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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    Causes.—Those of you whose attention has not been particular]} directed to this subject, may be surprised to learn that fibrous tumors of the uterus are far more frequently met with in the unmarried and barren, than in those who have borne children. Such, however, is a well established truth ; and the existence of this form of uterine growth is by no means of rare occurrence. The cause of these tumors is in- volved somewhat in obscurity—and authors differ in opinion on the sub- ject. External violence will sometimes lay their foundation ; and men- strual suppression will, in my judgment, be found a common antecedent to their development. In the patient before us, it is a rational conclu- sion that suppression has been the cause. Dysmenorrhoea, too, of the congestive type, will, I think, be found among the causes of this class of uterine tumors. Symptoms.—The symptoms, which result from fibrous tumors of the uterus are of a mixed character—general and local. Sometimes nausea and vomiting, and enlargement of the mammary glands supervene. But the principal disturbances are local—such, for example, as a fre- quent desire, and sometimes an inability to pass water from mechanical pressure of the tumor against the bladder. Indeed, the latter will occasionally become much distended, and the distention will even reach the ureters and kidneys, giving rise to a comatose condition of the brain. Pain in defecation, hemorrhoids, prolapsion of the mucous membrane of the rectum, constipation, also, from pressure of the tumor, may be classed among the effects or symptoms of fibrous growths of the uterus. Bearing down pains, with displacement of the womb, the displacement depending on the portion of the uterus at which the tumor is found. There is one symptom attending the sub-mucous fibrous tumor, which is almost always present, and which constitutes much of the danger, but in this case it is absent. I allude to the profuse hemorrhages, which, as a general rule, may be said to characterize the sub-mucous tumor. You may ask—and very properly so, what is the source of the hemorrhage in these cases ? The bleeding proceeds from the mucous or investing membrane which becomes congested, the vessels relieving themselves in this periodical loss of blood, which at times is fearfully profuse, and ex hausting to the patient. Why should this usual accompaniment of the sub-mucous fibrous tumor be wanting in the case before us ? Is not the fact explained in the pale and anmmic aspect of this patient’s counte- nance? Comparatively, there is no blood in the system—and what is there has lost, through disease, its ordinary properties. This excep- tion, then, to a very general rule, imparts additional interest to the case. Diagnosis.—This is an important subject for us to consider; and it will oftentimes require all your sagacity and vigilance to distinguish be- tween fibrous tumor of the uterus, and the various conditions of the organ, which occasionally simulate the presence of the tumor. The fol
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