Arsenicum The parts burn like fire. When the characteristic Arsenic thirst is present. Fetid smell.
Apis mel.
Stinging pains about the parts; but no thirst.
Belladonna Throbbing about the parts, and sense of weight.
Calcarea carb. Leucophlegmatic. The cold air strikes through her. Her feet feel as if she had no cold, damp stockings.
China, and Secale may be indicated; and should be studied in such cases.
Creosote An offensive smelling ichor discharges from the part.
Lachesis Much distress after sleeping.
Sulphuric acid Much debility with sensation of tremor all over the body.
These indicating symptoms disappearing under the influence of the corresponding remedy, there is reason to expect complete restoration. The course of the improvement should be most carefully watched; we wait patiently till the improvement has entirely ceased, before we repeat the dose, or resort to another remedy. And then make a new prescription, according to the totality of the symptoms and leading indications present.
DISORDERS OF THE VAGINA concluded
MORBID GROWTHS: TUMORS; POLYPI; CYSTS; GRANULATIONS.
MORBID GROWTHS OF THE VAGINA. The morbid growths, which occur in the vagina, are not very frequent; and they almost always coexist with similar growths in the uterus, as they spring from an internal dyscrasia which pervades the entire system indeed, but which finds its greatest facility of development on the mucous membrane of the genitals: a dyscrasia which is always of a very suspicious character, and which in many instances appears nearly allied to the cancerous.
These so-called morbid growths, are in reality but hypertrophies or overgrowths as to their structure. And therefore they are truly homologous growths. But they are animated by a perverted physiological or vital principle. Thus a purely scrofulous tumor may be looked upon as merely an enlarged gland, which is inspired by what we may term the scrofulous diathesis. So a fibrous tumor, whether hard or soft, pendulous or adherent, is but the abnormal or unlimited development of fibrous or fibro-cellular tissue with its accompanying secretion, but inspired by a morbid principle which may be constitutional, and possibly related to that which appears in cancer. In like manner the serous cysts appear to be but hypertrophic glands or follicles even, which in their magnified condition still retain their former power of secreting serous fluid: and whose hypertrophic condition is due to the fact that some morbid principle, it may be the influence of some neighboring tissue affected with cancer, has vitiated, perverted its normal vitality. And even the so-called granular vegetations, will thus appear to be but hypertrophic developments of still more minute anatomical structures, influenced by some specific poison, as the sycosis. These formations may be briefly described under the heads of fibro-cellular tumors, including soft polypi; fibrous tumors, including soft polypi; fibrous tumors, including hard polypi; serous cysts, encysted tumors; and granular vegetations.
I. “The softer kinds of polypi (or of adherent tumors), growing from (or upon) the mucous membranes, consist of rudimentary or more nearly perfect, fibro-cellular, or connective tissue, which is made succulent by serous or synovia-like infiltration in its meshes. Paget, Path. Anat.; Art. “Fibro-cellular Tumors. These tumors bear some resemblance to the serous cysts, to be subsequently described, and also to the soft or colloid cancerous growths, (“gelatinous sarcoma,) with which they have sometimes been confounded. But they do not appear to originate in the same minute glandular structure with these cysts; nor yet do they present the same positively malignant characteristics with the colloid cancer.
These fibro-cellular tumors take their name from that of the submucous tissue from which they spring; and of which they are principally composed. And they retain their name of tumor exclusively, as long as they remain closely adherent to or embedded in the neighboring parts. But when they become outgrowths, pendulous, suspended by narrow pedicles, they are termed polypi. These morbid growths, of which the suspended or polypoid variety is much the more numerous, may appear upon any part covered by mucous membrane. “The peculiar yellow color of the basis-substance of these tumors makes them look at first like fat; it is due however not to fat, but to a serous, or synovia- like, or very viscid fluid, which is infiltrated through the substance of the tumor. Among the most frequent seats of these tumors in the female are the labia and vagina. Plua For a full exposition and some examples of these tumors, consult Paget.
II. The fibrous tumors are more exclusively pendulous, or polypi. These are not unfrequent in the uterus, sometimes perhaps in the vagina; and sometimes even in the pelvis external to the vagina. In this latter situation they may consist of cysts, fleshy or fibrous tumors, which grow underneath the mucous membrane of the vagina; in the cellular membrane behind the vagina; or they may be more immediately attached to some part of the osseous frame-work of the pelvis, whether the product of diseased periosteum or not. (++) Churchill. These inter-pelvic tumors may not attack attention, until from their size they impede the free action of the rectum or the bladder; or render parturition difficult by occupying an important portion of the pelvic cavity. In some instances these tumors are of the nature of fungous or cancerous growths.
But ordinarily the tumors of fibrous form, which appear in the vagina, and still more especially in the uterus, are attended with serious inflammation in the adjacent tissues. And the inflammatory disease which arises in connection with uterine fibrous tumors, or polypi, must be the great cause of the local and general painful symptoms and haemorrhages which arise in such cases. Thus in the Allopathic practice it has been discovered, by the hard experience of the ill-success which has so often attended the removal of these tumors of the vagina, and uterus, whether pendulous or still adherent, that the tumor is not the disease; but rather merely the result of it. And high authority cautions against removing these tumors, before first curing the disease which causes them if they can. “In cases in which the polypoid tumor (which is the easiest of extirpation) can be removed, the patient is only half cured, if extensive inflammatory mischief is allowed to remain. Bennett.
POLYPOID TUMORS.
POLYPI, VAGINAL AND UTERINE Under the head of fibro-cellular tumors of the vagina, were described those formations, usually vascular, which are principally adherent to the vaginal mucous membrane; but which sometimes become pendulous outgrowths, such as are termed soft polypi. These pendulous growths, or polypi, are perhaps more frequently found within the vagina, than those which continue adherent although in most cases they arise from the uterus. And in many instances in which they thus originate in and still draw their support from the uterus, they are found occupying the vagina; having been expelled from the interior of the uterus, to which, however, they still remain attached by their fibrous pedicle or stem.
In the present section, will be described polypi in general, with reference to their structure; mode of origin; causes; attendant and consequent symptoms, and proper treatment.
Polypi have been divided into three varieties, corresponding to their general differences of structure; these are the glandular; the vesicular, and the fibrous. Glandular polypi consist in enlargements of the glandulae nabothae in the canal of the cervix. They sometimes occur in clusters, about the size of currants, and are suspended by very fine pedicles. The cellular, mucous, fibro-cellular, gelatinous or vesicular polypi, are the least frequent; grow with the greatest rapidity; and may attain the most considerable size: these have already been sufficiently described under the head of fibro-cellular tumors or soft polypi. The fibrous polypi constitute the most common variety, and may occur at the same time in the uterus and in the nasal fossa.
These morbid growths received the name polypus, or many-footed, partly from their fancied resemblance to the polypus marinus (a sea animal); and in part from their being found in some cases to take their rise from more than one stem or foot. They are generally round, oval or pyriform; but may assume other shapes in consequence of the pressure of the surrounding parts. The polypi are covered by the mucous membranes of the uterus or vagina, from which they arise; they may vary from the size of a filbert to that of a child’s head; they are mostly insensible to the touch, but bleed from the least contact, as well as spontaneously. They are attached to their base by a pedicle of variable size, some- times being connected by a slender stalk, like that of a leaf, at others by a fleshy attachment of considerable thickness. The glandular polypi are soft in texture, and may contain a small quantity of mucilaginous fluid. The cellular variety is soft, and in great measure composed of cells which contain a yellowish liquid. The fibrous polypi are more dense in structure, sometimes hollow; and either empty or containing blood, gelatinous or fatty matter, and hair. And whatever may be their structural consistence, hard or soft, vascular, mucous or fibrous, whatever their variety in size, and whatever the circumstances attending their development, all polypi have these two general characteristics: they take their origin from cavities or outlets of the body which are lined by mucous membrane; and they are attached by a pedicle or stem.
