The polypi are made up of different constituents, vascular structure, fibrous tissue and mucous membrane; and these different tissues are but the prolongations of the mucous and sub-mucous organs from which they spring. Or they may be considered as hypertrophies of some of the minute glands or mucous follicles; attended by a corresponding hypertrophy of all the neighboring organic tissues, whether mucous, cellular or fibro-cellular. And according to the different proportions of these constituents and of the fluid infiltrations, the polypus itself becomes hard or soft fibrous or vesicular; as is the case in the formation of hard or soft cancer. As regards their exact seat in the genitals, polypi occasionally arise from the vaginal walls; less often from the mucous membrane of the fundus; but more frequently from the interior of the cervix uteri and even from the os tincae.
In addition to these three most general varieties of polypus, some authors enumerate also certain other morbid growths as polypoid, though we think with hardly sufficient reason. Leadem p. 272. The first mentioned of these are the cauliflower excrescences. These arise only on some part of the os uteri; may attain an enormous size, so as to fill the entire pelvis; occasion a profuse, watery and sometimes offensive bloody discharge, and collapse when emptied of their contents. A remarkable symptom has been observed in connection with the cauliflower excrescence; this is a loss of sight without any apparent alteration in the structure of the eyes. These morbid growths may be considered to be either of a syphilitic or of a cancerous nature; but they do not resemble polypi, since their root or base is as broad as any other part of their growth. Plus Davis’ Obstet., II., p. 736.
Another form of morbid growth, which has, improperly, as it appears, been termed polypoid, is the fungous. The term fungous growth, seems to be more properly applicable to those vegetations, principally verucca and condylomata, which frequent the external rather than the internal genitals; and to that form of cancerous disease known by the name of fungus haematodes. Davis, I., p. 73.
The causes of polypi are not very definitely ascertained. They take their origin from a certain dyscrasia of the system which is always of a suspicious nature; although less positively malignant than that which is developed in the form of cancer. As already stated in treating of the fibro-cellular tumors, which if pendulous are properly termed soft polypi, these growths sometimes appear in connection with actual cancerous disease.
Polypous tumors may appear in single or in married females, mostly of the middle age; they do not necessarily prevent conception, but usually appear to destroy its product by abortion.
The symptoms which make their appearance in connection with polypi are very important. These growths are not themselves particularly sensitive or painful. But a very severe form of inflammation is almost attendant upon their presence. This may arise from the same general influences which develop the polypi themselves; or in consequence of the irritation which the morbid growths occasion in the lips of the os uteri and other parts with which they come in contact. Ulceration of these irritated and inflamed surfaces is not uncommon.
The other most remarkable and constant symptom of polypus is the haemorrhage, which is hardly ever wanting. Hemorrhages which arise in connection with polypi are irregular as to their time and quantity; but constantly recurring, and by no means proportioned to the extent of the tumor. A small polypus may occasion as great a loss of blood, as one much larger; and it is stated that the very large polypi are less troublesome in this respect than those which are smaller.
The reason of this liability to greater loss of blood where the polypi are small than where they are large, will be found in the fact, now perhaps for the first time stated, that the hemorrhage itself is not from the polypi at all, but from the inflamed, congested mucous surfaces of the adjacent parts. The small polypi, especially, have no such vascular developments as would account for the alarming hemorrhages which often appear in connection with them.
The discharge which appears in connection with polypus is either mucous, or muco-purulent. In other respects the constitutional symptoms are very similar to those which arise in cancerous cases; even to the sallowness of the complexion. Only the intense, lancinating, stabbing or burning pains, singly, successively or in paroxysms, which are constantly the attendants of cancer, do not appear to result from polypus. Neither is the discharge so offensively fetid.
Fibrous growths of the uterus principally occur in unmarried and sterile females above thirty years of age; comparatively few are observed in women who have borne children. Many of these forms of morbid growth may appear in the vagina; but more often in the cervix uteri. But under this captain of morbid growths of the vagina, we have given all the description and general principles of the nature of these tumors, which will be necessary, whatever may be their exact situation in the interior of the pelvis. For their treatment will depend not so much upon their exact location, on the vaginal wall, the cervix or the fundus uteri, as upon the local and constitutional symptoms which they may occasion.
Thus in the treatment, at the end of this section, we present at one view, the principal indications for all the remedies which may be most frequently called for, in adherent or pendulous, fibro-cellular or fibrous tumors, whether arising from the vaginal walls, from the cellular tissue external to the vagina, or from the cervix or body of the uterus.
Aurum The mind is tending more or less strongly towards self- destruction. She thinks much about it, even if she does not intend it.
Calcarea carb.
Leucophlegmatic constitution. The patient cannot sleep after three A.M. The pit of her stomach is convex, like a saucer turned up, instead of being concave. Feet feel constantly as though she had on cold, damp stockings. Menses too often and too profuse. Vertigo on walking up stairs.
Conium Intermission in the flow of urine. Soreness and swelling of the breasts preceding the menses. Vertigo on turning in bed, or on turning the head when lying in a recumbent position.
Lycopodium Urine containing red sand, as a constant symptom. Much borborygmus, particularly in the left hypochondrium. Aggravation of symptoms at four P.M.; amelioration at eight P.M. Varices of the lower extremities. Also in cases in which sharp pains are occasionally running round each labia.
Mercurius In case where there is evidently a mercurial condition of the whole system. The mouth and teeth show it, the glandular system, the urine, and the skin show it. The symptoms are worse at night. They are worse also in damp, cold weather.
Mezereum (Compare with Mercurius) All the joints feel as if bruised, they feel weary, as if they would give way. She often has violent toothache at night. A fearful burning pain runs along the left malar bone, from the right to the left.
Nitric acid Urine exceedingly strong, like horse urine. Sleeps badly the latter part of the night. Leucorrhoea of mucus which can be drawn out. Flesh-colored, green leucorrhoea. Pressing in the abdomen, as if everything were coming out at the pudendum, with pain in the back through the hips, down the thighs.
Petroleum Much diarrhoea through the day, never at night. Moisture and itching of the hairy surface of the labia. The menstrual blood causes an itching of the genital organs.
Phosphorus Tall and slim persons. Occasional attacks of violent hemorrhage. Great sensation of emptiness and weakness in the abdomen. Constipation, the stool being slender, dry and difficult to evacuate. Sour eructations and belching of quantities of wind. Feels very sleepy after meals, particularly after dinner.
Phosphoric acid A remarkable state of indifference, from which she cannot arouse herself. Great sense of weakness. (Compare also, Phosphorus, Sepia, Pulsatilla).
Platina Constipation. The stool always being difficult, because it inclines and adheres to the parts like clay. Much tenderness of the vulva. Hysterical, spasmodic. The physical symptoms disappear and the mental symptoms appear, and vice versa.
Pulsatilla Very tearful; she weeps at every thing, whether it is joyful or sorrowful. Menstrual irregularities, which see, for further indications characteristic of this remedy.
Silicea She always gets worse at every new moon. See indications for Silicea, as given under the head of Leucorrhoea and Menstrual Irregularities.
Staphysagria The patient is very sensitive to the least mental impression. Her teeth turn black, and cannot be kept clean by much brushing. They exhibit black traces and streaks through their middle. She has much trouble with her teeth.
Teucrium marum verum Irritated, tremulous sensation in the whole body. Frequent biting as if of insects in the various parts of the body. Creeping sensation in the vicinity of the polypus.
