Page:Sexology.djvu/198

 bowels moved by a cathartic, and in ease the patient should be in the least constipated, I do not deem it objectionable in the least.

During this stage, if her physician is not present, she should be examined now and then by the nurse, in order to know the progress made in the dilatation of the mouth of the womb. If, after every five or six pains, no progress is detected, there should be no hurry in summoning the phy- sician. When, however, the mouth of the womb is so ex- panded as to be of the size of a silver dollar, the physician should be present.

How to make an Examination.

Place the patient on her left side with knees drawn up. The nurse lubricates with oil or lard the index finger of her right hand, introduces it into the vagina, running it upwards and backward in the direction of the spine. When she reaches the tumor, let her feel for an opening in the membrane that covers the child. If she is in doubt whether her finger is then in the mouth of the womb, let her keep it within until a pain comes on, and, if the finger is within the womb, she will feel the mouth contract around it like the string of a purse. She can then detect the size of the opening. When the womb is relaxed, she may confound the thin mouth of the womb with folds of the vagina, but not so when it is in a state of contraction. The mouth of the womb is sometimes difficult to find, because it lies backward, and high up. The examiner should not he satisfied until it has been found and its dimen- sion fairly measured. Care should be taken, during these examinations, not to press too hard against the tumor, lest the bag of waters should be broken. The waters, enclosed in an elastic bag around the head of the child, assist in