A practical text-book of the diseases of women / by Arthur H.N. Lewers.

  • Lewers, Arthur H. N. (Arthur Hamilton Nicholson)
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A practical text-book of the diseases of women / by Arthur H.N. Lewers. Source: Wellcome Collection.

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    where the patient is very nervous, by taking- every trouble to reassure her, and to persuade her, that she is not going- to be hurt in any way. Distracting her at- tention by a few questions, is another help to attain the end in view, namely, as little resistance as possible from the'abdominal muscles. Light palpation frightens the patient least, and does not give rise to any discomfort, it should always be employed first. We may employ deep palpation later on, when we have learned all we can by light palpation, and when time has been given for the patient to become a little accustomed to the examination. The Kidneys.—It is good practice to try and feel the kidneys in each case. The right one is more easily felt than the left. To succeed in this the patient must not be too fat, the abdomen must be fairly relaxed, and there must be a fair amount of space between the ribs and the iliac crest. In trying to feel the lower end of the right kidney, press the fingers of the right hand pretty steadily and firmly backwards and a little up- wards in the interval between the iliac crest and the ribs. The fingers of the left hand at the same time being placed under the patient making pressure for- wards towards the fingers of the right hand. It is best to press the fingers of the right hand steadily, and to make tilting movements forwards with the fingers of the left hand. In a great many cases, far more than anyone who has not tried it would imagine, the lower end or more of the right kidney can in this way be recognised. If it is not felt at first, we may succeed by getting the patient to take a deep breath. The lower end of the left kidney is not so often to be made out.