Essentials of gynæcology : arranged in the form of questions and answers ; prepared especially for students of medicine / by Edwin B. Cragin.

  • Cragin, Edwin B. (Edwin Bradford), 1859-1918
Date:
1893
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Licence: Public Domain Mark

Credit: Essentials of gynæcology : arranged in the form of questions and answers ; prepared especially for students of medicine / by Edwin B. Cragin. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    In the second or hyperplastic stage, there is an increase of the intermuscular connective tissue, with or without a slight increase of the muscular tissue. The vascularity is decreased by the growth of connective tissue around and compressing the blood vessels. The third, or sclerotic stage is a result of the former, the uterus becoming more dense, less and less vascular and finally atrophied. What are the symptoms ? Most of the symptoms are either due to the increased size of the uterus or to the complicating endometritis. The symptoms usually date from parturition or abortion. The following are common— A feeling of weight in the pelvis. Pains radiating to the back, limbs and different parts of the body. Irritability of bladder and rectum. Leucorrhoea. Menstrual disturbances, especially nienorrhagia, due to the endo- metritis. Abortion in the early stages. Sterility, later. Reflex neuroses. What are the physical signs ? The uterus in the early stages is uniformly enlarged, soft and tender ; later harder, and in the late stages irregularities of shape may be detected. The canal is enlarged in all its dimensions and the sound passes easily. The os is usually patulous ; the cervix may be large and nodular. From what must you differentiate chronic metritis ? From early pregnancy, small fibroid tumors and malignant disease. How would you differentiate chronic metritis from early pregnancy. In early pregnancy the enlargement of the uterus is more in the antero-posterior diameter ; in metritis the enlargement is more uni- form. The uterus is tender in metritis, usually not in pregnancy. In pregnancy, also, the cessation of menstruation and softening of the cervix usually aid us in the diagnosis.
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