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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    always, for though intercourse may be difficult and painful, still it may be accomplished ; and again, complete intercourse is not necessary for impregnation. The causes which induce dyspareunia are also often of themselves obstacles to impregnation. The nervous irritation produced is often extreme, the health breaks down from the exhaus- tion produced by repeated suffering, and so much misery is caused in some cases that the mind orives way. Symptoms.—These will naturally vary with the cause producing this condition. Painful or difficult coitus may be regarded as the fjeneric symptom, but the kind and degree of this will depend upon circumstances. In one case the mere contact of the finger or male organ will serve to produce the most violent spasm, in another little or no inconvenience is experienced at the orifice, but severe aching, or dragging, or sickening pain is complained of when pressure is made further in. If any condition of the pelvic organs be detected in married women likely to produce inconvenience in sexual relations, althou2:h no complaint may have been made by the patient before- hand, the practitioner will do well to inquire more carefully into the matter. Treatment.—Kemembering that dyspareunia is seldom an idio- pathic but generally a symptomatic disorder, our first effi3rt should be directed to ascertaining the causal condition. This may need much care and consideration on the part of the practitioner, but it will well repay him, for unless he succeed, treatment can but be empirical, and will probably be of little avail. Should any imperforate condition or unusual thickening of the hymen be detected, the propriety of an operation for its relief will at once occur. In the case of a newly-married patient it will generally be advisable to administer some anaesthetic, not so much with a view to rendering her unconscious of ]iain, as to relieve the natural distress incidental to the exposure and requisite manipulation. Should the hymen be found to be intact, a crucial incision may be made and the opportunity taken of passing a speculum to dilate the vaginal orifice, a little lint soaked in carbolised oil being then inserted to prevent adhesion between the divided edges. Occasionally it happens that some small vessel is divided, and the hajmorrhage is somewhat free. Cold, torsion, ligature, the application of nitric acid or caustic to the bleeding point, or failing these a touch with a red-hot knitting-needle, will generally succeed in arresting the haemorrhage. Should atresia of the vulva or vagina be detected, an operation must be resorted to. This will be found fully described under Atresia. Where hyperresthesia or undue sensitiveness of the vulval orifice is present, physiological rest for a time, hip-baths, tonics, local sedatives in the form of pessaries, ointments, or lotions will be advisable.—(See Formulas.) Change of air, sea-bathing, bodily exercise, and strict attention to the laws of health, will also assist materially in impi'oving the tone of the nervous system and contributing towards recovery. Where excoriations or fissures of the vulva exist, the application