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.

    97/332 (page 77)
    as an accident or sequela of that state—the former class falling chiefly under the notice of the gynaecologist. (A) Haemorrhages Independent of Pregnancy. The most satisfactory method of considering uterine_ haemor- rhages is by dividing them into classes according to their causa- tion. Class I.—Cases in which no deviation from the normal structure can be found in the uterus or uterine appendages, and where some constitutional ail- ment is the exciting cause; or where nothing, either general or local, can be made out. Class II.—Cases in which the uterus itself may be healthy, but sufficient disease of the tubes, ovaries, or broad ligaments, &c, exists to produce the haemorrhage. Class III.— Cases in which the disease is evidently uterine. Class I. Under this definition we may include : 1. General or constitutional disease, such as Haemophilia; Purpura hemorrhagica; Malaria, with splenic enlargement. 2. Certain forms of cardiac disease, more especially mitral regurgitation; a tendency to amenorrhoea is, however, the rule. 3. Causes obstructing the flow of the blood into the in- ferior vena cava, such as constipation, and pressure of a large tumour, not necessarily pelvic. 4. Causes interfering with the portal circulation, as con- gestion of the liver. 5. Bright's disease, accompanied by high arterial tension. 6. Excess of physiological function, as hyper-lactation. 7. The haemorrhage of early menstruation. 8. The haemorrhage occurring at the menopause, and as the result of change of climate. In all the above the pelvic organs would necessarily be thoroughly examined, to exclude any local cause. Treatment, as a rule, should be on general principles. In some of these disorders a profuse loss is the patient's gain, as in cardiac disease or hepatic congestion, and no treatment should be directed to stay it.