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.

    76/332 (page 56)
    Certain mental changes also occur; whereas previously she mixed freely with the opposite sex of her own age, she now becomes shy and avoids them; hysterical manifestations may also arise. At first, menstruation may appear once and cease for some months, then become regular; in others a regular rhythm is assumed from the very onset. Premonitory symptoms of menstruation are not uncommon—back-ache, groin-ache, pains down the inner side of the legs, and general pelvic uneasiness often usher in the menstrual flow. These are accompanied by changes in temper and mental condition, usually of an irritable nature. The breasts often become swollen, the areola slightly darkened in colour; infra,-orbital lines appear, and deepening of already existing pigmentation takes place. Irritation of the bladder is not un- common. The mucous membrane of the cervix and vagina becomes darker and more congested as the onset of the flow approaches, and the cervix itself is softer to the touch. The labia are congested and slightly enlarged. Before the appearances of the flow, there is slight elevation of temperature (four-fifths to one degree), and the excretion of urea is augmented : a temperature of ioo° and slightly over, may occur for the first twenty-four hours of the flow in highly nervous women. Increased vascular tension is present at the onset or a few days before it, and at that time attains its maximum: the minimum tension is found to be from one to four days after the cessation of the flow, from which time it gradually increases up to its maximum again. In the week following menstruation, there is very frequently a general feeling of well-being and a greater capacity for exertion, both mental and physical. The uterus probably contracts painlessly and rhythmically all through a patient's sexual life, but more especially during menstruation: this fact, with the general increase in vascularity of the pelvis, must always be borne in mind when considering any menstrual disorder. Ovulation.—It has been generally accepted as true that at each menstrual epoch a Graafian follicle comes to the surface of the ovary, enlarges and distends its coverings, and finally ruptures, setting free the ovum. By some means unknown to us this finds its way into the Fallopian tube of its corresponding, or possibly opposite, side; whether by application of the fimbriated end to the site of the ruptured follicle, or by the passage of the ovum along the ovarian fimbria into the tube, is at present uncertain; haemorrhage takes place into the ruptured Graafian follicle, which gradually contracts, its cavity filling up, forming what is termed the corpus luteum, chiefly by cellular multiplication of the granular layer. At the end of the second month, the cicatrix is scarcely