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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    ing from parturition, as from fracture of an anchylosed coccyx, or from undue straining or rupture of the ligaments producing subse- quent inflammation in the sacro-coccygeal joint; blows or falls upon the coccyx producing fracture or dislocation, or even inflammation in the joint. Exercise on horseback; prolonged sedentary occupations. Sy7n2)toms.—The most constant and characteristic symptoms are pain on defsecation, on sitting down, or on attempting to rise from the sitting posture. In some instances there is pain on walking or prolonged sitting. The pain is not always acute, nor at all times equally severe; it is aggravated by pressure, and, as a rule, is not present when the patient is lying down quietly. Some patients dread sitting down; they rest upon one hip only, or support them- selves partially by placing one hand on the chair, leaning over to the opposite side. Before attempting to rise, especially from a low seat, which they generally instinctively avoid, the hands are placed upon the edge of the chair and the body thrown forw^ards, so as to avoid, as fiir as possible, putting any strain upon the parts affected. Any sudden or violent movements produce such agony as to make the patient cry out. Diagnosis.—With one finger inserted in the rectum, the other hand being pressed externally, intense pain is produced on pressure over the sacro-coccygeal joint, or on moving the coccyx. In some instances, however, there is no evidence of any lesion of the coccyx, but the presence of painful haemorrhoids or fissure of the anus is detected. Retroflexion of the uterus with acute metritis may occasionally be found to account for the intense pain. Prognosis.—Instances are met with where after long and intense sufiering the disease seems to wear itself out, the patient getting well spontaneously without treatment. Although the disease may last for years and cause considerable annoyance and distress, it is singular that the general health becomes so little impaired. Treatment.—Where the aflection seems to be more of a neurotic form, tonics, such as iron, strychnia, quinine, or arsenic • careful regulation of the bow^els ; counter-irritation ; morphia suppositories, or the hypodermic injection of morphia over the seat of pain, or the application of chloroform and belladonna liniments, may first be tried. Any uterine, ovarian, or i-ectal disorder should be treated by a])pro- priate remedies. If local inflammatory symptoms be present, a few leeches may be applied to the part, followed up by counter-irritation. Should these measures fail in affording relief, a radical cure of the aflection must be had recourse to. This may generally be accom- plished either by severing the attachments of all the coccygeal muscles or by extirpation of the coccyx itself. In the former case a tenotomy knife is passed at the point of the coccyx, and carried up subcutaneously as far as the sacro-coccygeal joint. The coccyx is then entirely freed from all muscular attach- ments by an incision first on one side, then on the other, and lastly all round the tip of it.