Since the above-mentioned severe forms of disease usually have no ap preciable influence upon the nervous system, such an influence can be exerted only by the affections treated of in this chapter. Also according to our own observations, only such women suffer from nervous affections, or rather their nervous affections only become aggravated or assume a different form, who have residues of inflammation in or about their geni tals, especially in the parametrium. This can easily be explained if we consider how richly supplied the parametrium is with ganglia and nerves, and how freely they anastomose with each other, and with the peripheral and central nervous system, and if we also remember the rich nervous supply of the pelvic organs themselves. This fact was long ago empha sized by W. A. Freund, and together with H. NV. Freund, he investigated the changes on nerves and ganglia imbedded in cicatricial tissue. Klotz has discussed this same point, and A. Heger, especially in his last treat ise, has emphasized it.
Reaction upon a Healthy _Verrone System.—The influence exerted by these diseased conditions upon the nervous system varies greatly accord ing to the individuality, temperament, psychological condition, and general health of the patients; especially according as their nervous system is healthy, weakened or diseased, and this explains the fact that a large majority of patients of this class present no nervous phenomena. Most of those women bear their pain and recurring inflammations in the same manner as men suffering from long-continued disease.
Dragging pains in the course of the broad and round ligaments, and neuralgia in nerve trunks and their branches, radiating from the lumbar and sacral plexuses, are frequently observed in women with apparently healthy nervous systems.
Frequently, thus, a parametic residue in the region of the sacral plexus produces all the symptoms of sciatica; that it depends upon geni tal disease can often be easily proved, for if we mechanically make trao tion upon such a cicatrix, pain is felt in the region supplied by the ischi atic nerve; or if the residues are situated higher and irritate more the lumbar plexus, and if pressure or traction is made upon the same, pain is felt in the region of the crural or obturator nerves; in both instances ' flexion and extension of the corresponding extremities can often be pro duced by mechanical irritation.
It is also observed, but more rarely, that in such cases a neurosis de volopes in the corresponding foot or upper half of the body.
Reaction upon a Weakened, Diseased _Nervous women who by excessive loss of blood and strength during prolonged disease become anomie, or in nenropathic individuals, the reaction of inflammatory resi dues on the nervous system may frequently be observed.
Diseases of the nervous system, aside from the severer forms, are ex tremely frequent, and so are diseases of the female genitals; therefore the two forms of disease frequently coexist. Genital disease is not the only cause of these severe nervous affections, but it is, as Hegar states, " an essential factor," renders them worse, may also give rise to new symp toms, and there is no doubt that we would perform a great service for these patients if we could eliminate this factor.
Dr. GeOrge Beard of America, in his treatise on " Neurasthenia," has called our attention to the frequency of slight diseased conditions of the nervous system, which were formerly partially known to us under the name of nervous weakness, nervousness.
The same subject has latterly been clearly treated of by Rudolph Arndt in a manner more in agreement with our observations. He con siders neurasthenia not as Beard, a disease sui generis, but simply as a symptom, or collection of symptoms of morbid processes and diseased con ditions in the peripheral or central nervous system, the anatomical nature of which we are not always able to ascertain. He asserts that there are no functional disturbances without changes in the organs themselves. Neu rasthenia is usually the precursor of severe hopeless affections, not only of the nervous system, but also of other organs. Hypochondriasis, hys teria, epilepsy, catalepsy, chorea, etc., are only peculiar higher grades of neurasthenia. Furthermore Arndt states that the healthy and diseased nerves react, according to the laws of nervous contraction and irritability, discovered by Pftfiger, and developed by Bezold, Wundt, Lister, Benedikt and Brenner; healthy nerve function is performed according to the laws of contraction and irritability of healthy nerves; diseased nervous func tion, according to those of diseased and abnormally nourished, i.e., ac cording to the laws of contraction of fatigued, worn-out nerves. The law of contraction and irritability of nerves discovered by experiments with the galvanic current on frogs, has been confirmed by thermic, chemi cal and mechanical irritations.
We could not abstain from alluding to the above statements of Arndt, because they may well be applied to the connection between genital and nervous diseases.