DYSII ENORRI1 EA.
Painful menstruation is a concomitant symptom of such a large num ber of diseases of the female sexual organs that any consideration of its relief by electricity .or other means must necessarily be deferred till we treat of the individual affections with which it is associated. There are instances, however, where dysmenorrhea exists and yet where careful local examination reveals no appreciable cause, such as displacement or distortion of the uterus, or inflammatory affection of the cellular tissue or peritoneum adjacent to this organ and its adnexa, or changes in the ovaries or the tubes. It is ordinarily in the unmarried that this variety of dysmenorrhea is met with, and for want of a better term the word neuralgic is applied to it. There is present apparently a depressed nervous tone, a lack of nerve nutrition, a local hyperesthesia, which ex presses itself in some by neuralgias in various parts of the body and in others by dysmenorrhea. The menses are often scanty, there is non satisfaction of function, as it were. If we can make these women lose more blood at the menstrual periods, at the same time toning up the nervous system, we can often cure the dysmenorrhea. In other instances, again, the flow is profuse enough and free enough, but still the pain has the neuralgic type. The diagnosis of neuralgic dysmenorrhea must be reached purely by exclusion. Absence of evidence of local disease will point strongly to the pain being neuralgic in character.
In the treatment of this variety of dysmenorrhea such general consti tutional measures as seem called for by the individual case hold unques tionably the first place. Electricity, however, properly utilized, will
serve as a valuable adjunct. The sedative property of the galvanic current is obviously called for, and this is best attained by abdomino-vaginal galvanization, with mild currents; and it seems to us, with the positive pole internal, that its sedative effect may be more directly utilized. In virgins abdomino-lumbar galvanization should be tested before resort to internal. Very exceptionally, and this where the flow is scanty and in sufficient stimulus is a probable source of the dysmenorrhea, the faradic current may be tested cautiously, in the hope that with increase in the flow the pain will diminish. In the vast majority of instances of the neuralgic type of dysmenorrhea, however, galvanism is preferable to faradism, and it aims both at sedation and at improvement of local nutri tion, on the lack of which the pain in a.measure depends. Electrization should, by preference, be resorted to daily, for the week preceding the onset of the flow, and may be depended upon for good results, although general constitutional measures, medicinal and hygienic, in this instance far outrank electricity in value; indeed neuralgic dysmenorrhea very frequently will not yield any more readily or permanently to electricity than it does to other general and local means.