The student's guide to the diseases of women

Front matter

J. WW &a\

Digitized 1

THE

Preface

The sections on treatment I have endeavour f«

selected with a view to illustrate the instruments which

S a Til 18 ^ t0 Want' and the ^e of uS 7 I aS the VanetieS 0f displacement of the uterus and adjacent parts. For the figures of many of

indicated in the woodcut I am indebted to the courtesy

difleiei t pessaries m position, namely Figures 28, 33 61, and 47, are drawn to a scale two-sevenths the size of nature. In Figure 3, showing the mode of introducing the uterine sound, and in Figures 42, 43 44 and 45, illustrating the varieties of prolapse, the seal,' is two-ninths of the natural size.

With respect to nomenclature, I have retained several terms, such as "ovaritis," "ovariotomy," vaginitis," and " vulvitis," which are in common use, although not formed according to etymological propriety, m preference to introducing such terms as tne more strictly accurate " oophorectomy " in place of ovariotomy." I have, however, discarded the awkward hybrid word " endocervicitis," since its sense can be as conveniently expressed by the term "cervical endometritis." In describing the histology of cancer of the cervix and body of the uterus, while not differing considerably from the chief authorities, I have followed, in the main, the results of my own microscopical investigations.

14, St. Thomas's Street, May, 1879.

CONTENTS o

Chapter I. Means Of Physical Diagnosis

PAGE

Vaginal Touch and Bimanual Examination— Abdominal Palpation combined with Percussion and Auscultation — Examination with the Uterine Sound— Rectal Touch— Exploration of the Bladder— Mode of passing Catheter — The Speculum, Eerguson's Tubular, Bivalve, Sims', Neugebauer's — Dilatation of the Cervix by means of Tents— Use of Hydrostatic Dilating Bags . . . . . . . . . . - . 1

Chapter II. Physiology Op Normal Menstruation

Relation of Menstruation to Ovulation — Soiu'ce of the Menstrual Blood — Period of Possible Conception — Commencement and Cessation of Menstruation — Symptoms and Concomitants of Menstruation . . 30

CHAPTER IK.

MALFORMATIONS OF THE UTERUS AND YAGINA.

Absence or Rudimentary Development of Uterus — Atresia of Uterus, Vagina, or Vulva — Congenital Uterine Atresia— Congenital Vaginal Atresia — Acquired Uterine Atresia — Acquired Vaginal Atresia — Stenosis of the Os Externum — Stenosis of the 'Os Internum . . . . . . , , , . . . . . 33

X

CONTEXTS.

Chapter IV. Displacements Of The Uterus Axd Pelvic Viscera

PAGE

-Relative Importance of Displacements of the Uterus- Relation of Displacement to Hyperemia and Inflammation—Normal Position of the Uterus— Causation of Displacements in general— Retroversion and Retroflexion of the Uterus— Anteversion of the Uterus— Anteflexion of the Uterus— Prolapse of the Uterus and Vagina— Inversion of the Uterus . . 59

Chapter V. Hyperplasia And Atrophy Of The Uterus

Subinvolution, Hypertrophy, and Hyperplasia of the

Uterus — Superin volution and Atrophy of the Uterus 1 3 1

CHAPTER VI. HYPERiEMIA AND INFLAMMATION OF THE UTERUS

Active Hyperemia of the Uterus - Passive Hyperemia of the Uterus — Inflammation of the Uterus — Acute Metritis and Acute Endometritis — Chronic Inflammation of the Cervix, Chronic Cervical Endometritis, Ectropion, Erosion, and Follicular Degeneration of the Cervix — Chronic Endometritis and Chronic Metritis — Membranous Dysmenorrhea .. 146

Chapter VII. New Growths Of The Uterus

Mucous and Glandular Polypi of the Uterus— Fibroid Tumours of the Uterus, or Fibro-myomata — Fibro-cystic Tumours — Fibroid Polypi — Cancer of the Cervix Uteri — Cancer of the Body of the Uterus — Tubercidosis of the Uterus . . . . . . . . 206

*

DISEASES OF THE LTEBINE LIGAMENTS AND OF THE ADJACENT PEBITONETTM AND CELLULAB TISSUE.

Pelvic Peritonitis, or Perimetritis- Pelvic CeUulitis or Parametritis, with Pelvic Lymphangitis-Pelvic Htematocele

Chapter XI. Diseases Of The Vagina And Tclva

Vaginitis— Cicatrices of the Vagina— Vaginal Cysts - Primary Cancer of the Vagina— Cystic Dilatation of the Urethra— Vulvitis— Follicular Vulvitis— Gangrene of the Vulva— Cystic Dilatation of the Vulvo-vaginal Glands— Inflammation and Abscess of the Vulvo-Vaginal Glands— Varicose Dilatation of the Veins of the Vulva— Htematoma, or Thrombus of the Labium— Eruptions— Vascular Caruncle of the Urethra— Hyperplasia of the Clitoris— Hyperplasia of the Nymphse— Elephantiasis of the Vulva— Cancer of the Vulva— Lupus 344 xii

CONTENTS.