The Quality of Out-Patient Practice

J. F. Payne
1886 BMJ (Clinical Research Edition)  
Aug:.y 7186.] --B I3BRTIBBMMEDICM Z JQVBX4L. 285 the exact positio of the feetus, which by the end of., the course we could pIetty confidbitly do. The second or vaginal examination was intended tolpartly verify the first;, and, in addition, by noting the state of the os uteri and vagina, we were expected (to give an opinion as to how long off labour was, etc. Only four men were admitted to this course at one time, which lasted a month, six days a week. Four, to six fresh iases were examined
more » ... s were examined daily, and the fee was about £5. On one occasion I was fortunate enough to discover twins, both pre-'senting by the head-verified by vaginal examination. I cannot speak too highly of this course, which was taught by Dr. T. Felsenreich, Professor Karl Braun's first assistant. Now that the summer session is almost closed, and in the view of the fact that many of the fresh graduates will go to Vienna to prosecute investigations denied to us in England, I strongly urge all not to miss taking out this course, for they will find it invaluable in after-life. Only quite recently I was called in consultation to a case at our Cottage Hospital here, where one of the surgeons was in ,doubt as to, whether his patient was pregnant or naot. She strongly denied, pregnancy, and I must say her appearance was strongly "ovarian." The abdomen was large enough almost for full term, but the breasts and nipples were those of a virgin. On abdominal palpation, the case was clear as regards pregnancy. I could make -my ,hands meet deep in the pelvis, and I diagnosed ovarian disease, springmng from the left ovary, and this was afterwards verified on operation. The os was that of a virgin, and the cervix long and conical, a state of affairs usually considered as precluding pregnancy.-I am, sir, yours faithfully,
doi:10.1136/bmj.2.1336.285 fatcat:vfclca622bglhjzvzst33v32qa