Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

  • Bedford Gunning S., 1806-1870.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the diseases of women and children / by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Diamosis.—From the history of the case, as given by the patient, I am inclined to the opinion that the pruritus was due to pregnancy—^but you must remember, gentlemen, that if I be correct in this view, the case is rather an e.xception; for -we generally find that pruritus resulting from gestation usually ceases after delivery. In the present instance it has not done so. Treatment,—This will depend upon the cause of the pruritus, and the condition of the parts. It is not improbable that an abstraction of a small quantity of blood from the arm, together with saline cathartics and a lotion of the borat of sodaj, say 5 j to Oj of water would have sufficed to relieve this patient, if early employed. But from the description of her sufferings, something more potent will, no doubt, be required. This, however, can only be determined by e.xamining the true condition of the parts. [Here the patient was placed on the bed, and the Professor pro. ceeded with the examination. The internal surface of the labia majora, the vestibulum and clitoris, were seats of extensive ulceration.] You perceive, gentlemen, as I separate the vulva, the extent of morbid action in which these parts are involved ; and it is truly lamentable to think that this poor creature, who is dependent for her daily bread on the “ sweat of her brow,” should have been so long afllicted with this painful affection. “ My good woman, I neglected to ask you whether or not your bowels are regular ?” “ They are much confined, sir.” “ How is your appetite 1” “ Very bad, sir. You see, sir, I am losing my flesh because I can’t eat.” Pruritus pudendi, gentlemen, is very apt to lead to emaciation; and, in the case before us, marked as it is by general decay wf the constitution, if we limit our remedies to local applications, we shall fail in affording relief. We must conjoin general with local treatment. The first thing that I shall do will be to touch the ulcerated surfaces freely with the solid nitrate of silver. [Here the Professor cauterized the ulcerations.] Under the circumstances of the case, I pre- fer this application to any other. It should be repeated every fourth or fifth day, as may be indicated by the progress of the disease. The parts should be cleansed with castile soap and tepid water ; and, as far as prac- ticable, rest enjoined on the patient. IFis woman will be benefited by a brisk cathartic, and I shall, therefore, order the subjoined pills, to be followed in the morning by gj of epsom salts: 5 Massie Hydrarg. gr. iv Aloes gr. ix Saponia gr. 'j Divide inpiL ij. When the bowels have been freely moved, a table-spoonful of the fol lowing may be taken three times a day : 5 Pulv. RheL 3 j Carbonat SodiE ) M 3 ij • Pulv. CalumbiB ' Aquas Menthae ) ^ ^ ^ aa | vj i£ Aquas Puras J
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