The FLESHY MOLES appear to be but the fuller development of the perverted process just described in connection with blighted ova. These in the modern pathological language are termed cancerous degenerations. They remain three or four months – “until at length the degenerated ovum is expelled, consisting of the nest- like membranes and a small embryo of two or three weeks’ growth, or in some instances the foetus may have disappeared, and traces only of the umbilical cord remain. They may either consist of a solid mass, or they may contain a central cavity possessing a distinct lining membrane, in which there yet remains some of the liquor amnii. The solid moles are generally much larger than the hollow ones, and of a more irregular form. The larger ones are abut the size of two fists. If the texture be examined, it will be found solid, but not very dense, spongy like the placenta, but more filamentous in some parts; in others consisting of fibrinous clots, and also portions of the foetus such as one or other extremity. The limbs of the foetuses have occasionally, though very rarely been discovered. – Churchill.
The HYDATIDS, or VESICULAR MOLES constitute what are termed the hydatiginous degenerations of the ova. “The hydatids themselves, in the recent state, are full of transparent fluid, and are either round, pyriform or oblong in shape, the size of the vesicles greatly varying. Some of them are borne upon pedicles, others are growing from the larger hydatids. As a rule, the activity of the growth and the increase of the villi, (which degenerate into hydatids) are greatest in early pregnancy, and it is at this time that the hydatiginous degeneration is most prone to occur. These hydatids bear a very close external resemblance to polypi or pediculated tumors; so much so that some of the latter named growths occurring in the virgin females have been considered to be hydatids. But it is now well settled that the name hydatids shall be applied only to such formations as may arise in connection with or subsequent to sexual intercourse and impregnation. Although here it must be remembered that the death of the embryo not being immediately followed by the expulsion of the ovum, the molar formation may be retained for months; and the hydatiginous variety for years, and then be discharged without prejudice to the character of the female who may have become a widow in the meantime.
The hemorrhage which is apt to occur at the period of the expulsion of the hydatids by successive installments, renders them more dangerous than moles of other varieties.
The molar pregnancy which results from the presence of the hydatid variety is more strongly marked; since in this form the uterus at the fifth or sixth month may be as large as it should be at the end of pregnancy. It is not easy to determine the presence of this disease with absolute certainty, at least in the early months. But the duration of the abdominal enlargement beyond the term of uterogestation; the disproportion between the size of the tumor and the period since it was first observed, together with the absence of quickening, of all foetal movements and of the sounds of the foetal heart, will conclusively prove that a regular pregnancy is not present. Then the greater weight of the abdomen, and the absence of resonance will distinguish it from physometra. The absence of sense of fluctuation will in like manner serve to distinguish molar pregnancy from hydrometra. The occasional hemorrhages and even the irregular discharge of a colorless, inodorous, aqueous fluid, are relied upon by some authors as unfailing diagnostic signs; but they are by no means sure to occur in every variety of molar pregnancy; and even when they are present they are far from being so characteristic of the existence of moles, as to afford any positively reliable indication. Indeed, the actual condition, in many cases, is only determined by the result, as seen in the nature of the substances discharged.
A careful study of the symptoms of the patient, will be necessary in order to determine the nature of the case; and to make the proper prescription. As abnormal growths, the womb seeks to expel these moles sooner or later. This is effected by uterine contractions and pains similar to those of ordinary confinement, but more closely resembling such as occur in cases of miscarriage after the death of the foetus. The large quantity of water and sanguineous discharges which may attend such efforts at expulsion, sometimes render the case very serious. And it will be the object of the Homoeopathic practitioner to promote this expulsion, and so remove the cause of the dangerous condition.
For the treatment of moles, hydatids, & c., we can at present give but few special indications. To promote their expulsion, Pulsatilla and Secale corn, have been recommended. The hemorrhage, which may follow such expulsion, must be treated as other hemorrhages, according to the indicating symptoms present.
Calcarea carb. and Silicea have been recommended to remove a disposition to the formation of moles.
The following remedies have been recommended for particular study in these abnormalities. Calcarea carb.; Sulphur; Silicea; Mercurius; Aconite; Arsenicum; China; Ferrum; Graphites; Belladonna; Hyoscyamus; Kali carb.; Lycopodium; Sabina; Sepia. And in general all the remedies mentioned in this work under the various heads of Cancer, Tumors, Polypi and Dropsy, should be carefully studied and compared. For it is only by selecting the medicine in accordance with all the constitutional symptoms and conditions, in such cases, that we can hope, either to promote the expulsion of these morbid growths, or to prevent their recurrence.
