Licence: In copyright
Credit: The principles of gynaecology / by W. Blair Bell. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
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![dysmenorrhea, whilst in sacralgia the application is made over the seat of pain, which is in the lower lumbar and sacral region, by means of electrodes composed of flat pieces of flexible metal about three inches square. In both cases the electrodes should be connected to the positive pole of the static machine, and the patient should be placed in a suitable position on the insulated platform during the application. X-RAYS.—The X-rays may be used with advantage in certain chronic lesions of the vulva, such as leucoplakia, gonorrhoea] warts, tuberculosis, and recurrent malignant disease. Researches have been carried out on the Continent and in America with the object of proving the value of the X-rays in the treatment of fibro- myomatous tumours of the uterus. It is claimed that under the influence of the application of these rays, not only do the pain and haemorrhage cease, but that the tumours actually diminish in size. It is impossible to obtain any record of work done in this direction in the United Kingdom. On the Continent the pioneers of the X-ray treatment of fibromyomatous tumours are Albers Schonberg and Bordier. The mode of action is said to be manifold ; in the first place, that X-rays cause atrophic changes in the ovaries whereby an artificial menopause may be induced ; secondly, that they have a direct retarding action on the growth of the tumour. It is generally supposed that a fibromyoma originates from the uterine arterioles, from the adventitia of which embryonic cells multiply and form concentric layers of smooth muscle fibres. Advantage is taken of the fact that the X-rays act specially on embryonic cells, and any beneficial action following the application of these rays is attributed partly to this mode of action. Thirdly, that the rapidity of growth of a fibromyomatous tumour is to a certain extent in proportion to the circulatory activity of the uterus, hence whatever decreases the circulation of the organ may also decrease the fibromyomatous growth. Too small a dose will cause stimulation of the growth, a moderate dose inhibition, while an excessive close brings about cell atrophy. It is obvious, therefore, that if good be obtained the dosage of the X-rays must be a factor of prime importance. Bordier employs a hard tube (9 to 10 Benoist), and screens the tube from the skin by sheets of aluminium from h to H mm. in thickness. He continues the exposure until one of his pastilles placed on the skin underneath the filter has acquired the tint 0 on his scale. This observer states that with correct technique the effect of the X-rays on the ovaries and on the tumour can be secured without producing a dermatitis, and he claims that there is a great field of usefulness for this method of treating uterine fibromyomata. It is, however, hardly likely that this method of treatment will supplant the surgical procedures which have given such excellent results in recent years, except, perhaps, in those cases in which surgical interference is contraindicated owing to the presence of some other organic disease.](https://iiif.wellcomecollection.org/image/b21534056_0570.jp2/full/800%2C/0/default.jpg)
