Pathology and treatment of diseases of women.

  • Martin, August Eduard, 1847-1933.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Pathology and treatment of diseases of women. Source: Wellcome Collection.

    76/500 (page 56)
    first year of life which corresponds quite exactly to the menstrual type. It must be looked on as a sign of precocity, inasmuch as the genitalia, especially the ovaries, are found usually in full development, and also the genital development of the body is far advanced in proportion to the age. Not infrequently anomalies of other organs, as hydrocephalus, tumors, etc., are associated with the condition. (Gebhard, Veit's Hand- buch. ) Those hemorrhages which appear sometimes post partum in new-born girls and then again disappear do not belong to menstruatio precox. Regular bleedings may also persist during the climacterium beyond the usual time. They can be called menstrual only if a careful examina- tion of the uterine mucous membrane excludes another cause (tumors, etc.). In the treatment of the hemorrhagias a causal genital disease must naturally be attacked. In case of obscure etiology bloodletting shortly before the beginning of the menses plays a peculiarly important röle. One can restrict the menorrhagia at times by considerable scarification shortly before the beginning of menstruation. In other cases a decrease of the hemorrhage can be obtained at times by the use of ergotin (R. ergotin Denzel, secal. cornut. pulv., ää. 5.0, ft. pilul No. 100. Sig. Three times daily three pills) and extractum hydrastis canad. fld. (four times daily up to 25 drops), stypticin (cotarnin hydrochlorid) 0.05 four times daily, or by absolute rest in bed and by avoidance of all exertion at the time of the menorrhagia, also by ice-bags to the abdomen. As a means of Controlling the hemorrhage we recommend especially vaginal irrigation with hot sterile normal saline solution at 50° C. (122° F.). We have seen better results from this than from the use of cold in the form of ice-cold irrigations. Menorrhagias without definite anatomic causes resistonly very rarely, and singly, an energetically continued local treatment of this kind, but such cases come under observation once in a great while. Only slight changes in the mucosa with an important increase in the size of the uterus then exist. As a last resort vaginal extirpation of the uterus has been rightly recommended for such desperate cases. But this never should be done before trying to overcome the hemorrhage by thorough and often-repeated abrasio mucosae uteri (curettage) and subsequent cauterization (see page 31). C. Dysmenorrhea We have no reason to designate as dysmenorrhea those disturbances which most women experience at the time of menstruation, the pains in the back, the discomfort, the feeling of heaviness in the abdomen, gap- ing, a continuous desire to urinate, and so forth. These are attendant Symptoms of menstruation which are borne by most women prüdently as associated with this process. Only when the disturbances render the