Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    158/332 (page 138)
    5. The presence of new growths in the uterine cavity; 6. The menopause, producing the so-called senile endo- metritis. Pathology.—There appear to be at least two distinct types of endometritis: one in which the main feature is a glandular hypertrophy, where the glands project as polypoid protrusions, and are productive of a profuse leucorrhceal discharge, and the other in which there is dilatation of the blood-vessels; in this latter variety the mucous membrane is much thickened, and scattered over its surface are villous projections which can be felt by the finger after dilatation of the cervix and which bleed freely ; the glandular element is little changed; the chief characteristic of this form will be found to be haemorrhage and not leucorrhoea : this condition constitutes fungous endometritis. Symptoms.--There are usually one or more of the following- present :— 1. Leucorrhoea; 2. Menorrhagia and metrorrhagia; 3. Sacralgia and groin-ache. Added to these are sympathetic disturbances of the digestive and nervous systems, often with loss of flesh. There is usually a tendency to abortion. A pronounced neurasthenic condition is frequently the ultimate termination of such cases. Leucorrhoea is very common ; as it is usually combined with the cervical discharge, its distinctive characters are not certain; in consistence it is less viscid than the cervical leucorrhoea; a brownish colour is present when metrorrhagia occurs. Menorrhagia is also frequent, and is further complicated by metrorrhagia; these are leading features of the second pathological variety : the loss may be in excess of the ordinary flow, or amount to periodic flooding, in which case constitutional symptoms like anaemia and debility soon make their appearance : dysmenorrhoea may be present, and in certain cases membranous casts of the interior of the uterus are passed. The sacralgia is a wearing pain rather than a severe one ; it can be localised over the base of the sacrum, and may be relieved by pressure; it is increased by over-exertion, and is better after rest. The pain in the groins is of a dragging character, and is influenced much in the same way as the sacralgia, by rest and exertion. Diagnosis.—This can only be made by a consideration of the previous history of the patient, her prominent symptoms, and the physical signs present: these last are—(1) An enlarged uterus, which can be made out bimanually. (2) By the speculum, the leucorrhceal discharge in more or less quantity may be seen