CONTRA-INDICATIONS TO THE USE OF ELECTRICITY.
In the present state of our knowledge of the electro-therapeutics of the female sexual organs it does not appear advisable to resort to electri zation in the presence of any specially acute process. Sub-acute inflam matory affections may be very cautiously so treated, even as care is called for in the application of any of our routine methods. Such, in brief, seems to be the safe position to-day. Engelmann is somewhat bolder. The only strict contra-indication which he appears to recognize is the idiosyncrasy of the patient. Ile is inclined to think that the opinion that the presence of active inflammation contra-indicates the use of electricity is the result of our as yet insufficient knowledge, and although he nowhere seems to disregard this view in his practice he is evidently hopeful that the future will prove it too absolute. Whether this will prove the case or not, it is wise to-day to limit the application of elec tricity to chronic processes, and when exceptionally it is tested in the presence of sub-acute processes it should be done with extreme caution, and by preference at the house of the patient, where prolonged rest in bed may be enforced.
AmENORRHEA.
Under the term amenorrhea are included instances where, between the age of puberty and of the menopause, there is entire absence of the menstrual discharge; or else, if present, where it is scanty and irregular. Aside from pregnancy and lactation, when amenorrhea is physiological, the chief causes are absence or imperfect development of the essential organs of generation, impoverished conditions of the blood or nervous system, certain organic diseases.
Electricity in one or another form has always been a favorite thera peutic agent in case of amenorrhea. It has been used indiscriminately, without, usually, special individualization of the cause of the symptom, and hence, while results have at times been satisfactory, very frequently they have been disappointing. In dealing with the symptom, amenor rhea, with the end in view of relieving it, it is of first importance to estimate the cause, for while certain forms of amenorrhea yield to the persistent application of electricity, in case of others but little hope of relief can be fostered, and in others still positive harm may be done.
Of the instances where electricity is indicated, and yet where it cannot be predicated at all as to what the outcome from its use will be, cases of imperfect development of the essential sexual organs hold the front rank.
Where careful examination, by preference under an anesthetic, satisfies us that the uterus, the ovaries, and the tubes, are present and purely imperfectly developed, then the inference is warrantable that if we can stimulate development we may be able to establish the function the outward manifestation of which is the regularly recurring menstrual flow. There is one factor which considerably aids us in these instances in esti mating the probable outcome of the treatment instituted, and this is the presence or absence of molimina. If the woman has never had any of the subjective sensations which accompany the appearance of the menstrual flow—if, in other words, we can gain from her no history which will lead us to think that the sexual system is only dormant, as it were, and only needs stimulus for full development and action—then the outlook for success from the application of electricity or other stimulant and nutrient agents is very gloomy. Still, even here, seeing that we are dealing with the function which chiefly differentiates the woman from the man, how ever improbable the result, resort to the methods shortly to be indicated is but doing full justice to the woman. It should be stated, however, that these are the instances where the attainment of our aim is highly improbable, and where electricity and other agents scarcely ever yield other than negative results.
A further class of cases where amenorrhea either absolute or relative is present, are those where the essential sexual organs are apparently normally developed, where the history tells us of irregularly recurring molimina, and yet the woman has either never menstruated, or else scantily or irregularly, or else regularly for a while, when, without cause specially apparent, menstruation has ceased. Such instances are to be sharply differentiated into those where the cause is an impoverished con dition of the blood or nervous system, or the presence of some organic disease, or else where the only determinable cause, and this an hypothe tical one, is a lack of tone in the sexual organs Electricity here may be productive of good or of harm according to the case.