Charles Gottleib Raue.

Special pathology and diagnostics : with therapeutic hints online

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leucorrhoea ; giddiness when turning in bed ; intermitting flow of
urine.

Hamamells, after a blow, the ovary swollen, with a diffused agoniz-
ing soreness over the whole abdomen ; menses irregular, very painful,
with exacerbation of all the sufferings at the catamenial epoch ; reten-
tion of urine.

Hepap, when suppuration takes place, indicated by frequent crawls.

Ignatia, disappointed love; constant running of thoughts in that
direction ; sighing, despondency ; leucorrhoea, which passes off with
labor-like pains.

Lachesis, left ovary ; tensive, pressing pains and stitches ; inability
to lie on the right side on account of a sensation as if something were
rolling over to that side; menses scanty, with labor-like pressure from
the loins downward ; swelling of the ovary ; suppuration.

Merc, stitching, pressive pains in the lower region of the abdomen,
left side ; upper portion of the abdomen distended ; stool, with great
tenesmus ; constant urging to urinate, with scanty emission of a thick,
brown-red urine, causing burning in the urethra ; perspiration with-
out relief ; great weakness and emaciation; nightly aggravation and
restlessness; menses suppressed.

Mux v., after previous use of dijBferent allopathic drugs.



412 FEMALE OEGANS.

Platina, excessive sexual desire, from an incessant tickling within
tlie genitals ; painful pressing towards the genital organs, as if the
menses would make their appearance ; profuse or suppressed menses,
with palpitation of the heart, headache, restlessness and weeping;
haughtiness.

Pulsatilla, after getting the feet wet ; suppression of the menses, with
nausea, coldness of the body, chilliness and trembling of the feet ;
pressure on bladder and rectum ; thirstlessness, weeping, meek dis-
position.

Zincum, boring pain, relieved by pressure and during the men-
strual flow.

Compare Aurum, China, Clematis, Hedeoma, Jod., Ph. ac, Phyto-
lacca, Podoph., Sabina, Sep., Staph., Thuya.

Hydrops Ovarii, Ovarian Dropsy ; Formation of Cysts

in the Ovaries.

Most of these cysts originate in a degeneration of the G-ranfian fol-
licles, which become distended, in rare cases, even to the size of a
child's head ; containing a clear, yellowish, serous^ or thick, limpid
fluid. There may be one or several of such cysts.

The multilocular tumors consist in a new formation of multiple-
cysts, growing out of the parenchyma of the ovaries. They some-
times attain an enormous size, and contain either a serous or jelly-
like fluid, which is dark if mixed with blood.

The alveolar degeneration of the ovary destroys all the original struc-
ture of that organ; its whole substance becomes transformed into
larger and smaller cavities, which are separated by a fine tissue.
Some of these cavities attain the size of a fist, whilst others remain
quite small. At first the organ retains its roundish shape ; later, by
the extension of some of these cavities, it becomes uneven. The
contents of these cavities is mostly a yellowish, tough, honey -like
substance, though the larger ones sometimes contain a thinner fluid.
This degeneration is generally complicated with cancer of the ovaries.

There are yet cysts to be mentioned which, instead of a fluid,
contain hair, teeth, and hones ; their interior walls present a structure
which is quite similar to that of the cutis, having an epidermis with
sudorific and sebaceous glands, and sometimes a hairy growth. Such
cysts are called dermoid cysts ; they sometimes attain the size of a
walnut, or even a fist.

Its symptoms^ in the first stage, may be identical with those of an



OVARIAN DROPSY. 413

oophoritis ; but usually all such signs are wanting, and the cysts, as
long as they remain small, give no inconvenience whatever. When
attaining a certain size, however, they exercise a pressure upon the
bladder and the rectum, causing difficulties in urination and defeca-
tion. When pressing upon the nerves, which run down on the pos-
terior wall of the lesser pelvis, they cause pain in the small of the
back, or pain and numbness in the lower extremities; and when
pressing upon the veins in the pelvis, they cause oedematous or vari-
cose swellings on the lower extremities. At the same time we ob-
serve, in some cases, a swelling of the mammae and a darkening of
the rings around the nipples ; sympathetic vomiting and general
malaise; thus simulating very closely the commencement of preg-
nancy. When the cysts grow further, they rise out of the pelvic
cavity, and most generally the patient feels relieved of those symp-
toms which are caused by their pressure upon the pelvic organs ; in
some cases, however, all these symptoms continue, as the cysts or
portions of them within the pelvic cavity still continue to exercise
the same compression upon the pelvic organs.

Increasing still more, they gradually fill the abdominal cavity,
press against the diaphragm and compress the abdominal organs ; the
natural consequences of which are: vomiting, shortness of breath,
palpitation of the heart, bronchial catarrh, disturbed secretion of
urine, deficient nutrition, and consequently ansemia and hydremia,
which ends in general marasmus.

Their growth is not a steady one ; they are frequently observed to
increase and decrease in size periodically; the first taking place
generally before and the latter after menstruation. As frequently
intervening symptoms may be mentioned those of peritonitis, which
are the more severe the more rapidly the cysts grow. If a cyst
bursts, either by its own excessive distention, or by external violence,
its contents issue into the abdominal cavity and cause a general peri-
tonitis; or it may, in consequence of previously-formed adhesions
and inflammatory processes, find its way into another of the abdom-
inal organs, and be thence discharged.

Physical Signs.

As long as it remains in the pelvis, it may be diagnosticated by an
examination per vaginam or rectum, where it appears as a well-
defined swelling, dislocating the uterus in this or another direction,
according to its position. The less the swelling takes part in the
motions of the uterus the more sure is its diagnosis.



414 FEMALE ORGANS.

When it ascends from the pelvis, it appears first as a painless,
well-defined swelling over the horizontal ramus of the pelvic bones;
later it rises still his/her, inclinins; more towards the middle-line of
the abdomen, and yielding, more or less, a sense of fluctuation ; the
distended abdomen appears arched and changes its form scarcely any
during different positions of the body.

Percussion yields a complete, dull, flat sound, where the tumor
touches inside the parietal walls ; the percussion sound is dullest,
therefore, where the swelling is most prominent, thus differing from
ascites, which gives a full sound, where the distended abdominal walls
appear highest; for underneath that position lie, in ascites, inflated
intestines.

Tlierapetitic Mints, — Compare Oophoritis and Peritonitis.

Apis, sudden stitches, like bee-stings, in the tumor, or sharp,
cutting pains, with scanty urine and constipation; bearing down,
and pain in the small of the back, as if the menses would come on;
numbness of the corresponding lower extremity ; thirstlessness ; pale
skin ; oedema ; right side.

Arsen., burning pain; restlessness; anxiety; oppression; sinking
of strength; great thirst, but little drinking at a time; dropsical
swelling all over.

Ca!c. c, distention and hardness of the abdomen ; pressure in the
rectum, and bearing down in the womb ; profuse and too early
menses.

Canth., burning pain ; great sensitiveness of the abdominal walls ;
constant, painful urging to urinate and defecate ; tenesmus in the
bladder and rectum ; wretched, sickly appearance.

China, after great loss of fluids; general anasarca; meteorism.

Sodium, pressing, bearing down towards the genitals ; constipa-
tion ; acrid leucorrhoea, corroding the linen ; dwindling and falling
away of the mammas; strumous constitution.

Lycop., painful, boring stitches in the left ovarian region ; pressure
on the rectum and bladder ; pain in the sacral region, especially when
rising from a seat ; red, sandy sediment in the urine ; ascites ; varicose
veins on the legs.

Where proper Homoeopathic treatment should show no influence
in staying the growth of such tumors, or improving the general
health of the patient, such cases belong then to the field of operative
surgery.



LEUCOREHCEA. 415

Uterus.

Leucoprhoea, Catarrh of the Uterus.

Always at the time of the cataraenial period the mucous membrane
of the uterus is found in such a hypereemic state that its overfilled
blood-vessels burst, and occasion what is called the menstrual flow ;
this normal hypersemic state might be called the physiological catarrh
of the uterus. It becomes morbid, pathological, when it occurs at a
time when no ripe ovula are cast off. It is, therefore, clear that the
j)redisposition to uterine catarrh lies between the time when menstrua-
tion begins until it ceases.

Exciting causes are, all such disorders as cause a stagnation in the
proper circulation of the blood, as heart and lung diseases ; chronic
constipation, &c. ; direct irritations, as sexual excesses, masturbation,
pessaries, &c.; or a general weakness of the system and general morbid
conditions, such as typhus, cholera, small-pox, and other infective
diseases; chlorosis; scrofulosis; tuberculosis, &c.

Its pathological features are like those of any other catarrh : hy-
peraemia, swelling, dryness at first, and afterwards increased secretion
of mucus. When becoming chronic, the mucous membrane thickens
and becomes hypertrophied, and is sometimes studded with polypous
excrescences ; its color turns brownish or slate-colored ; the secretion
becomes more or less purulent ; the follicles of the portio vaginalis
swell on account of the closure of their excretory ducts ; whilst their
secretion inside is still going on ; they form little round bodies of the
size of a hemp-seed or larger, and are known under the name of
ovula Nabothi. Furthermore, we find, if the process lasts long enough,
diffuse catarrhal erosions, mostly on the posterior lip of the mouth of
the womb ; or follicular ulcers, which originate in the bursting and
suppuration of the above-named ovula Nabothi; and also granidating
others, which differ from the rest by their exuberant granulations,
which bleed easily.

Symptoms. — An acute attack is characterized by drawing pain in
the small of the back and in the inguinal region, a feeling of fulness
and heaviness in the pelvis, dysuria and tenesmus. External pressure
upon the lower part of the abdomen is painful. There is more or less
fever. After three or four days the patient observes a discharge from
the genitals, which at first is transparent and sticky, staining the linen
grayish ; by-and-by it becomes opaque and more or less purulent.
In the further course of eight or ten days the fever gradually sub-
sides, and after that the discharge diminishes until it finally ceases.




416. FEMALE OEGANS.

In chronic cases, the commencement is not easily ascertained. The
patients have had, long before they attach much importance to it, a
discharge from the womb, which varies considerably in different cases.
Still it is of the same nature as that above mentioned, staining the
linen grayish, and making it stiff; sometimes, even, clots of a gelatinous
mass issue forth. That is characteristic of a uterine catarrh. A puru-
lent discharge is just as liable to have its source in the vagina ; and
if the discharge be corrosive, the presumption is that it originates
there. In some cases, the os uteri closes, owing to the sticky dis-
charge and the swollen state of the neck of the uterus; and, in con-
sequence, a collection of large masses of mucus within the uterus
takes place, which are finally expelled by labor -like contractions of
the uterus — uterine colic. The longer the catarrh exists, the more it
changes the mucous lining of this organ, and the greater, of course,
must be its effect upon the monthly period. In some cases, the flow
becomes very profuse ; and in others, very scanty ; and almost always
it is attended with more or less pain. Conception is not necessarily
prevented, if the catarrh does not extend to the tubes or causes them
to be closed ; but it has been observed that women suffering with
chronic uterine catarrh are very prone to miscarry. A chronic uterine
catarrh may be endured for a long time ; but it finally betrays itself
by paleness and an earthy color of the face, weakness and relaxation
of the muscles, anssmia and hydra3mia. The most frequent expres-
sions of chronic uterine catarrh are hypersesthesia, neuralgic and
spasmodic complaints ; all of which we find united under the popular
expression of hysteria. The progress of the disease is always slow ;
and amongst its complications we find a chronic parenchymatous
metritis, inflections of the uterus, and closure of the cervical canal of
this organ.

In giving Therapeutic Miuts, I shall unite both uterine as well
as vaginal catarrh. Both are known under the popular name, leucor-
rhoea or whites, as the most prominent and sometimes the only symp-
tom of the two.

Aesculus hip. Pain in the small of the back and hip, with a lame
feeling ; the pain extends from the abdomen to the small of the back,
which makes it almost impossible to get up and to walk after sitting ;
constipation and piles.

Aletris farinosa, in cases of debility from protracted illness, loss of
fluids, defective nutrition, &c. ; great disposition to abortion.

Alumina, profuse, purulent, yellow, corroding discharge, worse
before and after the menses.



LEUCORRHCEA. 417

Aralia racemosa, offensive discliarge, with pressing- down pains in
the uterus.

Am bra, discharge only at night ; thick mucus with stitches in the
vagina before the discharge ; pieces of bluish, white mucus.

Amm. c, watery, burning discharge from the uterus ; profuse, acrid
leucorrhoea.

Amm. mup., leucorrhoea with distention of the abdomen, without
accumulation of wind ; discharge like the white of an egg, after pre-
vious pinching around the navel ; brown, slimy, painless leucorrhoea,
after every discharge of urine.

Arsen., discharge, dropping out while standing, and emitting flatu-
lence; acrid, corroding.

Baptisia tinct., acrid, fetid discharges; ulceration of the os uteri
and vagina; debilitated state of the system.

Bell., acute catarrh ; pressing, as if all the contents of the abdomen
would issue through the genitals, which is followed by a discharge of
white mucus.

Bovista, after the catamenia; while walking, thick, slimy, tenacious
mucus, like the white of an egg; also, yellow, green, acrid, corrosive.

Calc. c, milk-like discharge during micturition, or flowing only in
spells profusely; too early and too profuse menstruation; paleness of
the face; weak feeling in the chest, especially when talking; weak-
ness in the knees; emaciation.

Carbo veg., discharge only in the morning, when rising; soreness
and rawness in the pudendum.

Caulophyllum, profuse secretion of mucus in the vagina; yellowish
spot on the forehead, commonly called "moth."

Caust., weakening leucorrhoea, with too scanty menses; discharge,
particularly at night; yellow face.

China, leucorrhoea instead of the menses ; painful pressing towards
the groins and anus; bloody discharge, occasionally clots of black
blood; or fetid, purulent matter, with itching and spasmodic con-
traction of the inner parts.

Cocculus, flesh-colored, watery discharge, instead of the menses,
mixed with a purulent and ichorous liquid; on bending or squatting
down, the fluid gushes out; distention of the abdomen and pain, as
of a heavy stone; on sitting down, bending, treading, or any other
motion, a pain, as of internal ulceration.

Collinsonia, leucorrhoea in connection with pruritus, obstinate consti-
pation, and dysmenorrhoea.

Conium, white discharge, burning, smarting, excoriating; contrao-

21



418 FEMALE ORGANS.

tive, labor-like colic, from botli sides of the abdomen; -weakness and
lameness in the small of the back and subsequent lassitude; old
maids.

Ferrum, in chlorotic patients, thin, watery discharge, at first smart-
ing and corroding; palpitation of the heart; earthy, yellowish face;
painfulness of the vagina during an embrace; swellings and indura-
tions in the vagina.

Gelsem., white discharge; feeling of fulness in the hypogastrium;
aching across the sacrum.

Graphites, perfectly white discharge, very profuse, especially in the
morning on rising from bed; weakness in the back and small of the
back, when walking or sitting.

Hamamelis, especially in those profuse discharges which simulate
a hemorrhage and constitute a drain on the system as severe as a
bleeding.

Helonias has been recommended in cases of general atony, anaemia,
and torpid condition of the system.

Hydrastis, tenacious discharge ; erosions and superficial ulceration
of the cervix uteri and vagina ; great sinking and prostration at the
epigastrium, with violent and continued palpitation of the heart.

Ignatia, violent crampy pressing in the region of the womb, resem-
bling labor-pains, followed by a purulent, corrosive discharge ; mild
dispositions who bear sufferings, even outrages, without complaining.

lodium, old leucorrhoea, most abundant at the time of the menses,
rendering the thighs sore and corroding the linen ; dwindling and
falling away of the mammae ; goitre.

Kreosot., leucorrhoea before and after the menses, especially when
standing and walking, not when lying or sitting ; the yellow discharge
is acrid and corroding, offensive, causing redness and itching in the
vulva; menses too early, too profuse, and too long.

Lachesis, leucorrhoea before the menses, copious, smarting, slimy,
stiffening and staining the linen greenish ; the menses appear at the
regular time, but are too short and too feeble.

Lycop., profuse discharge, not constantly but in starts, which are
always preceded by a sharp cutting pain in the hypogastrium ; pale
face, with frequent flushes or circumscribed redness of the cheeks;
discharge of wind from the vagina ; jerking of the lower extremities.

Magn. mur., early in the morning after urinating and after stool.

IVlercur., inflammation of the genitals ; discharge of different nature,
always worse at night.

Natr. mur., leucorrhoeal discharge after contractive colic, pressing



METRITIS. 419

downwards, early in the morning, at night, when walking; acrid
pain in the genitals ; cutting pain in the urethra after micturition ;
yellowness of the face; and especially after local applications of
nitrate of silver.

Nitr. ac, mucus — which can be drawn out — flesh-colored, greenish,
cherry-brown, fetid ; after mercurial treatment.

Nux v., fetid discharge, tinging the linen yellow; after all sorts of
allopathic nostrums.

Phos., in consequence of chlorosis ; watery slime, especially during
or instead of the menses ; acrid, smarting, corrosive, drawing blisters.

Podoph., discharge of thick transparent mucus, attended with con-
stipation and bearing down in the genitals ; prolapsus uteri and ani.

Pulsat., burning discharge, thin and acrid, milky, thick and white,
without pain ; when lying, or before and during the menses, which
are scanty ; inclination to looseness of the bowels ; chilliness ; thirst-
lessness; peevishness; sadness.

Sepia, in the climacteric period ; during pregnancy ; during pu-
berty, when there is a sense of pressure and bearing down in the
pelvis, stinging pain in the ovarian region, frequent urging to urinate,
and itching in the genital organs ; the discharge is of a varied nature.

Silic, acrid, excoriating discharge ; or milky, in paroxysms, with
cutting in the umbilical region; frequently, also, discharge during
micturition.

Sulphur, discharges of all sorts, mild and excoriating; in most
chronic cases, just as in all other chronic catarrhal affections ; burn-
ing of the soles of the feet, and heat in the crown of the head ; too
much animal heat; feeling of faintness, with strong craving for nour-
ishment, about eleven o'clock every forenoon.

Parenchymatous Metritis, Acute and Chronic Infarct of

the Womb.

The substance of the womb itself is hypergemic, oedematous, and
consequently enlarged. It appears, on account of its congested state,
of a more or less dark-red color, and sometimes contains exudates of
blood. "When it becomes chronic, this redness gradually disappears,
as by the exuberant growth of the interstitial tissue the small blood-
vessels become compressed, only some of the veins grow varicosed
on account of the obstruction in the circulation ; the substance itself
appears pale, dry and tense, and greatly enlarged in thickness. This
state of things, whether acute or chronic, is always more or less com-



420 FEMALE OEGANS.

plicated witli inflammation of the mucous lining inside of the organ,
(uterine catarrh,) or an inflammation of its peritoneal covering, (puer-
peral peritonitis.)

Its causes are the same as have been detailed in the chapter on Uter-
ine Catarrh ; to which I shall only add, that in a number of cases the
starting point is delivery, puerperal metritis, and the shameful crime
of producing abortion.

Symptoms. — It sets in, more frequently than uterine catarrh, with a
chill, followed by fever-heat ; there is pain in the small of the back
and inguinal regions; pressure in the pelvis; great soreness and
sensitiveness of the abdomen; dysuria and tenesmus; the same
symptoms, only in a higher degree, than in uterine catarrh. The
menses suddenly cease flowing, when it develops itself during the
monthly period, or they do not appear at all, or they burst forth, in
some cases, as a violent metrorrhagia, — metritis hemorrhagica. Being
almost always complicated with uterine catarrh, it must, of course,
produce similar characteristic discharges from the womb.

In the most favorable cases the disease runs from eight to fourteen
days.

Much more serious are cases of puerperal metritis. Its most
frequent causes are : operative manipulations during parturition ; or
great mental excitements or depressions during the puerperal state ;
also a faulty diet, taking cold, &c., during that period. It is often
complicated with puerperal fever ; a dissolution of the blood, similar
to that of typhus. The disease always commences in the first days
after confinement, before the uterus has yet regained its normal posi-
tion and size. It is characterized by chills, high fever, great tender-
ness of the abdomen, burning thirst, vomiting, suppression of lochial
discharge, and a tendency to putrescence. A frequent complication is
phlegmasia alba doleris, or m.ilh-leg ; which is a metastatic inflammation
of one or several large veins of the thigh, causing a white, shining,
very painful swelling of the whole leg.

CHROisric infarcts of the womb show no such acute features; their
most characteristic symptom is a hearing -down feeling. In the com-
mencement, the menses generally flow long and profusely ; later, how-
ever, when the exuberant interstitial tissue compresses the blood-
vessels of the organ, they become scanty and often cease altogether
for months and years. Otherwise we have the same symptoms as in
chronic uterine catarrh, which is always attending it. Conception is
not necessarily prevented; and pregnancy often proves a curative
agent.



METRITIS. 421

Therapeutic Hints. — Compare Uterine Catarrli and Peritonitis.

Aconite, high fever; dry skin; intense thirst; great restlessness;
fear of death, and predicting the hour of death.

Arnica, when induced by external violence.

Arsen., burning pain ; indescribable anguish and restlessness ; sudden
sinking of strength ; burning thirst, drinks often, but little at a time ;
burning in the veins ; aggravation about midnight ; puerperal metri-
tis ; signs of dissolution of the blood.

Beliad., violent pains by spells ; clutching pains, as if something
with nails were clawing the intestines together ; meteorism, without
eructations ; great sensitiveness and heat in the abdomen ; painful
bearing down in the pelvis towards the genitals and the rectum ; with
constant, ineffectual desire for stool ; suppression of the lochial or
menstrual discharge, or else vitiated, fetid discharge. Congestion of
the head, with delirium, redness of face, and throbbing of the carotid
arteries ; drowsy dozing with startings, or drowsiness, with inability
to go to sleep.

Bryonia, wants to lie perfectly still ; the slightest motion causes pain ;



Online LibraryCharles Gottleib RaueSpecial pathology and diagnostics : with therapeutic hints → online text (page 42 of 65)