Volume 1

Treatise on therapeutics / A. Trouseau and H. Pidoux.

  • Trousseau, A. (Armand), 1801-1867.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Treatise on therapeutics / A. Trouseau and H. Pidoux. Source: Wellcome Collection.

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    records that it forms the twelfth part of the cases. In adult women it is more common. Yet we would say that our observations in private and hospital practice do not include asufficiently large nurnber of facts to fur- nish complété statistics. We hâve collected a considérable nurnber of cases of menorrhagic chlo- rosis, both in young girls and in married women. Not one of these pa- tients had uterine lésions; this fact we proved by examination of ail the married women; but in the case of the girls, where such examinations would hâve been difficult and unsuitable, we judged from the rapiditv of recovery, and the good health wliicli we observed for several years after- wards, that the utérus was exempt from severe lésions. In speaking of treatment, two principal points are obvious: one, men- orrhagia; the other, chlorosis. Menorrhagia is combated by remedies which we usually think contra- indicated in chlorosis; the treatment of chlorosis is supposed to be apt to excite the menstrual flow. It would seem impossible to avoid striking upon one of these two rocks. Let us consider whether the préparations of iron are really emmena- gogues. It cannot be doubted that iron restores the health and the ute- rine flow in achlorotic woman who lias amenorrhœa; but does the iron act as an emmenagogue or as a reconstituent ? Whenever we give ferruginous drugs in cases of chlorosis complicated with amenorrhœa, the first phenomenon observed is a return of color to the tissues, and at the same time, diminution of the depraved appetite, the pains in the stomach, the palpitations of the heart, shortness of breath, bellows murmur in the blood-vessels, thirst, etc., so that, after six or eight weeks of a properly conducted treatment, the appearance of most vigorous health returns; ail goes well, but the courses do not yet ap- pear. If we continue the treatment it is not rare to see actual sanguine plethora supervene while the menses are still absent. Health is then re-established, chlorosis is cured—but amenorrhœa persists. Soon, in their turn, the menses appear and take tlie normal course. In such a case, iron acts at first as a reconstituent; and after the health has been re-established, the functions of health, including men- struation, are re-established in their turn. The patient does not recover health because hcr menses bave returned under the influence of iron, but, on the contrary, the menses return because health has been recovered under the influence of iron. The point is completely proved, for if it were otherwise, we should hâve seen the return of menstruation give the signal for the return of health; whereas the contrary has occurred, It is because they hâve not followed the évolution and succession of these different phenomena that practitioners hâve always imagined iron to be an emmenagogue; and this error, accredited for âges, will long continue to prevail against the most manifest facts, against the closest observation, for we are so made as to like to hold to an error, and to resist truth obstinately.