Chapter XV., page 244. It is enough here to counsel a thorough (Part 3)

absence of corpora lutea in degenerated ovaries, 593 Davies, J., case of late child-bearing, 602 Davis, L., analysis of forty-five cases of bladder tumor, 481 Decidua, uterine, in extra-uterine pregnancy, Fig. 143, 344, 345 Defecation, difficulty in, as a symptom, 158 Deformed pelvis, 95 Delayed menopause, 601 Demme-Granicher, case of fibrosarcoma of vagina in a child, 570 634 INDEX Depressor, Hunter, Fig. 29, 88 Diabetes, urine of, a cause of pruritus, 160 Diagnosis of disease in any organ. See organ affected and disease af- fecting Diameters of pelvis, 96 Diarrhea in rectal disease, 158 Digital examination of rectum, 123 of vagina, 34 Digital exploration of uterine cavity, 94 Dilatation of uterus, 91 Dilator, urethral, double-ended, Fig. 45, 102 uterine, Hanks, Fig. 33, 91 Wathen, Fig. 34, 92 Discharge, rectal, 157 in hypertrophic proctitis, 509 vaginal. See Leucorrhea in case records, 7 in clinical history, 18 Diseases, constitutional, causing amen- orrhea, 141 Doderlein, lactic acid, bacterium of, 355 "Dodging time" of menopause, 611 Dressing forceps, uterine. See Forceps Drumming of bladder, 109, 465 Ducts, milk. See Breast of Miiller, 197, Fig. 71, 198 Dudley, E. C, tables of differential diagnoses, 195-196, 308-309 Dysmenorrhea, 128 associated with pelvic lesions, 129 differentiated from abortion, 441 due to poor health, 130 membranous, 131, 172 neurotic, 130 obstructive, 129 with fibroids, 129 with malformation of uterine organs, 129 with no pelvic lesion, 130 with pelvic inflammation, 129 with retroposition and anteflexion, 129 Dyspareunia, 146 in clinical history, 11 Dysuria. 151 Ears, ringing in, in menopause, 613 Echinococcus cyst, differentiated from large ovarian tumor, 314 from small ovarian tumor, 299 Ectopic pregnancy and chorioepithe- lioma. See Pregnancy, extra-uterine, and Chorioepithelioma, ectopic Edebohls vaginal speculum, Fig. 32, 91 Edgar, J. C, on frequency of abortion, 437 Edwards, W. A., views on adherent prepuce in the child, 557 on malignant disease of the uterus and ovaries in children, 278, 576 on masturbation, 575 Elevated pelvis position, 58 Emmet, T. A., views on dilatation of urethra, 448 on laceration of the cervix, 204, 207, 209 on pelvic circulation, 48 on vesico-utero-vaginal fistula, 479 on vesico- vaginal fistula, 475 Emmet curette forceps, 89 Endocervicitis, 184 definition of, 165 Endometritis, a cause of hemorrhage at menopause, 618 of sterility, 150, 151 acute septic, 174 acute simple, 173 anatomico-pathological classification of 171 atrophic, 171 chronic simple, 176 decidual, differentiated from mem- branous dysmenorrhea, 131 definition of, 165 exfoliative, 172 fungous, 171 glandular, 171 gonorrheal, 179 acute, 180 chronic, 182 hyperplastic, 170 hypertrophic, 170 in old women, 183 interstitial, 171 not preceded by an acute stage, 177 INDEX 635 Endometritis, polypoid, 172 post-abortum, 176 pseudodiphtheritic, 172 senile, 183 tuberculous, 173 Endometrium, anatomy of. 166 before puberty, 168 decidual modification of, Fig. 146, 352 during pregnancy. 169 following menopause, 169 normal, Fig. 65, 167 pathology of, 169 Endoscopy, direct, 110 Enterocele of vagina, 371 Enteroptosis, 67 body pose in. Fig. 19, 67 Enuresis, 154 in children. 578 Epilepsy, incontinence of urine in, 485 Epispadias, 393, 445. 459 Epstein on vulvo-vaginitis in children, 566 Erosion of cervix. See Cervix, erosion of Escherich, on bladder affections in children. 579. 581 Etiology of disease in any organ. See organ affected Evacuator. bladder, Kelly, Fig. 46, 102 Examination, positions for. See Po- sitions Exanthemata, menorrhagia in, 135 Excision of tissue for microscopic ex- amination, 62 Exploration of uterine cavity, digital, 94 External genitals. See Genitals, ex- ternal Extra-uterine pregnancy. See Preg- nancy, extra-uterine Exudate, pelvic. See Inflammation, pelvic I'ai-.kicius, case of myoma of vagina, 381 Face, aspect of, in pregnancy, 420 Fades ovarina. 29 4. 295, 302 Fallopian tube. See Tube, Fallopian Family history. See History, family Fecal accumulation, differential diag- nosis of, from ovarian tumor, 309 Feces, character of, as a symptom of rectal disease, 158 incontinence of, in children, 585 Fen wick, E. Ft., on villus- covered and bald bladder tumors, 481 Ferguson cylindrical speculum, 86 Fetus, mummified, 345 Fibro-cystic tumors of uterus, 253 Fibroids. See Uterus, fibroids of Fibroma. See Uterus, fibroids of; also Ovary, fibroma of Fibromyoma of rectus muscle, 310 Figure, the, in late pregnancy, 426 Fimbriated extremity of tube, Fig. 116, 285 Finger, examining, points noted by, 36, 40 introduction of, into vagina, 35 used as speculum, 36 Fischel, on erosions of cervix in chil- dren, 563 Fissure in ano, 503, Fig. 194, 504 diagnosis of, 504 differential diagnosis of, 505 in children, 585 symptoms of, 503 syphilitic, differentiated from fissure in ano, 505 Fistula, between bladder and extra- uterine fetation sac, 480 between bladder and ovarian cyst, 480 between bladder and pelvic ab- scess, 480 blind internal differentiated from fissure in ano, 505 entero-vaginal, 387 in ano, 516 complete, 516, Fig. 196, 517 diagnosis of, 518 blind external, 517 blind internal, 517, Fig. 196a, 517 symptoms of, 518 recto-vaginal, 386 recto-vesical. 480 uretero-intestinal, 493 uretero-uterine, 492 uretero-vaginal, 386, 492 636 INDEX Fistula, uretero-vaginal, differentiated from vesicovaginal fistula, 478 ureterovesical, 492 urethro vaginal, 386 vesicointestinal, 479 vesico-uterine, 479 differentiated from vesico- vaginal fistula, 479 vesico-utero-vaginal, 479 vesico- vaginal, 384, 474 diagnosis of, 477 frequency, etiology, and pathol- ogy of, 474 symptoms of, 476 Fistulse, genital, diagrammatic repre- sentation of, Fig. 189, 476 scheme of, Fig., 155, 385 ureteral, 492 vesical, 474 Flashes or flushes, hot, 612 Floor, pelvic. See Pelvis, floor of Flowing. See Hemorrhage Forceps, bladder, alligator, Fig. 50, 105 Emmet curette, Fig. 30, 89 rectal, long alligator, Fig. 62, 125 tenaculum, double, 85 uterine dressing, Fig. 23, 83 vulsellum, Fig. 25, 85 Foreign bodies in any organ. See organ affected Fourchette, Fig. 156, 389 Fowler, case of incontinence of feces in a girl of thirteen, 585 Frankel, function of the corpus luteum, 13 Friedlander, C, doubtful case of pri- mary tuberculosis of vagina, 365 Gait, the, in late pregnancy, 426 Galactocele, 539 Garceau, cases of primary ureteral tumors, 493 Garre, case of five mammae, 538 Gartner's duct, cyst of, Fig. 154, 381 diagram of, Fig. 120, 290 Gautier, V., cases of precocious men- struation and precocious maturity, 564 Gee, on hematuria a sign of infantile scurvy, 583 Gellhorn, G., on development of hy- men, 396 General appearance, in case records, 8 General health, in case records, 8 General paralysis, retention and in- continence of urine in, 485 Genital fold, Fig. 157, 392 Genital hemorrhage in the child, 571 Genital organs, development of, Figs. 158-162, 395 external, at beginning of third month, Fig. 157, 392 atrophic changes in, at menopause, 595 development of, 392 inspection of, 33 Genital ridge, Fig. 157, 392 Gierke, cases of cystitis with yellowish plaques, 471 on noma of the vulva, 570 Girls, little, vulvar hemorrhages in, 572 young, examination of, 25 Glands, Bartholin's, abscess of, 409, Fig. 176, 411 abscess of ducts of, Fig. 175, 410 anatomy of, 391 cancer of, 414 collection of discharges from, 61 cyst of left, Fig. 174, 409 cysts of, 408 differentiated from enterocele, 371 from hernia, 413 differential diagnosis of cyst and abscess of, 412 lurking-places for infection, 180 Lushka's coccygeal, 159 lymphatic, of breast, 533 enlarged in cancer, 553 mammary. See Breast Skene's, anatomy of, 101 collection of discharges from, 61 lurking-places for infection, 180 thyroid, function of, 593 Gonococcus, characteristics of, 179 in cervical canal in children, 577 infection, 179 Gonorrhea, 179. See also organ affected history of, caution in procuring, 183 latent, in women, 182 INDEX 637 Gonorrhea, latent, lurking-places for gonococcus in, 452 Goodsall and Miles, analysis of symp- tom of cancer of rectum, 527 enumeration of abscesses in anal region, 515 on fistulse originating posterior to anus, 518 Graafian follicles, degenerated after infectious diseases, 577 enlarged, 290 Graves bivalve speculum, Fig. 27, 87 Gross, S. D., statistics of sarcoma of breast, 551 Growth, failure of, a cause of amen- orrhea, 139 Gumma. See organ affected Gusserow, fatty degeneration of fi- broids, 253 percentages of ages at which fibroids occur, 249 Guy on, observations on closure of os uteri in old age, 624 Hand, examining, showing protective sleeve, Fig. 2, 31 Hanks uterine dilator, Fig. 33, 91 Hann, R. G., case of late child-bearing, 603 case of recurrence of sexual feeling at forty-nine, 614 Hare, F., case of inhalation of amyl nitrite stopping menstruation, 596 Hart and Barbour, views on pelvic floor, 220 Heart disease, a cause of hemorrhoids, 500 of pelvic congestion, 467 menorrhagia in, 135 Heart sounds, fetal, auscultation of, 429 Hegar, view that tubes, uterus, and vagina form a duct for the gland, the ovary, 593 Hegar's sign, 425 bimanual palpation for, Fig. 179, 425 Hematocele, pelvic, Fig. 142, 343, 347 differentiated from pelvic cellulitis, 196 Hematocolpos, Fig. 171, 360 Hematoma of ovary, 346 Hematoma of vagina, 377 of vulva, 400 Hematometra, 360, Fig. 172, 398 Hematosalpinx, 334, 360, Fig. 139. 335 danger of rupturing, 398 diagram of, Fig. 173, 399 differentiated from small ovarian tumor, 298 Hematuria, a sign of papilloma of bladder, 483 a symptom of ureteral tumors, 493 in children, 583 Hemophilia, in children, 571 menorrhagia in, 135 Hemorrhage, at menopause, 617 of unexplained causation, 619 following curetting, 94 from anus, in hemorrhoids, 502 genital, in the child, 571 in fibroid tumors, 260 uterine. See Menorrhagia and Met- rorrhagia Hemorrhoids (or piles), 498 external, 500 inflamed, with erosion, Fig. 193, 499 not to be pushed into anus or squeezed, 501 frequency and etiology of, 498 internal, 501 hemorrhage as a symptom of, 157, 502 prolapsed, Fig. 193, 499 with edema of anal margin, Fig. 193, 499 mucoid discharge in, 502 thrombotic, Fig. 193, 499 types of, Fig. 193, 499 Hermaphroditism, 399 false, female, 400 male, 400 true, 399 Hernia, anterior, into vagina, 368 inguinal, in labium majus, 412 differentiated from rectocele. 37 1 intestinal, into vagina^ differentiated from cystocele, 368 labial, 412 in the child, 558 638 INDEX Hernia, vulvar, differentiated from rectocele, 371 Heubner, on masturbation, 575 on vulvo- vaginitis in children, 567 Hilton's white line, Fig. 191, 495 Hind-gut, arrested development of, 496 development of, Fig. 158, 395 Hirst, B. C, cases of operations on pregnant women by mistake, 418 cases of ovarian tumor in upper ab- domen, 302 History, family, 7, 12 method of getting, 5 previous, 7, 12 Hitschmann and Adler's views on en- dometritis hypertrophica, 171 on the endometrium, 168 Holt, L. Emmett, on masturbation, 575 on vulvo-vaginitis in children, 567 Horizontal section of uterus, Fig. 67, 171 Hot flashes in menopause, 612 "Hottentot apron," 394 Hours, P., on metrorrhagia of puberty, 573 Houston, valves of, 122 Huguier, case of true hypertrophic elongation of cervix, 225 cases of abscess of duct of Bartho- lin's gland, 410 Hunner, G., technique of finding tu- bercle bacilli in urine, 469 Hunter vaginal depressor, 89 Hurdon, E., cases of papilloma of Fallopian tube, 337 views on sarcoma of uterus, 278 Hiisler, G., on primary tumors of blad- der in children, 582 Hydatid disease. See Echinococcus "Hydatid fremitus," 299 Hydatid of Morgagni, 327 Hydatidiform mole, 441, Fig. 182, 442 diagnosis of, 443 pathology of, 441 symptoms of, 443 Hydrocele of canal of Nuck, 213 Hydrosalpinx, 333, Fig. 138. 33 1 differentiated from small ovarian tumor, 298 follicular. 334 Hydrosalpinx, intermittent, 334 Hydrup-Pederson, case of atresia of vagina in child following diphtheria, 569 Hymen, Fig. 156, 389 anatomy of, 390 atresia of, a cause of amenorrhea, 140 development of, Fig, 162, 395 different forms of, Figs. 163-170, 397 imperforate, 396 in the child, 560 malformations of, 396 rigid, a cause of sterility, 150 with pin-head opening, 396 Hyperemesis gravidarum, 434 Hypernephroma differentiated from ovarian tumor, 313 Hypophysis cerebri, tumors of, at- tended by amenorrhea, 419 Hypospadias, 393, 444 Hysteria, anuria in, 156 polyuria in, 485 Illness, present, in clinical history, 22 Imperforate anus, 497 rectum, 496 Inbreeding, a cause of sterility, 151 Incarceration of ovarian tumors, 315 Incontinence of feces in children, 585 of urine, 154, 485 Infancy, gynecological affections of, 555 Infant at birth, uterine organs of, seen from above, Fig. 205, 562 Infantile uterus, 140, 202, Fig. 117, 286 vulva, Fig. 203, 556 Infectious diseases, menorrhagia in, 135 Inflammation, pelvic, 187 a cause of cystitis, 467 causing fixation of uterus in pro- lapse, 223 differential diagnosis of (table), 195 dysmenorrhea in, 129 exudate in, differentiated from cancer, 277 from fibroid, 263 routes of infection in, 187 Injuries of. See Vulva, Vagina, Ure- thra, Bladder, injuries of Insemination without penetration, 149 INDEX 639 Introitus vaginae, Fig. 156, 389 Instruments, care of, before and after use, 30 for examination, list of, 28 in diagnosis, 77 Intercourse, sexual. See Coitus Intermenstrual pain, 132 Intestines, gas or fecal matter in, differentiated from large ovarian tumor, 309 Intra-abdominal pressure, variations in, 224 Irrigator, uterine, Bozeman-Fritsch, Fig. 35, 92 Irritable bladder, 485 Ischuria, 155 Isthmus of Fallopian tube, Fig. 116, 285 Itching. See Pruritus at anus after going to bed, a symptom of piles or eczema, 157 of vulva, 160 Jacobi, M. P., on menstrual wave theoiy, 595 Jacquemin's sign, 422 Jaundice, menorrhagia in, 135 Jet of urine from ureteral orifice, Fig. 52, 107 Johnson, F. W., case of fibromyoma of rectus, 310 Jung, on gonococcus in cervical canal in children, 577 Kakels, S. W., on vulvo- vaginitis in children, 567 Kehrer, E., cases of pregnancy in rudi- mentary cornua, 433 Kelly and Cullen, on myomata of uterus, 249, 258, 261 on myoma of vagina, 381 Kelly, H. A., case of fibroid that had developed while under observa- tion, 251 cases of imperforate hymen following typhoid fever, 560 method of injecting kidney to pro- duce renal colic, 312 pus cells in urine of cystitis con- verted into mucus in presence of proteus infection, 472 Kelly cystoscope, Fig. 49, 104 double-ended urethral dilator, Fig. 45, 102 evacuator, Fig. 46, 102 meatus calibrator, Fig. 44, 101 ureteral catheter, Fig. 48, 103 ureteral searcher, Fig. 47, 102 wash-bottle suction apparatus in use, Fig. 55, 113 Kennedy, W. J., case of late child- bearing, 602 Kerley, on causes of enuresis, 579 Kidney, ache in, a sign of papilloma of bladder, 483 echinococcus cyst of, differentiated from ovarian tumor, 313 movable, differentiated from ovarian tumor, 313 palpation of, 70, 71 polycystic disease of, differentiated from ovarian tumor, 313 simple cysts of, differentiated from ovarian tumor, 313 tumors of, differentiated from ova- rian tumor, 313 Kisch, cases of prolonged menstrua- tion, 603 table of gynecological affections found during menopause, 589 Knee-chest position, 56, Fig. 13, 56 modified for cystoscopy, Fig. 53, 111 side view of, Fig. 14, 57 Kobelt's tubules, diagram of, Fig. 120, 290 Kraurosis vulvas, 404 Krieger, E., statistics as to age of the menopause, 597 Labia majora, anatomy of, 388 malformations of, 394 Labia minora, adherent, 394 anatomy of, 390 cysts of, 413 malformations of, 394 Labium ma jus, Fig. 156, 389 hematoma of, 400 . hydrocele of, in the child, 559 tumor of, differentiated from entero- cele, 371 from hernia, 413 640 INDEX Labium minus, Fig. 156, 389 Labor, premature, definition of, 436 Laceration of cervix. See Cervix, laceration of Laceration of perineum. See Peri- neum, laceration of Lactation, a cause of amenorrhea, 141 prolonged amenorrhea a symptom in, 419 Lactation atrophy of uterus, 203 Lactation hypertrophy. (See Breast) Latent gonorrhea, 182 Latent seedling fibroids, 251 Leg holders, 57 Leopold, on erosion of cervix in chil- dren, 563 Leucorrhea, 143, 355 a cause of pruritus, 160 a symptom of endocervicitis, 185 of endometritis, 177 of pregnancy, 420 bloody discharge in, 144 "currant juice," in hydatidiform mole, 443 fetid discharge in, 144 in case records, 7 in children, 144 in clinical history, 18 in fibroid tumors, 261 in married women, 145 in old women, 146 in virgins, 145 normal vaginal discharge and, 355 watery discharge in, 144 white discharge in, 143 yellow discharge in, 143 Leukemia, menorrhagia in, 135 Levator ani muscle, Fig. 150, 373, Fig. 151, 374, Fig. 152, 375 Ligament, infundibulo-pelvic, Fig. 116, 285 of ovary, Fig. 116, 285 Ligaments, broad, attachments of, 44 diseases of, 211 varicocele of, 212 round, attachments of, 45 diseases of, 212 hydrocele of, 213 tumors of, 212 Uterine, anatomy of, 44 Ligaments, uterine, diseases of, 210 mechanics of, 222 utero-ovarian, 214 utero-sacral, 213 attachments of, 44 course of, in intraligamentous tumor, Fig. 135, 317 in retroperitoneal tumor, Fig. 134,316 Light for cystoscopy, varieties of, 111 Linea alba, pigmentation of, 67, 427 Linea nigra, 67, 427 Lineae albicantes, 67 Lithopedion, 345 Lithotomy position, 57 Liver, cirrhosis of, a cause of pelvic congestion, 467 tumors of, differential diagnosis of, from ovarian tumors, 312 Locomotor ataxia, incontinence of urine in, 155, 485 Long female catheter, Fig. 43, 101 Lubricant for vaginal examination, 35 Lund, F. B., ovariotomy on three- months-old child, 294 Luys urine separator, Fig. 59, 119 McBurney's Point, 337 McCosh, A. J., case of early carcinoma of breast, 550 McDonald, E., on rhythmical con- tractions of pregnant uterus, 424 Macula gonorrhoica, 411 Mamma. See Breast Marchand, F., on chorioepithelioma, 280 on pathology of hydatidiform mole, 541 Mastitis, acute, 542 carcinomatous, 543 chronic, 543 actinomycotic, 544 interstitial, 543 lobular, 543 syphilitic, 544 tuberculous, 543 Mastodynia, 553, 539 Masturbation, 574 a cause of leucorrhea, 144 of sterility, 151 of vaginismus, 379 INDEX 641 Masturbation, and pruritus, 161 breast changes in, similar to preg- nancy, 421 Maturity, precocious, 564 case of, Fig. 207, 565 Meatus calibrator, Kelly's, Fig. 44, 101 Meatus urinarius, Fig. 156, 389 Memory, loss of, in menopause, 613 Menopause, 587 age of occurrence of, 597 atrophic changes in, 17 blood pressure in, 613 delayed, 601 delusional insanity in, 615 displacements of uterus at, 620 dodging time of, 611 duration of, 611 dyspepsia in, 615 eczema vulvae at, 621 gastritis, atonic, in, 615 gastro-enteritis in, 616 hemorrhages of, 617 heredity as affecting, 598 high arterial tension in, 613 hot flashes in, 612 hyperchlorhydria in, 615 in clinical history, 16 influence of race and locality on, 597 injuries of vagina after, 621 insomnia in, 613 intercostal neuralgia in, 663 irritability of temper in, 613 loss of memory in, 613 melancholia in, 615 mental diseases at, 615 nervous system in, 613 neurasthenia in, 614 nutrition in, 616 obesity at, 616 phenomena of body and mind in, 612 premature, 598 associated with obesity, 599 pruritus vulvae at, 161, 621 psychoses in, 615 pulse rate in,