Platina. Painful sensitiveness, with inward coldness of the vulva.
Silicea. Violent burning and soreness of the parts, with an eruption on the inner side of the thigh.
Sulphur. Troublesome itching of the part, with pimples all around. Generally symptoms of sulphur.
Thuya. The sufferings are increased during motion and immediately afterwards. The pain during motion is at times so severe that she is compelled to lie down.
HAEMORRHAGE from these erectile tumors may require Arnica. If the bleeding be the result of coition. And the remedy that will cure the hemorrhage may also cure the tumor itself if allowed to act a long time.
Carbo veget. If the blood be of a venous appearance, or very pale.
Coccus cacti. Pain in the vulva, so severe on going to bed that she is obliged to sit up in bed and to go to sleep in that position. The tumor of the vulva increases, gets hard and is sensitive to the touch. Throbbing and burning in the tumor of the vulva and excoriated feeling on walking.
Creosote. If the bleeding be continuous, with marked intermissions; at times becomes pale and almost entirely ceasing and then recommencing a fresh.
Lachesis. The hemorrhage seems to be vicarious; the pain increases in intensity until relieved by the flow of blood, then as the hemorrhage subsides the pain returns.
Phosphorus. The blood flows profusely for a while, and then ceases for a long time.
Pulsatilla. The blood is very changeable in its appearance. It is more apt to flow in the day time when walking. It is intermittent.
Sulphur. Flushes of heat; weak fainting spells; cold feet heat on the top of the head; very hungry from eleven till twelve in the forenoon- cannot wait for her dinner.
For INFLAMMATION of the Erectile Tumors, study the remedies under Vulvitis.
For ULCERATION of those various Tumors, study the remedies mentioned under Ulceration of the Vagina.
For POLYPI, ULCERS and CANCER of the Vulva, see these titles under Diseases of the vagina and Womb.
BLOODY, OR OOZING TUMORS.-These are most apt to occur in persons who have passed the middle period of life,-and who may have received constitutional and even local injuries from too frequent childbirth, or from similar causes. These tumors are not so well defined and circumscribed of some dependent portion of the labia or vulva. And they may arise even in virgin females, from accidental violence to the parts. From their size and situation they may occasion no small suffering, and be made to exude a watery or even bloody discharge,-which is much increased by walking. For the treatment of these, as well as of other tumors of the external genitals, study the remedies and indications given above, and also those under Vaginal and Uterine Tumors, in a subsequent chapter.
VARICOSE VEINS.
VARICES. Dilatation of the veins, with thickening of their coats, is termed varix, varices of varicose veins. This enlargement is believed to occur first in the submuscular, then in the subcutaneous or superficial veins. And this statement of its rise and progress, explains the insufficiency of the ordinary surgical method of treating this disorder, and shows the reason of the frequent relapses which follow its apparent cure by compression.
Varicose veins often appear in pregnancy, in the latter months of utero-gestation; and are commonly supposed to be caused by the pressure of the gravid uterus upon the iliac vessels and inferior cava. But this local pressure can be but a single one of the exciting causes; since varices are seen in some who are not pregnant, and they do not make their appearance in the larger proportion of those who are. If the pressure were the main cause, all or nearly all pregnant women should have more or less of this varicose condition before they are confined,–which is far from being the case.
The constitutional condition of the system in general and perhaps of the organs of venous circulation in particular, which gives rise to varices, under the influence of exciting causes, is no doubt similar to that which produces haemorrhoids. In each affection, constipation seems to exert no small provoking influence,–although it may be that the same deep-seated disorder of the constitution may at the same time cause the varicose and the constipated condition. The varicose and the haemorrhoidal enlargements are alike liable to rupture and to occasion serious hemorrhage. And both these disorders are equally amenable to Homoeopathic medication. The appropriate remedies, taken in season, will entirely cure the varicose condition; or, if resorted to only after the enlargement has already become very extensive in the later months of utero-gestation, will at least prevent its further increase. And as on the one hand Homoeopathic treatment perseveringly employed will entirely remove the constitutional predisposition to varix; so on the other hand the highest allopathic authority states, that “this condition of the veins gradually increases in amount and severity with every succeeding gestation.[ Churchill, Diseases of Women, Chap. VI.)
The various and severe pains and all the attendant symptoms and conditions of varices below the knee, in the thighs, in the labia, vagina and even in the os uteri itself,–the appearance of the enlarged veins themselves, their color, inflammation or rupture, and the concomitant and constitutional symptoms and seasons and occasions of aggravation, will enable the attentive physician to prescribe in such cases, with the certainty of greatly ameliorating the general health, and so of improving the prospect in parturition, as well as of removing the varicose diathesis itself.
The vascular nature of much of the substance of the external genitals predisposes them to varices. Such enlargement of the external veins should be treated as similar affections are in other parts of the body. Here, as well as elsewhere, all the attendant and constitutional symptoms should be carefully observed and taken into account in prescribing.
Apis m. Stinging pains prevail, with or without constipation.
Arnica. If the varices are very sore, with a bruised feeling.
Arsenicum. If they burn like fire.
Carbo veget. If they cause dysuria.
Causticum. If they are much worse when walking.
Ferrum. In weakly persons with fiery-red face.
Graphites. If they itch very much; and have little pimples on their surfaces. Itching blotches on different parts of the body.
Lycopodium. This remedy is most frequently required. Red sand in the urine. Borborygmus and constipation are indications.
Nux vomica In persons who live on wines and highly seasoned food, and keep late hours. Constipation.
Sulphur. Coldness of the feet. Heat on the top of the head. Hungry and faint from eleven o’clock till noon. Weak faint spells. Flushes of heat.
Zincum met. Varicose veins and fidgety feet.
HERNIA OF THE EXTERNAL GENITALS.
Hernia of the Vulva, or Perineal Hernia, and Cystocele, are rare forms of displacement, considered here because, although more common in pregnancy, they may occur in the unimpregnated female. Perineal hernia of the vulva consists in the descent of a loop of intestine; in cystocele a portion of the bladder is involved. In either case the tumor occupies the lower and most posterior portion of the labia majora of one side. And in this position it may be detected between the edge of the anus and the tuberosity of the ischium.
By placing the patient in the horizontal position the hernia may easily be reduced; and the gurgling sound which accompanies the reduction, as well as the reduction itself, sufficiently indicates the nature of the difficulty. Perineal hernia is to be distinguished from an encysted tumor by this facility of reduction; the latter of course being incapable of reduction. While cystocele is usually indicated with equal clearness by the irritation of the bladder, and consequent desire to pass water, which will result from pressure on the tumor in such cases. And the size of the tumor itself may be seen to change as the bladder becomes more full, or is relieved of its contents by the use of the catheter. This operation may be necessary therefore in order to facilitate the complete reduction of this form of hernia. For the treatment, study the remedies mentioned under Prolapse of the Vagina and Uterus.
NEURALGIA OF THE VULVA.
NEURALGIA in the external genitals, usually appears in connection with a similar affection in the vagina. Under this latter head we shall speak more particularly of the causes and treatment of this painful disorder.
ASCARIDES OF THE VULVA.
The PARASITES which infest the external genitals of the female are of two kinds,–ascarides and lice. The former may escape from the rectum, and lodging in the folds of the vulva, cause there an intense pruritus, or even nymphomania. And even where it is impossible to detect their actual presence in the external genitals, so strong is the sympathy between the mucous membrane of the rectum and vulva, that the irritation in the latter is equally intense with that in the former organ; and no less distressing than that which results from the presence of the vermin in the vulva itself. The latter mostly infest the roots of the hair upon the mons veneris and labia majora.
