On the nature of the membrane occasionally expelled in dysmenorrhœa / by J.Y. Simpson.

  • James Young Simpson
Date:
[©1846?]
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Licence: Public Domain Mark

Credit: On the nature of the membrane occasionally expelled in dysmenorrhœa / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    The membranous shreds passed in some of these cases [o: dysmenorrhoea] evidently (remarks Dr Copland) consist of plastioi lymph thrown out in the cavity of the womb. . . . That j; degree of inflammatory initation exists in the internal surfactt of the uterus, even in the neuralgic form of the disease, is provec (t by the formation and expxilsion of a false membrane in many caset of that form. That this membrane is induced by the similar statfi of inflammatory action to that which sometimes occurs in othei mucous surfaces, and gives rise to a similar exudation, is most pro- j^, bable, notwithstanding the absence of other inflammatory pheno- mena, and the neuralgic character of the pain.' In a number of cases, I have had an opportunity of examining from time to time the form and structure of these dysmenorrhea! j, membranes. Two or three years ago, my observations upon them , led me to believe that they were not new or false membranes formed of coagulable lymph, and secreted by the mucous surface oi the uterus, but that they in reality consisted of the mucous mem- brane of the uterus itself, hypertrophied and separated. All my- later observations have gone to confirm me in the same opinion; viz. that the productions in question are not the results, as is. generally supposed, of fibrinous or plastic exudations upon the free surface of the mucous membrane of the uterus, but that they con- sist of actual exfoliations o/that membrane itself. The proof of this opinion rests upon different grounds :— Fio'st, The dysmenorrheal membrane presents anatomical peculi- arities that are never seen in any simple fibrinous or inflammatory exudation; and these anatomical peculiarities, on the other hand, specially pertain to, and are characteristic of, the structure of some mucous tissues, such as that of the uterus. One special illustration may suffice. Professor Keid, Krauss, and others, have shown, that the surface of the mucous membrane of the uterus is marked by numerous orifices of small tubular glands, ciypts, or follicles, opening upon it (the uterine glands of some modern authors). This struc- ture I have distinctly traced in different specimens of dysmenorrheal membrane from different individuals. Secondly, The general configuration and character of the surfaces^ of the dysmenorrheal membrane are such as would result from the origin which I have attributed to it, namely, the exfoliation o\. detachment of the mucous membrane of the uterus. In those in- stances in which the membrane is thrown off in one piece, and without disintegration, it presents exactly the flattened triangulan ' Dictionary of Practical Medicine, vol. ii. pp. 844, 845. See also Dr Fergusson iir the Library of Medicine, vol. iv. p. 311 ( a not uncommon effect of dysmenorrhoea is the formation of coagulable lymph modelled to the shape of the inner surface of the uterus). Dr Righy's Essay on Dysmenorrhoea, p. 39 ('\fibrinovs exudaUons every} now and then attend these cases of dysmenorrhoea).—Z)r Ashwcirs Ireatise <m> Female Z)£seaies, p. 105 and 107, &c.