A practical treatise on the diseases peculiar to women : illustrated by cases, derived from hospital and private practice / by Samuel Ashwell.

  • Ashwell, Samuel, 1798-1857.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases peculiar to women : illustrated by cases, derived from hospital and private practice / by Samuel Ashwell. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    tion; and in proportion as the anaemia disappears under the influence of this new modification of the nervous system, the whole train of diseased action, the difficult respiration, constant sensation of uneasi- ness and listlessness, impaired digestion, gastralgia, vomiting, tym- panitis, and limpid urine, together with all the strange nervous symp- toms, which seemed dependent on some organic alterations of the solids, gradually subside and eventually vanish, as a fresh supply of blood is generated in the system. Diagnosis.—It will be allowed, after what has been advanced, that chlorosis is not an inflammatory disease. It is indeed most intimately connected with anaemia, and closely resembles (except in the pale greenness or dinginess of the skin) that state of system which is the result of hemorrhage or any undue secretion. Such symptoms, there- fore, as severe headache, pain in the side affecting the breathing, dis- tressing action of the heart, and several others, must not, and cannot, where proper caution is observed, be mistaken for, and treated as acute inflammatory affections. From the want of this caution, I have wit- nessed very injurious consequences ; the practitioner having forgotten, what in female disease it is peculiarly important to remember, that severity of pain and rapidity of pulse, are generally indications of irritability and excitement, not of inflammation; requiring narcotics, carminatives, and at the most counter-irritation; not bleeding, active purgatives, or spare diet. If my definition be correct, amenorrhcea, which may, and often does exist, quite independently of chlorosis, cannot be regarded as a synonymous disease. It is impossible that there should be chlorosis without more or less of amenorrhcea, yet it is often seen that there is amenorrhcea without any degree of chlorosis. It is quite true, that when amenorrhcea has not been cured or relieved —when it has produced, by its long continuance, extensive constitu- tional derangement—that then chforotic symptoms will appear, and ultimately, the series of morbid phenomena constituting chlorosis will be clearly seen. Kor must it be forgotten that chlorosis is itself a frequent cause of amenorrhcea, by its prevention or protraction of puberty, on which menstruation depends; and, subsequently, even when the catamenial function has been established, leading to its partial suspension, and occasionally to its entire suppression. There will be no difficulty in distinguishing chlorosis from chronic affections of the abdominal viscera, especially from hepatic, splenic, and renal disease, or indeed from any morbid state, of which anaemia and pallor are prominent symptoms. The period of life, the peculiar aspect of a chlorotic patient, and the derangement of menstruation, will insure a correct diagnosis. In the complication of chlorosis with amenorrhcea, the ovaries and uterus are principally affected. Here the chlorosis may have existed for some time, preventing the complete establishment of puberty and menstruation, but allowing both in a partial degree. After some months, when the function entirely ceases, there is a marked deteriora- tion of the general health, and the malady becomes a double or com- plicated one. It is chlorosis with amenorrhcea. Or, this combination may gradually occur as the result of amenorrhcea, produced slowly