A practical treatise on the diseases of women

Front matter

J

A tf V ^

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Preface To The Second Edition

In a science so rapidly progressive as that of medicine, the profession has a right to expect that, when its approbation of a work is manifested by a call for a new edition, the author should respond by giving to his book whatever of additional value may be derivable from more extended experience, maturer thought, and the opportunity for correction. Fully sensible of this, the author of the present volume has sought by a careful revision of the whole, and by the addition of a chapter on Chlorosis, to render his work more worthy of the favor with which it has been received. Circumstances, however, have prevented him from rendering this revision in all respects as thorough as he could have wished. The first edition was so large that he reasonably anticipated ample time for the preparation of a second, and when, within six months after its publication, he was called upon to revise it for the press, the call found him unprepared, and the labor thus unexpectedly undertaken has had to be performed under the pressure of excessive professional duties. Even under these adverse circumstances, the author hopes that many imperfections have been removed, and that material of some value Las been introduced.

He takes this opportunity of expressing his sincere gratitude to many of his confreres who have generously encouraged him

Vlll PREFACE TO THE SECOND EDITION.

by their commendation and indorsement, and to acknowledge his indebtedness to Drs. James L. Brown, J. C. Kott, and Theophikis Parvin for valuable suggestions which have greatly aided in whatever improvement may be noticed in this edition.

No. 86 Fifth Ayemte, New York, March. 1S69.

Preface To The First Edition

This work was undertaken with the conviction that a treatise, such as that which the Author has aimed to prepare, was needed as a text-book for the American student and a book of reference for the busy practitioner.

ISTo department of medicine has made greater advances within the last few years than Gynecology ; yet the record of its progress is, for the most part, to be found only in special monographs, journals, transactions of societies, &c, which are inaccessible to the mass of the profession in this country. It has. therefore, seemed to the author that a volume which should, within a limited space, present the latest aspect of the subject in a systematic form, could scarcely fail to prove useful, while his position for the last thirteen years as a teacher in this department has encouraged him in the hope that his familiarity with the needs of the student may, to some extent, have fitted him to undertake the task.

In the preparation- of the treatise the Author has, therefore, striven to be as concise and practical as possible, and to bring the subject up to the level of the most recent improvements. Many chapters will, probably, appear very short when the importance of their subjects is considered; but it has been his effort to condense within the narrowest limits all that is of real value in reference to the matters treated. In furtherance of this view some very rare conditions have been omitted, as, for example, Physometra and llydrometra.

As the speciality of Gynecology is being rapidly separated

X PEEFACE TO THE FIRST EDITION".

from its sister branch, Obstetrics, this volume has been devoted to diseases of the non-pregnant woman; such affections as phlegmasia dolens, puerperal fever, mammitis, &c, being properly referable to the province of the accoucheur.

The discussion of all unsettled questions has been avoided, the writer preferring to state the views which he regards as correct rather than to risk confusion by entering upon lengthy arguments.

The space allotted to historical sketches may be regarded by some readers as unnecessary ; yet it has seemed to the Author that the information thus conveyed with respect to the progress of this art from the earliest times might not be unacceptable to the earnest student. At the same time, the Author would disclaim any pretensions to profound research by confessing that he has drawn largely upon contemporaneous writers for his facts. He has more particularly availed himself of the publications of Drs. H. Gr. Wright, of London, John Watson, of this city, Colombat de l'Isere, of France, and of Dr. Francis Adams's Notes to Paulus iEgineta. The works of Hippocrates, Paul of ^Egina, Aetius, and some others have, indeed, been constantly by his side, bat many which have been referred to have been quoted through modern writers.

The Author takes much pleasure in acknowledging his indebtedness to Dr. B. F. Dawson, of this city, for material assistance in preparing the work for the press.

February, 1868.

Chapter I. Historical Sketch Op Uterine Pathology

PAGE

Chapter II. The Etiology Of Uterine Diseases In America

Want of Air and Exercise

Excessive Development of the Nervous System

Improprieties of Dress ....

Imprudence during Menstruation

Imprudence after Parturition .

Prevention of Conception and Induction of Abortion

Marriage with Existing Uterine Disease

53 54 54 57 57 58 59

CHAPTER III. DIAGNOSIS OF TnE DISEASES OF THE FEMALE GENITAL ORGANS . 62

Rational Signs of these Diseases . . . . . .63

Management of Patient during Physical Examination . . 65

Means of Physical Diagnosis . . . . . .66

Anaesthesia ........ 66

The Vaginal Touch . . . . . . .66

Conjoined Manipulation, or Bimanual Palpation . . .67

Abdominal Palpation . . . . . . .69

The Rectal Touch ....... 69

Vesico-rectal Exploration . . . . . .69

The Uterine Sound and Probe . . . . .77

The Endoscope . . . . . . .85

The Exploring Needle . . . . . 85

The Microscope . . . . . . S6

Auscultation and Percussion . . . . . .86

Recapitulation of Means for exploring Pelvic Viscera and Tissues . 86

Xll

CONTEXTS.

CHAPTER IV. Normal Anatomy Vulvitis

Purulent Vulvitis .

Follicular Vulvitis

Gangrenous Vulvitis Inflammation of the Vulvo- Vaginal Gland . Eruptive Diseases of the Vulva Phlegmonous Inflammation of the Labia Majora Rupture of the Bulbs of the Vestibule

Pudendal Hemorrhage

Pudendal Hematocele Pudendal Hernia Pruritus Vulv^: , Coccyodynia page

87 88 88 90 92 93 95

102 103 108

PROLAPSUS VAGINAE AND VAGINAL HERNIA

. 144

Prolapsus Vaginas .......

. 144

Vaginal Hernise .......

. 148

Cystocele ........

. 148

Rectocele ........

. 149

Enterocele ........

. 149

CONTENTS,

Xlll

Chapter X. Fistulse Of The Female Genital Organs

Urinary Fistula ....

Vesico-Vaginal Fistula

Urethrovaginal Fistula

Vesico-Uteriue Fistulse

Vesico-Utero- Vaginal Fistulse Treatment .....

Cauterization ....

Suture .....

Preparation of the Patient

Sims' s Operation

Bozeman's Operation .

Mastin's Operation

Elytroplasty ....

Closure of the Vagina Urinary Fistula Requiring Special Treatment Vesico-Uterine Fistulse Vesico-Utero-Vaginal Fistulse Fistulse with Extensive Destruction of the base of the bladder,

FAME

154 155 155 155 155

167 168

Chapter XIX. Page

. 272

Varieties of Cervical Ulceration ....

. 272

The Granular Ulcer ......

. 273

The Follicular Ulcer . .

. 280

The True Inflammatory Ulcer . - .

. 281

The Syphilitic Ulcer ......

. 282

The Corroding Ulcer ......

. 284

The Cancerous Ulcer ......

. 284

Chapter XXI

ASCENT AND DESCENT OF THE UTERUS Ascent of the Uterus .....

Descent or Prolapsus of the uterus .

Methods of Replacing the Uterus .

Methods of Sustaining the Uterus

Means adapted to Decreasing the Weight of the Uterus

Means for Strengthening Uterine Supports

Elytrorrhaphy .....

Sims's Operation of Elytrorrhaphy

Methods of Replacing the Uterus ....

Methods of Checking Hemorrhage, the Uterus being left in Situ Methods of Amputating .....

357 358

Chapter XXV Chapter Xxyi

PELVIC PERITONITIS .

CHA PTER XXVII.

Methods of Operating .

Means for Causing Closure of the Sac .

398 399

CHAPTER XXVIII.

Methods of Operating

400 410

CHAPTER XXIX.

CHAPTER XXX.

UTF.RINE POLYPI

CHAPTER XXXI

XVI

CONTENTS.

CHA PTER XXX II.

CANCROID TUMORS OF THE UTERUS .

Fibro-plastic Tumors .

Recurrent Fibroid Tumors

PAGE

449 450

CHAPTER XXXIII.

EPITHELIOMA, OR EPITHELIAL CANCER OF THE UTERUS

Ulcerating Epithelioma, or Corroding Ulcer of the Uterus Vegetating Epithelioma, or Cauliflower Excrescence of the Uterus .

453 457

CHAPTER XXXIY.

DISEASES RESULTING FROM PREGNANCY

Uterine Moles ......

Cystic Degeneration of the Chorion, or Uterine Hydatids Subinvolution of the Uterus . . .

Superinvolution of the Uterus ....

463 466 468 470

CHAPTER XXXY.

Neuralgic Dysmenorrhcea .

Congestive Dysmenorrhcea Inflammatory Dysmenorrhcea Obstructive Dysmenorrhcea Membranous Dysmenorrhcea

472 473 476 477

478 485

CHAPTER XXXTI.

MENORRHAGIA AND METRORRHAGIA

. 487