Delayed menopause : its dangers and therapeutic indications : with a table showing the approximate age when the menopause should be established / by A. Ernest Gallant.

  • Gallant, A. Ernest (Albert Ernest), 1861-
Date:
1910
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Licence: In copyright

Credit: Delayed menopause : its dangers and therapeutic indications : with a table showing the approximate age when the menopause should be established / by A. Ernest Gallant. 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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    symphysis to the right. Diagnosis: Fibroma or cystoma. March 15, 1910, at St. Elizabeth’s Hospital, a large multi- locular, ovarian cyst was evacuated of several pints of clear fluid, and the sac removed. In one compartment was found a thick, viscid fluid, and on its interior a number of papillomata. Her convalescence was without notable event, but what of the prognosis? Third Danger: Delaying examination. Not in- frequently the physician failing to appreciate the gravity of the situation, temporizes, permitting the malignant growth to advance to a formidable degree, and thereby lessens the chances of removal and cure as in— Case IV.—Mrs. L. (26), sixty-eight years old. Her menses did not cease until some time after her fiftieth year. Since September 25. 1909, backache and flowing off and on, with malodorous discharge. Up to February. 1910, no vaginal examination had been made. February 18th she engaged Dr. F. LeRoy Satterlee, who examined and found a very narrow vagina, the cervix pushing up the bladder, filled with a cauliflower growth. The fundus could not be replaced. February 23, 1910, abdominal hysterectomy. The pathologist reported “typical medul- lary carcinoma of the uterus, etc. Nothing abnormal in the broad ligaments.” The questions of interest in this case are: Was the absence of disease from the broad ligaments due to the extreme torsion of retroversion? What is the prognosis in a women at sixty-eight years? and how much more favorable the prognosis had the uterus been removed some months or years earlier? Fourth Danger: Delay, through failure to make a correct diagnosis, leads to minor operation, where radical extirpation was imperatively indicated. Case V.—Mrs. H. (34), aged forty-two years; men- struated at seventeen (delayed four years); six children. On account of excessive, irregular flow, her physician curetted the uterus and repaired a lacerated cervix. Six weeks later the flow recurred and continued, off and on, for the past six weeks. Backache not relived by pessary; had lost flesh and strength and usual activity. November