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.

    210/332 (page 190)
    Should pregnancy take place, the iiterus, as it increases in size and ascends, will necessarily tend to stretch the adhesions, pro- ducing pain, but ultimately causing relief. Often, however, these adhesions prevent the physiological ascent of the uterus, and abortion takes place. Peritonitic adhesions may doubtless become entirely absorbed in favourable cases,and especially after pregnancy. Peritonitis may be acute or chronic, and may remain localised to the pelvis or become general. (iii.) Symptoms.—Acute Peritonitis.—The severity of the symp- toms does not seem proportional to the amount of the serous mem- brane involved ; a very small patch, for instance, over the ovary or in its near vicinity, is capable of giving rise to most marked in- dications of the disease; while situated elsewhere, possibly very little discomfort, comparatively speaking, results from its presence. The disease may be ushered in by a rigor or a feeling of chilliness, and the three salient features are: (1) Pain; (2) Retching and vomiting ; (3) Febrile symptoms. Frequency of, and pain in micturition (dysuria) or pain during defecation (dyschezia) may result according to the situation of the disease. The pain is usually situated on the affected side, often the left, and radiates over the lower hypogastrium and down one or both thighs; it is described as cutting, boring, or tearing in character, and has no rhythm in coming and going. It often comes on in paroxysms, especially at night, comparative freedom being enjoyed during the rest of the twenty-four hours. The retching and vomiting may be a marked and constant symptom or only slightly prominent; the author inclines to the opinion that the more frequent the vomiting, the greater the danger, as the general peritoneum is becoming involved. Febrile symptoms consist in an elevation of temperature (Fig. 107), sometimes considerable, a quick pulse not in propor- tion to this rise and increased rapidity of respiration, with headache, thirst, and dry skin. Chronic Peritonitis results from a gradual formation of adhesions as the sequel of an acute attack, or from a series of such attacks, recurrent peritonitis. The chief symptoms are:— Backache, pain in the right or left iliac fossa, especially on exer- tion. Leucorrhcea. Dysmenorrhea and menorrhagia, with liability to a fresh attack as the result of chill or any imprudence. Dyspareunia and stei-ility; should pregnancy occur, there is