Clinical lectures on the diseases of women / delivered in Saint Bartholomew's Hospital by J. Matthews Duncan.

  • Duncan, J. Matthews (James Matthews), 1826-1890.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the diseases of women / delivered in Saint Bartholomew's Hospital by J. Matthews Duncan. Source: Wellcome Collection.

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    pyrosis, nausea, disorders of liver, disordered secretions, Iiysteria, intellectual disturbance, and many, many more. All of these may accompany retroflexion, no doubt, but they are in no sense symptoms. You will utterly reject all this kind of pathology as worse than useless, and examine the matter more narrowly. I have no hesitation in telling you that, compared with tliis, you will then find retroflexion to be a very innocent affair. The rules I gave you for testing tlie reality or truth of direct symptoms apply to these indirect symptoms, and should be rigidly applied in order to your pursuing a right course for your patients. The mammary sympathies, pain, swelling, tenderness, develop- ment of areola, are occasional unchallenged remote symptoms of uterine disorder; so also is renal pain and tenderness ; so also are the flushings and curious neuralgia3 of the menopause. I am disposed to believe that a growing fibroid may cause insanity. I doubt sickness and vomiting as symptomatic of uterine disease, apart, of course, from pregnancy; and a few words are required to explain this doubt. Sickness and vomiting are often seen with perimetritis and with spasmodic dysmenorrhoea. But in the perimetritis it is not a proper uterine symptom, but a symptom of local peritonitis, and is observed in whatever region local peritonitis may be, whether near the uterus or not. Again, in dysmenorrhoea it is observed chai'acteristically only as the result of very severe pain, not as a proper uterine symptom, but with accompanying other evidence of the vio- lence of the pain; and as such it is observed in whatever part of the body such pain may be. Palpitation does not point to disease of the womb, but to antemia, whether caused by met- rorrhagia or not. A mujj?h-talked-of symptom is left infra-mammary pain, and I refer to it to repudiate it altogether. We may go on with our regular work in Martha'^ for months without hearing of it, and when it does occur it is inexplicable, or is an evidence of neuralgic weakness or hysteria. The place held by left infra- mammary pain should be given to pain above the left groin— the left [sometimes right] ovarian pain of modern neurologists ^]3ut this is not a remote pain, and you will hold in mind that