156 ovaries, 504 Sacculated urethra, 608 Saline injections, 116 enleroclysis, 135 general indications, 12S hypodermoclysis, iji intravenous, 119 preparation at time of operation. 1 27 of solution, 126 routes of entrance into circulation, 1 18 tem[)eralurc of solution, 127 Salpingitis, 484 Salpingo-oophorectomy, 973 dcfini 1. 973 5.974 number of position of patie operation, 074 special directions, 978 973 INDEX. 107 1 emi-prone position, 35 enile endometritis, 439 causes, 439 definition, 439 diagnosis, 439 differential diagnosis, 440 pathologic changes, 439 prognosis, 440 symptoms, 439 treatment, 440 bydrometra, 439 pyometra, 439 vaginitis, 273 causes, 273 definition, 273 diagnosis, 274 prognosis, 274 symptoms, 273 synonyms, 273 treatment, 474 epsis after labor a cause of disease, 142 eptate uterus, 310 eptic endometritis, 431 causes, 431 definition, 431 diagnosis, 434 differential diagnosis, 435 prognosis, 435 s)rmptoms, 432 treatment, 436 infection, 432 blood-changes, 56 intoxication, 432 exual intercourse as a cause of disease, 142 beet bath, 89 action, 89 technic, 89 bober's cannula for intravenous injections, Z29 hock, 857 Crile's observations, 859 diagnosis, 858 prognosis, 858 symptoms, 857 treatment, 859 wounds of vulva, 166 Dk ligatures and sutures, 824 Qkworm-gut, 825 fanple catarrhal vulvitis, 172 causes, 172 definition, 172 diagnosis, 173 prognosis, 173 it^^l Simple catatrB&l vulvitis, symptoms, 173 treatment, 173 varieties, 173 dermatitis of vulva, 216 causes, 216 definition, 216 prognosis, 216 S3rmptoms, 216 synonyms, 216 treatment, 216 endometritis, 417 ulcer of bladder, 630 vaginitis, 267 causes, 267 definition, 267 diagnosis, 269 differential diagnosis, 269 prognosis, 270 symptoms, 268 treatment, 270 varieties, 267 Sims's glass vaginal plug, 224 position, 35 Sinus tracts in abdominal wall, 878 causes, 878 prognosis, 879 treatment, 879 Sitz-bath, 87 action, 87 alkaline, 213 apparatus, 87 cold, 87 emollient, 213 graduated, 87 hot, 87 stimulating, 214 varieties, 87 Skene's bivalve urethral speculum, 595 pessary, 257 reflux urethral catheter, 595 Soap, sterilization, 814 Social condition as a cause of disease, 137 Soft diet, III Solid tumors of ovaries, 516 Sounding bladder, 618 ureters, 663 urethra, 588 Special operations, 955 abdominal myomectomy, loio catheterization of bladder, ion clitoridectomy, 961 combined vaginal and abdominal hyster- ectomy, 1009 INDEX. 1073 Sterilization: pitchers, 813 rubber drainage syringe, 814 drainage-tubes, 814 gloves, 813 safety-pins, 814 sheets, 813 ■ silk ligatures and sutures, 812 ureteral catheters, 665 silkworm-gut, 812 sterilizing room, 822 storage room, 822 surgical rubber pad, 813 thermometer for saline injections, 127 towels, 813 urethroscope, 587 wash room, 822 Sterilized milk, 107 compared with Pasteurized, 108 preparation, 107 Sterilizer for dressings, high-pressure steam, 807 Sterilizing room, 822 care, 822 description, 822 equipment, 822 high-pressure steam sterilizer, 822 instrument sterilizer, 822 water sterilizer, 822 Stimulants, cardiac and respiratory. 829 Stimulating sitz-bath, 214 Stitch-hole abscess, 875 causes, 875 diagnosis, 875 prognosis, 875 symptoms, 875 treatment, 875 Storage room, 822 care, 823 description, 822 equipment, 823 storage case, 823 washstand, 823 Stricture of ureters, 679 causes, 679 description, 679 diagnosis, 679 symptoms, 679 treatment, 680 of urethra, 596 causes, 596 description, 596 physical signs, 597 prognosis, 597 68 Stricture of urethra, symptoms, 596 treatment, 597 Subcutaneous wounds of \ailva, 168 definition, 168 symptoms, 168 treatment, 168 Subinvolution of uterus, 442 causes, 443 definition, 442 diagnosis, 444 pathologic changes, 443 symptoms, 444 treatment, 445 Submucous uterine fibroids, 370 Subperitoneal uterine fibroids, 369 Substitute for Kelly's pad (Ashton*s), 26 Suburethral abscess, 612 causes, 612 description, 612 physical signs, 612 symptoms, 612 treatment, 613 Superinvolution of uterus, 446 causes, 446 definition, 446 diagnosis, 447 differential diagnosis, 447 pathologic changes, 446 prognosis, 447 symptoms, 447 synonyms, 446 treatment, 447 Supernumerary Fallopian tubes, 484 ovaries, 504 Supplementary menstruation, 717 Supports of uterus, 318 Suppositories in constipation, 104 Suppression of urine (post-operative), 873 causes, 873 symptoms, 873 treatment, 873 Suppuration of abdominal wound, 876 causes, 876 diagnosis, 877 [)rognosLs, 877 situation, 876 symptoms, 876 treatment, 877 of |K'lvic connective tissue, 552 causes, 552 diagnosis, 553 patholog\', 552 prognosis, 553 INDEX. 1075 ^bal gestation, 556 ampullar, 558 causes, 556 changes in uterus, 563 classification, 558 course, 558 diagnosis, 565 history of ovum, 562 interstitial, 558 isthmic, 558 physical development of fetus, 562 symptoms, 562 treatment, 566 uberculosis of genital organs, 738 blood-changes in, 57 causes, 738 of cervix, 744 diagnosis, 744 differential diagnosis, 745 frequency, 744 symptoms, 744 treatment, 745 of Fallopian tubes, 747 description, 747 diagnosis, 748 prognosis, 749 symptoms, 748 treatment, 749 varieties, 747 of ovaries, 749 description, 749 diagnosis, 750 pathology, 749 symptoms, 750 treatment, 750 prognosis, 750 of ureters, 689 causes, 689 diagnosis, 690 pathology, 689 prognosis, 690 symptoms, 690 treatment, 690 of uterus, 745 description, 745 diagnosis, 746 differential diagnosis, 746 symptoms, 746 treatment, 746 varieties, 745 of vagina, 742 differential diagnosis, 743 frequency, 742 Tuberculosis of vagina, method of infection, 742 prognosis, 743 symptoms, 742 treatment, 744 of vulva, 739 diagnosis 740 differential diagnosis, 741 prognosis, 741 symptoms, 739 synonyms, 739 treatment, 741 jc-rays in, 76 Tumors of clitoris, 207 treatment, 207 varieties, 207 of ovarian ligaments, 551 of round ligaments, 551 of vulva, 195 angioma, 196 benign, 195 fibroma, 196 lipoma, 196 mixed growths, 196 myoma, 196 myxoma, 196 neuroma, 196 Turkish bath, 88 action, 88 apparatus for use at home, 88 Ashton's method of arranging interior of bath cabinet, 88 technic, 88 Turpentine stupe, 854 Two-horned uterus, 311 Tympany (post-operative), 853 treatment, 853 Umbilical region, contents, 58 Unhygienic conditions as causes of diseases peculiar to women, 138 I Ureteral calculus, 682 stricture, 679 tuberculosis, 689 Ureteritis, 688 causes, 688 diagnosis, 688 patholog)', 688 prognosis, 689 symptoms, 688 treatment, 689 Ureterocystotomy, 677 1076 INDEX. Ureterorrhaphy, 676 Ureterostomy, 677 Uretero-ureterostomy, 676 Uretero-uterine fistula, 769 Urcterovaginal fistula, 768 Ureters, 657 accidental ligation, 678 diseases, 679 injuries, 674 during an abdominal operation, 915 malformations, 672 methods of examination, 657 Urethra, 582 collecting discharges for bacteriologic examination, 49 for microscopic examination, 43 diseases, 593 malformations, 590 methods of examination, 533 Urethral caruncle, 613 Urethritis, 593 causes, 593 physical signs, 593 prognosis, 593 symptoms, 593 treatment, 594 Urethrocele, 608 causes, 608 definition, 608 dififerential diagnosis, 610 physical signs, 609 prognosis, 610 symptoms, 608 synonym, 608 treatment, 611 Urethroscopy, 585 Urethrovaginal fistula, 768 causes, 768 definition, 768 diagnosis, 768 prognosis, 768 • symptoms, 768 treatment, 768 Urinal, ambulatory, 764 Urine, suppression (post-operative), 873 Urogenital sinus, 158 Uterine colic, 721 fibromata, 368 fibroids, 368 ligaments, 479 examination, 479 Uterus, 2q6 bicornis. 311 Uterus, collecting discharges for bacteri examination, 50 for microscopic examination, 44 cordiformis, 311 development, 309 didelphys, 310 diseases, 313 dilatation and curetment, 955 displacements, 318 duplex, 310 foreign bodies, 315 in imperforate hymen, 160 injuries of body, 313 malformations, 309 membranaceous, 311 methods of examination, 296 position, 318 removal for diseased appendages, 56< septus, 310 subseptus, 311 supports, 318 tuberculosis, 745 unicornis, 311 .r-rays in cancer, 75 Vagina, 225 collecting discharges for bacteri; examination, 50 for microscopic examination, 44 development, 234 diseases, 242 in imperforate hymen, 160 malformations, 234 methods of examination, 225 prolapse of anterior wall, 246 sterilization of, for a gynecologic < ination, 24 tuberculosis, 742 wounds, 238 :>r-rays in cancer, 76 Vaginal cystotomy, 970 definition, 970 instruments, 971 number of assistants, 971 operation, 971 position of patient, 971 preparation, 971 douche. 91 action, qi apparatus. 91 cleansing, 94 hot, 92 INDEX. 1077 Inal douche, medicated, 94 technic, 92 warm, 93 atus, 295 causes, 295 definition, 295 treatment, 296 jrsterectomy with clamps, 999 after-treatment, 1005 definition, 999 instnmients, 999 number of assistants, 999 operation, looi position of patient, 999 variations in technic, 1005 with ligatures, 1006 after-treatment, 1009 definition, 1006 instruments, 1006 number of assistants, 1006 operation, 1007 p)osition of {>atient, 1006 impon, 177 method of making, 177 Mich in rectal examinations, 71 (inismus, 221 tuses, 221 efinition, 221 lagnosis, 222 fognosis, 222 fmptoms, 222 reatment, 222 {Initis, 266 dhesive, 273 auses, 266 efinition, 266 inph)r5ematous 274 onorrheal, 271 ranular, 272 apillary, 272 Boile, 273 fmple, 267 ilbercular, 742 •rieties, 267 pnoiectal fistula, 769 diagnosis, 72 1 Hook's method of urctero-cystostomy, 676 of uretero-ureterostomy, 676 jcocele of broad ligaments, 549 causes, 549 description, 549 diagnosis, 550 Varicocele of broad ligaments, prognosis, 550 symptoms, 549 synonym, 549 treatment, 550 Varicose veins, 189 causes, 189 definition, 189 prognosis, 190 results, 190 symptoms, 190 treatment, 190 Vascular tumors of urethra, 613 Vaselin as a lubricant, 24 Vegetations of vulva, 203 Venereal affections as causes of diseases peculiar to women, 143 ulcers of vulva, 200 warts of vulva, 203 Ventral fixation of uterus for prolapse, 331 hernia, 881 causes, 881 prognosis, 882 symptoms, 882 treatment, 882 suspension of uterus, 353 Vemicae, 203 acuminata, 203 causes, 203 diagnosis, 203 prognosis, 204 results, 204 symptoms, 203 treatment, 204 vulgaris, 203 Vertical and transverse tubules of pan)va- rium, 545 Vesical calculus, 643 causes, 643 diagnosis, 644 prognosis, 645 symptoms, 643 treatment, 645 neoplasms, 649 Vesico-urcthral fissure, 599 causes, 599 definition, 590 description, 59Q differential diagnosis, 600 physical signs, 600 symptoms, 600 treatment, 600 Vesico-uterine fistula, 764 causes, 764 Vesico-uterine fistula, definition, 764 Vulvar diagnosis, 764 Vulvitl prognosis, 766 diab. symptoms, 764 follic irealmem, 766 simp Vesico-uterovaginal fistula, 766 tubei causes, 767 Vulvov definition, 766 foi cysts prognosis, 767 of sj-mploms, 767 of treatment, 767 duett influ causes. 731 definition. 750 description, 750 Wandi diagnosis, 752 Warm Washr ca: treatment, 754 de hernia, 246 eq' Vestibule, development, rs8 loc Vicarious menstruation, 717 SU] definition. 717 wa diagnosis, 717 Water. frequency, 717 actio prognosis. 717 admi situation, 717 symptoms, 717 S ircaltnent. 717 distil Vomiting during an abdominal oj)cration. excft CJOQ filter Vulva, 152 [mpo absence. 154 in oh collecting discharges for bacteriolojjic natui examination, 4Q punt for microsco]iic examination, 43 quali diseases, 171 sped double, 155 sprin excision, 963 steril ganiility, 295 Wire ci incontinence. 295 Wound infantile, 155 cai malformations. i;+ pn methods of examination. 152 precocious development, 11:5 s>n enterocele. 104 ro-e]iiplocelc, 194 INDEX. 1079 o\mds of vulva, lacerated, 169 open, 168 punctured, 170 septic, 168 subcutaneous, 168 symptoms, 165 treatment, 166 )rlie's method of shortening round liga- ments, 357 RAYS in gynecology, 75 acne, 77 X-ra>'s in gynecology, cancer of uterus, 75 of vagina, 76 of vulva, 76 diagnostic value, 75 eczema, 77 elephantiasis, 77 genito-urinary sinuses, 76 lichen planus, 77 prurigo, 77 pruritis vulvae, 77 sarcoma, 76 technic, 75 tuberculosis, 76 PATHOLOGY, BACTERIOLOGY, AND PHYSIOLOGY, 15 ienn's Tumors second luvaed Euutioii Pathology and Surgical Treatment of Tumors. By Nicholas Senn, M. D., Ph. D., LL.D., Professor of Surgery, Rush Medical Col- lege, Chicago. Handsome octavo, 718 pages, with 478 engravings, including 12 full-page colored plates. Cloth, $5.00 net ; Sheep or Half Morocco, j6.oo net. " The most exhaustive of any recent book in English on this subject It is well illus- trated, and will doubtless remain as the principal monograph on the subject in our language for some ye^xs." ^Journal of the American Medical Association, toney's Bacteriology and Technic Nei%i'nin Bacteriology and Surgical Technic for Nurses. Bv Emily M. A. Stoney, Superintendent, Carney Hospital, Mass. Revised by Frederic R. Griffith, M.D., Surgeon, N. Y. i2mo of 278 pages, illustrated. {1.50 net. " These subjects are treated most accurately and up to date, without the superfluous reading which is so often employed. . . . Nurses will find this book of the greatest value." — The Trained Nurse and Hospital Rei'iew. ilarkson's Histolo^^ A Text-Book of Histology. Descriptive and Practical. For the Use of Students. By Arthur Clarkson, M. B., C. M. Edin., formerly Demonstrator of Physiology in the Owen's College, Manchester, Eng- land. Octavo, 554 pages, with 174 colored original illustrations. Cloth, {4 00 net. " The volume in the hands of students will greatly aid in the comprehension of a sub- ject which in most instances is found rather difficult. . . . The woric must be considered a valuable addition to the list of available text-books, and is to be highly recommended." — New York Medical Journal. porham's Bacteriolo^^ A Laboratory Course in Bacteriology. For the Use of Medical, Agricultural, and Industrial Students. By Frederic P. Gorham, A. M., Associate Professor of Biology in Brown University, Providence, R. I., etc. i2mo of 192 pages, with 97 illustrations. Cloth, $1.25 net. *' One of the best students* laboratory pu'des to the study of bacteriology on the mar- ket. . . . The technic is thoroughly modem and amply sufficient for all practical pur- poses."— American Journal of the Medical Sciences, taymond's Physiology NeiTa-'r^Hion Human Physiology. By Joseph H. Raymond, A. M., M. D., Pro- fessor of Physiology and Hygiene, Long Island College Hospital, New York. Octavo of 685 pages, with 444 illustrations. Cloth, $3.50 net. " The book is well gotten up and well printed, and may be regarded as a trustw(;rthy guide for the student and a useful work of reference for the genera: practitioner. The illustrations are numerous and arc well executed." — The Lancet, London. i N201 Aehton, V/illi£ur. E A829 Gynecology 1905 8076 NAME DATE DUE 4.4mI ^k^.Jf!wff!K.w^MtL.'A^..iM.... 