HYSTERO-NEUROSES.
This term is in general applicable to those varying symptoms which women complain of at the time of the menopause, and for the relief of which all our routine therapeutic measures are frequently unavailing. Not uncommonly, however, these neuroses accompany hyperplasia of the uterus or inflammatory remnants, and here obviously from what has gone before, in the application of electricity to these conditions the hystero neurotic symptoms may be ameliorated and even caused entirely to disap pear. In connection with this subject Engelmann reports marked instances of relief from the use of electricity. Ile states:' " For the speedy relief of many of the annoying reflex symptoms which accompany uterine disease, the galvanic current is the remedy above all others to be employed. We have no agent which equals it, and in the wonderful relief given lies, as I have already stated, one of the greatest dangers which accompanies the use of electricity; if any result follows, it is com plete, and even instantaneous. • Freed from suffering the patient believes herself to be well, and acts accordingly; increased exposure or exertion at once brings about that exacerbation of symptoms, a lighting up of slum bering fires, which we so often find in chronic pelvic disease after any slight indiscretion, against which the patient is guarded while cautioned by her pains; but free from these she no longer thinks of the underlying disease which has practically not been in any way bettered by the single application, though it has dispelled all suffering as if by magic. The electric current is the only agent which so rapidly overcomes the neuroses accompanying uterine disease, which are frequently of more importance in the eyes of the patient than the causative morbid condition; hence the value of electricity in gynecological treatment, even when not used for the relief of the local condition, as an aid to such applications as may be made; but where electricity is used for the treatment of the disease itself it serves a secondary, but to the patient far more important purpose —that of relieving her from distressing symptoms." Engelmann records a number of instances where marked relief from the hystero-neurotic symptoms was obtained through the use of electricity. The following
case, in particular, where pruritus vulvae was the form under which the neurosis manifested itself, is worthy of record. It is taken from his mono graph on " Electricity in Gynecology," to which we have repeatedly re ferred: " The patient came under treatment December 2d, having suffered for six years, ever since the appearance of the menopause, since which time she has been more or less constantly under treatment; for months at times in the hospital; eased now and then but never relieved; the apparent cause of the annoying pruritus was a profuse discharge from a partially prolapsed uterus. The dry treatment, bismuth and plain tam pons in vagina and vulva, were used with success, and the patient left completely cured in February. March 1st, she returned with aggravated itching, all the symptoms again appearing with increased severity after a cold from wet feet. Neither the former treatment nor any other relieved the ugly and annoying eczema, which covered a space the size of an ordinary sheet of note paper on either side of the vulva. The local condition as well as the suffering of the patient increased, notwithstand ing all efforts, and on May 12th, the galvanic current was used. Cotton covered metal ball electrodes were used, with from 4 to 6 milliamperes, the poles being moved about within the surface affected, remaining for perhaps half a minute in one place. At the point of any excoriation excessive burning was caused. On May 14th, when the patient returned, she was improved beyond recognition; the itching had entirely disap peared; she had slept throughout the night, the time during which her suffering was most agonizing before, and the ugly, deep-red surface, covered by heavy patches of the size of a nickel, was now smooth, with the exception of one single slight blotch, which was of a pale brown color and smooth. This treatment was continued on alternate days, and on May 21st she was again discharged, the skin normal, with the exception of a few thin scabs."