Diseases of women / by Lawson Tait.

  • Lawson Tait
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of women / by Lawson Tait. Source: Wellcome Collection.

    45/216 (page 25)
    they are healed. It would be a great blessing to women about to be married if their mothers would give them a little advice based on theii own experience; but there is a false modesty on these subjects ingrained in our English life which has to be paid for in much suffering amongst women. Fissures at the fossa navicularis are often left from the tear of the perinseum, which occurs at almost all first labors, and these are sometimes so painful as utterly to prevent intercourse. They are, besides, a con- stant source of discomfort in walking, and when the patient passes water. Sometimes even after the tear has completely healed, the scar remains so tender for months that coitus is impossible. If there is a fissure, it had better be divided, and the whole surface touched with solid nitrate of sil- ver, the parts being kept absolutely at rest for a few weeks. If it is only a tender spot, the use of a little cerate before intercourse will obviate all pain. The nymphas are also subject to a peculiar degenerative and atrophic change, which occurs only at or after the climacteric period. It is a very distressing complaint, and one of the most intractable with which we ever have to deal. It is very often, but by no means always, associated with vascular caruncle of the urethra, of which I shall speak further on. This affection has been alluded to by Simpson and various other authors, but no description which I have seen includes all the facts that may be ob- served in connection with it. It is always confined, in my experience, to the mucous membrane on the inner surfaces of the nymphae, and is never met with on the labia majora or in the vagina higher than the vestibule. It is a very frequent cause of the total suspension of marital intercourse, and is the real disease existing in a large number of cases of so-called va- ginismus, a term which is widely used as a cloak to cover ignorance and carelessness. A patient suffering from this disease will nearly always be found to be over forty years of age, and she will state that she has a slight yellow discharge, a good deal of scalding when she passes water, and that she suffers excruciating agony on any attempt at intercourse. This latter is always the first symptom in date; and when a case comes under the notice of the gynaecologist, it will generally be found that intercourse has been discontinued for many months, if not for several years. The misery is very great, and a great deal of the climacteric drunkenness, too common among women, is due to this disease. When the labia are separated and an inspection made, one or two spots of red- ness on the mucous surface of the nymphae will be observed, varying in color from a palish brick-red to a bright purple; and if these be touched they will be found to be exquisitely tender. If very carefully observed in a chronic case, these spots will be found to be very slightly below the .evel of the normal mucous membrane. If a case be watched for a long time, it will be found that the spots are transitory and spreading; that after lasting for some months, tlie red coloring either entirely disappears from the spot observed, and comes out at another, or extends serpigi- nously, disappearing from the old site as it progresses towards the new. This process is very slow, but it explains the intractable nature of the disease, which is seldom content until it has passed over the whole mu- cous surface of the nymphae. During its progress, the vestibule of the vagina slowly contracts, until, as in the case of a widow lady now under my care, it may be so reduced as barely to admit a finger, even though the patient has borne several children. In her case the disease has been going on for nearly six years.