Diseases of women : including their pathology, causation, symptoms, diagnosis, and treatment a manual for students and practitioners / by Arthur W. Edis.

  • Edis, Arthur W. (Arthur Wellesley), 1840-1893.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of women : including their pathology, causation, symptoms, diagnosis, and treatment a manual for students and practitioners / by Arthur W. Edis. Source: Wellcome Collection.

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    sexual organs cannot long continue without entailing constitutional disorder, or injuriously affecting the condition of other organs.' The question then is, what symptoms or combination of symptoms lead us to infer that some local mischief is present and necessitate an examination 1 Menstruation being the most important function, any disturbance of this will probably be the first indication to arrest our attention, such as defect, excess, irregularity, pain, &c. As a rule, in ordinary cases of amenorrhoea, more especially in those associated with chlorosis, tubercular cachexia, or anaemia from over-work or insufficient supply of nourishment, no local examination is necessary; but should the menstrual molimen recur at regular intervals, and the patient suffer much pain and discomfort, although no discharge of blood appear outwardly, we are justified in resorting to a local examination, as thp case may prove to be one of retention of the catamenia from imper- forate hymen or os uteri, and if not relieved may prove fatal. Where menorrhagia persists and is not influenced by ordinary remedies, but produces marked anaemia, debility, and impairment of the general health, an examination should always be resorted to even whilst the haemorrhage continues, more especially if the loss be exces- sive, for a polypus, fibroid tumour, or cancer may be present. In cases of dysmenorrho&a the question of resorting to examination is often a very perplexing one. After the usual recognised means have been tried, on the supposition of its being neuralgic or con- gestive, and where the discomfort is so great as to unfit the patient for her ordinary duties, or her general health suffers materially from the frequently recurring paroxysm of j^ain, an examination with the view ot detecting any flexion or obstruction is clearly indicated, and should be resorted to. In cases of leucorrhcea in single women, it is well to try first what influence iron and aloes, with some astringent injection, or sea- bathing, will produce; but should the general health suffer, more especially where there is any phthisical history, and the discharge continue excessive, spite of all our remedies, an examination should ])e made. Where patients complain of hearing down, dragging pain in the hips and loins, pressure upon the bladder, causing retention of urine or frequency of micturition, and there is no habitual constipation to explain the symptoms, or these persist after the former has been remedied, an examination had better be instituted. Having learnt all that is possible from the patient's statements as to her sufferings and symptoms, and having decided that a local in- vestigation is necessary to complete the diagnosis of the case, the reasons for this should be briefly stated to the patient, and her per- mission obtained. It is best to leave entirely to the patient, as a general rule, the option of her mother or friend being present in the room during the examination. But in the case of young unmarried girls, especially if there is the least tendency to hysteria, it is always a prudent precaution to insist upon the mother or some other discreet married friend being present.