The disappearance or 'absorption' of fibroids before the menopause / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1904
Catalogue details

Licence: In copyright

Credit: The disappearance or 'absorption' of fibroids before the menopause / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the relation of syphilis to diseases of the female organs, turned atten- tion to the experience of Boquet, who gave potassium iodide to a syphilitic patient with bleeding fibroid, and found that the hemorrhages ceased. He therefore tried the salt in non-syphilitic cases and the results, he maintained, were good, for not only did the metrorrhagia come to a stop, hut the tumour was markedly diminished. Boquet’s theory that syphilis may sometimes determine the evolution of a uterine fibroid is not based on any substantial evidence. Legram,s suggestion about gummata, quoted by Sliaw- Mackenzie, deserves a little consideration, but that observer in describing three cases of what he terms syphilitic disease of the uterus, ranks them under parenchymatous and fungous metritis rather than gumma. He thinks that some cases diagnosed as fibroid are really syphilitic. Stanmore Bishop,9 joining in this epistolary controversy, expressed great scepticism about Boquet and Legrain’s views, which Shaw- Mackenzie was inclined to support. Bishop was ready to admit that in the published cases where syphilis complicated fibro-myoma the bleeding might have been mainly due to specific disease of the endo- metrium, the source in all cases of the haemorrhage so essentially characteristic of uterine fibroids. When the specific disease of the endometrium was relieved by potassium iodide the bleeding naturally decreased, and the symptoms set up by swelling with possibly ulcera- tion of the endometrium would likewise disappear. But, as Bishop remarks, these effects of treatment by iodide do not show that the salt acts on the tumour itself. Shaw-Mackenzie,10 in another letter very reasonably insisted that the issue of the discussion at the Meeting of the Association was between fibroid and inflammatory products, between simple and syphilitic inflammation, between opera- tive and medical treatment. The subject of errors of diagnosis caused by masses which dis- appear after medical treatment need not further be discussed. The masses are clearly products of inflammation which may be syphilitic, although on that point Murdoch Cameron is dumb. They, however, are not fibroids. They have been discussed at length above because so much stress has been laid on them, and also because without doubt theii disappearance under treatment has been wrongly described more than once as an instance of the absorption of a uterine fibroid. 2. Disappear ance of Fibroids caused by Destructive Inflammatory hanges. This is the commonest explanation of a genuine example of the disappearance of a fibroid even when we exclude the bodily