Home >> Manual Of Medical Diagnosis >> Diseases Of Uncertain Or to Neuralgia >> Diseases of the Uterus_P1

Diseases of the Uterus

constitutional, menstruation, local, dependent, disorder and catamenia

Page: 1 2 3

DISEASES OF THE UTERUS - is but little to be said on the diagnosis of this class of diseases, which are perhaps legitimately regarded as a special department of practical medicine : but in the very fact of a ski, cialitg there is a tendency to abuse, and unfortunately persons are always to be found who will use any pretext to extend their own fame and to enrich themselves without any feeling of honor, without any sense of morality or propriety. A professional sect has grown up in England in consequence of the minute—the needlessly minute investigations of the aecoucheurs of France, which, impelled by such motives, assumes to itself, under the guise of this specialite, the management of all the diseases of the female sex; rightly or wrongly, with reason or without reason, referring them all to changes in the uterus. Diseases are spoken of as of frequent or constant occurrence which we search for in vain, except in a very few instances, in the dead body. In reality, small as is our list of local maladies connected with the uterus and vagina, even these are mainly due to constitutional causes, and are best met by constitutional remedies.

§ 1. Imenorrhcea.—Absence of the catamenia must be distin guished from chlorosis, inasmuch as tardy, scanty, painful and suppressed menstruation are very often found altogether indepen dent of general signs of anaemia ; the face may be florid, the pulse good, the body well nourished, and the general health fair, not withstanding the coexistence of amenorrhoea. Perhaps all this indicates a condition of local as well as general congestion which interferes with the due performance of the function, but quite as often the aspect of the patient is fallacious, and the real condition is atonic, the color of the face being the effect of venous conges tion rather than of general plethora. This is proved not only by the coldness and clamminess of the hands and feet, but by the fact that the menstrual functions become regular under the judicious employment of tonics, and that if they be not regulated, chlorosis will speedily supervene.

When dependent on local causes, total absence of the secretion may persist through life ; or the fluid, unable to find an outlet, may accumulate in the uterus and vagina : in each of these there is some defect of organization. In other instances, exposure to cold exerts some influence on the uterus, probably in the first place causing congestion, which is followed by sudden suppression; but, if the function be not speedily restored, a constitutional state is developed, and the disorder loses its loc,a1 character.

Though so intimately connected with age, the function is really dependent on the development of organs which age implies, and therefore in cases of retarded menstruation we have to look to the girlish or womanly appearance of the patient before interfering with the uterus ; while, in the absence of the catamenia after mid-life, we have to remember that the involution of the uterus and ovaries takes place much earlier in some females than others. Suppression for a time almost always follows after an attack of any severe disease, and, if the individual have attained a certain age, may be persistent.

In amenorrhcea which is not accompanied by amemia we must always remember the possible coexistence of pregnancy : this suspicion is more likely to be just if previously the catamenia were always regular, and is proportionally less probable if they have been irregular in their appearance.

Irregular menstruation is only to tre regarded as a symptom of constitutional disturbance, and not as a local disorder. The catamenial periods are then often attended with pain ; dysmenorrhcea is sometimes also complained of when the flux is regular, but scanty or pale : in all of these the disorder is unquestionably dependent on constitutional causes. The pain in such cases is probably neuralgic, as it is associated with other sensations of an analogous kind, headache, backache, &c. : it generally precedes the menstruation, and is most intense at the commencement of the discharge.

Page: 1 2 3