Page images
PDF
EPUB

by several German writers who confirmed his views in the main, namely, Eichstedt in 1859, Wernick in 1872. Beck had no knowledge of Wernick's paper, and that far was original. Dr. Mundè (Amer. Jour. of Obstetrics, 1883, vol. xvi. p. 846) writes as follows: "We ourselves have seen the gushing, almost in jets, of clear viscid mucus from the external os during evident sexual excitement, produced by a rather prolonged digital and specular examination in an erotic woman. The lips of the external os alternately opened and closed, with each gaping emitting clear mucus, until the excitement (which we confess to have intentionally prolonged by gently titillating the cervix with a sound through the Sims' speculum) reached such a height as to cause the woman to sit up on the table and thus end the experiment." Finally, I myself have seen the same condition of things occur more than once. With this array of proof we are forced to conclude that this is the physiological action of the womb during the performance of the sexual act. Now the practical conclusion of the matter is that abuse of the sexual relation, as is frequently the case in the recently married, results almost inevitably in the passing of a physiological state into a pathological condition, inducing disease of the cervix, which may, and if treatment be too long delayed will, extend to the body of the uterus, and we have a condition evolved from an innocuous

physiological act into a lesion which may be obstructive in character, producing dysmenorrhea, or, it may be, will cause amenorrhoea from the acuteness of the inflammation, or there may be so great engorgement as to end in menorrhagia, or metrorrhagia. Hence the importance of determining the truth of this physiological act, its important remedy being to forbid strictly and absolutely all communication of the husband and wife, until a cure is effected, and judicious advice, which will prevent any errors in the future.

CHAPTER III.

AMENORRHOEA.

AMENORRHOEA means absence of the regular monthly flow. It may be temporary in character, due to psychical influences, such as sudden fright, sad news, anxiety, etc. When a woman has reason to dread the occurrence of pregnancy, the period fails to make its appearance, and comes on, only when she is convinced that it is not the case. On the other hand, an eager desire for the occurrence of pregnancy may have the same result, the fear of sterility making the woman look for the period with great mental agitation. Attention has been called to cases of this kind by Parvin,* Raciborski,† and Bohata. These cases are not of frequent occurrence, but are still of great interest. It may be and often is due to conditions which are general and interfere with the general nutrition of the body, such as in wasting diseases, like consump tion, anæmia, and chlorosis, and in wasting fevers, such as typhoid. Sometimes it is due to excessive

* Amer. Practitioner, Sep., 1872, and Boston Gyn. J., vii. p. 208. ↑ Arch. Gen., May, 1865, and loc. cit. p. 576.

Wein Med. Presse, 1866, No 31.

corpulence. It may be due to plethora, to torpid liver, or congestion of the portal circulation. The action of the general conditions is to interfere with the process of ovulation; the stimulus is thus lacking. It is a disorder of great frequency among women who lead luxurious lives and thus derange the sanguineous and nervous systems, and so is often found among the members of the higher class of society all over the world. It is not a disease, but a symptom of many diseased conditions, as are each and every other of the disorders of menstruation.

We find the girl suffering with chlorosis, has amenorrhea; the latter does not cause the former but the former condition is the cause of the latter. The subject looks generally unhealthy, the skin of a whitish-green color, lips and tongue pale, the latter often covered with a whitish fur, loss of appetite, and indisposition to exertion, hereditary often in its origin, occurring in those girls who have handed down to them a constitution of lowered vitality" the gelatinous descendants of albuminous parents," is the phrase which describes them best. The subjects of chlorosis are blue-eyed, fair, face round, but have soft tissues and flabby muscles, and are incapable of much exertion without fatigue. It may be developed by the ordinary contingencies of social life. Hammond (Journal of Psychological Medicine) maintains it is an affection

of the nervous system, the blood changes being secondary. There is a diminution of the red-blood corpuscles, and this is the most important change we find. A more elaborate description is not needful here; I refer my readers to a general treatise on the practice of medicine. I wish simply to call attention to it, sufficiently to prevent error, and besides, while amenorrhoea is one of the symptoms, it is not necessarily so. To relieve the amenorrhoea the indication for an improvement of the general condition by ferruginous tonics, strychnia, phosphorus, and arsenic, with properly regulated exercise, diet, and hours of sleep, are the prominent remedies. We would especially emphasize the importance of regular and sufficient repose by sleep, emphatically, here, "nature's sweet restorer."

Plethora may be the cause of amenorrhoea. Excessive congestion of the mucous lining of the uterus is the consequence, and hence there is no flow. This is a condition which is to be remedied by depletion, local, as by cups to the loins, leeches to the vulva, or cervix, or by administration of saline cathartics, so as to diminish the blood-pressure. If it be due to the blood states of phthisis pulmonalis, or Bright's disease, we see in it a conservatism of nature, and these conditions being in themselves incurable, we would be criminal to hasten the end of our patient by bringing

« PreviousContinue »