A practical treatise on the diseases of women : prepared with special reference to the wants of the general practitioner and advanced student / by John Thorburn.

  • Thorburn, John, active 1866-1885.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of women : prepared with special reference to the wants of the general practitioner and advanced student / by John Thorburn. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    James Paget in the first Bradshaw lecture. Its resemblance, and also its dissimilarities to syphilis, scrofula, and epithelial cancer, point to a possible intermediate stage in development. The majority of writers, however, consider it to be only a manifestation of scrofula. Clinically we have a sore which alternately ulcerates and heals, creeping around the vulva, and leaving a depressed white scar to mai'k each step in its continu- ■ous progress. The sores are preceded by flattish discoloured tubercles, which are often very slow in ulcerating. As a rule, there is not much pain. Progress, though slow, is only too sure, and large tracts are covered with cicatricial contracted tissues before the disease comes to an end, if it does so during the life of the patient. As regards treatment, tonics, cod-liver oil, iodine, and arsenic appear, under good hygienic conditions, to exert a somewhat favourable influ- ence. They tend to induce, and may perpetuate, the cicatricial stage. Though removal by galvanic cautery, or by the most powerful escharotics, •often fails to aiTest progress, yet it may temporarily check the disease, and give time for constitutional treatment. Of late years, most success- ful results have been obtained by Volkmann, Yeats, and others, by thoroughly scraping off the surface, but I have as yet had no experience of this in lupus of the vulva. Should the cicatrices threaten to occlude the canal, the frequent passage of a large bougie may to some extent •obviate this danger. Noma. Under this name has been described a gangrenous condition which, as Si sequel of the zymotic diseases, or of the septic or pysemic puerperal affections, or as a manifestation of ejoidemic or spoi'adic erysipelas, some- times attacks the external parts of generation, as it may also do the face. Dr Hermann records some cases of each kind in the Ohstetrical Trans- actions, vol. XXV. p. 141. It seems to be a mistake to have given the this affection special name. It is simply gangrene, a sign of low vitality and embolic changes. Antiseptic poultices and liberal nutrition, with wine, as it may be thought desirable, are oiu- only resource. If sufficient vitality can be maintained to permit of separation of the slough before .a vital part is reached, the patient may be saved. Vulvitis. The vulva is not infrequently the seat of acute inflammation, and this may either be simply catarrhal, from cold or injury, or it may ensue from the spreading of va inal inflajnmation downwards, or it may be