EDMUND CARLETON, M.D.
Tumors of the Labia are uncommon. Why these vascular parts should generally be exempt, is beyond my power to explain. In the two cases that have come under my observation, it has been impossible to assign any particular cause for their existence. Probably this congress of Hahnemannians will not insist too strongly upon having the cause of general exemption and exceptional involvement pointed out.
The first case was brought to my notice by Doctor J.P. Ermentrant, of New York, and is well represented by photograph No. 1 Patient was fifty years old when she presented herself for operation, in 1879. She first noticed an enlargement of left labium eighteen years before. It was then the size of a pigeon’s egg. Four years later it had grown to the size of a hen’s egg.
Patient insisted that tumor then remained stationary until about six week before operation, when it suddenly assumed the proportions seem at my examination, just before its removal, as given by the picture. This last statement may be discredited. She would not have us believe that she had carried such an incumbrance so many years. it measured six and one-half inches in length and its greatest circumference was thirteen inches. Pedicle six inches in circumference, short and soft. the anterior surface of the tumor had already become the seat of a foul, offensive ulcer.
The skin and superficial fascia of the pedicle having been deflected upwards, a strong wire ecraseur was bought into requisition, on account of the vascularity of the parts, which contained numerous large and small blood vessels. We were somewhat annoyed with haemorrhage. After transfixion and double ligation, the case became more manageable; but the wire broke repeatedly, and it was found necessary to finish amputation with the knife. Upon section, the tumor was found to be fatty, and it weighed twenty-seven ounces.
The integument having been stitched and dilute Calendula applied the case was then turned over to Dr. Ermentrant. Later he wrote that he “applied Calendula four days, when it commenced to smell very fetid.” (Ligatures allowed to slough out with the stump.) “Then I used carbolic acid fourteen days, when good granulation commenced, and I used Calendula again to the time it was all healed.
About two weeks after the operation, several ulcers of the size of a dime appeared upon the face and forearms, which I considered metastatic. First she had Arsenicum two days, followed by Sulphur. They healed promptly, and her health has been good since.” This case was fully reported to the Homoeopathic medical Society of the State of New York soon after.
Case no. 2 was brought to my notice By Doctor Adelia B, Barber, of New York, January 22, 1980. This is the Doctor’s statement: “Miss E.R., age twenty-three, came to me January 14, 1890, suffering with a tumor of the right labium, comprising a pedicle five inches long, with a large, solid mass of tumor attached. These years before this she noticed a small, wart like growth, that rapidly increased in size. Three weeks previous to her coming to me, she slipped and fell. Within twenty-four hours the tumor had swelled to a large size, turned black and become covered with large blisters, which burst open, causing haemorrhage that lasted for four days. Ulceration followed with a discharge of pus.
“Miss R. also stated to me that she had been a cashier in a well-known restaurant in this city, where she stood many hours everyday. Preferring that, during the most busy part of the day, to sitting on a stool which she was permitted to use. being of a lively disposition, she had often stood at evening parties with her thighs tightly bugged upon incumbrance to help sustain its weight; but did not hesitate to join in a dance, when it would be impossible to prevent swinging, banging, down-jerking motions. This may account for the great length of the pedicle”.
She was put to bed by Dr. Barber and well nourished for ten days. At the end of that time, January 25th, 1890, while under ether, first the accompanying photograph (No.2) was secured, and then removal of the morbid growth was effected. Careful preliminary examination of the pedicle revelled the presence of three principle arteries, the largest apparently the size of crow’s quill. The entire structure was vascular. Those who have had to deal with haemorrhage from the labia a few times, do not lightly incur the risk of that accident.
Mr. Ford, the cutler, had made of me a chain ecraseur of prodigious strength. This I applied to the pedicle, without any preliminary cutting or tying, about three-fourths of an inch from its origin, so that a field of operation might be accessible afterwards, in case of the necessity of resorting to hemostatics. Slowly and with difficulty the chain was made to work its way through, some portions being extremely tough. Neither knife nor scissors were used, and scarcely any blood appeared.
The stump was carefully protected, so that it should not be even touched, and the patient was kept in bed on light-diet. In a few days the parts had an appearance almost natural. The tumor weighed twelve and one-fourth ounces, and was fibro-fatty.
Constitutional treatment can not remove such tumors when fully grown; but I am persuaded that the morbid tendency may be arrested at the start by the similar remedy. Else why is it that all the tumor cases come to its from outside the homoeopathic ranks? If all the world would live correctly for three generations, and employ only pure Hahnemannian physicians when sick, there would them be little need of us; the profession night disband, so far as the principal work of the present day is concerned.
Experience shows that it is best for the homoeopathic surgeon to have control of the after treatment of such causes as he operates upon. There will then be little danger of metastatic abscesses and the like; and recovery will be more natural and rapid under his treatment than under the mixed or contrary plan. By the way, I noticed when reading the report of last year’s meeting, that members were a little divided or mixed in their notions of therapeutics.
It should be calendula for clean cuts wounds with loss of substance; Staphisagria for lacerated wounds; Arnica for contusions and contused wounds; hypericum for wounds of nerves. Ask any graduate of the New York Medical College and Hospital for Women; they all have it at their tongue’s end. We apply these agents very dilute-one part to twenty-five or fifty of water-and their curative action is manifest to all observers. The potentized drug given internally also does the same work.
I have when a patient has just regained consciousness after anaesthesia, it is best to administer internally Nux vomica, or whatever may be the appropriate remedy for nausea and other symptoms, and apply Calendula to the part that has been cut. A day or two later may be a good time to give potentized Calendula internally. Of course there are many refinements of the rule given above. Who has not observed the good effects of Conium, when given to an old woman whose mammary glands have met with a severe bruising? You do not forget the peculiar field that Hamamelis occupies, after injuries to the lower bowel, accompanied with profuse venous haemorrhage.
Millefolium, after operations on the bladder, has repeatedly shown its power for good at my hands, even after the most severe lithotomies. The list might be greatly extended; but the rule should stand as given. It has sound pathogenesis in its favor, and it stands as given. It has sound pathogenesis in its favor, and it stands the test-the crucial test of experience.
Dr. Kent: I wish to call attention to the value and frequent use of Phosphorus as an antidote to the effects of Chloroform used in surgery. It is wonderful how much the action of the two drugs resemble each other. In both, they have dry mouth, and are comfortable only when the stomach is full of cold water, and as soon as it becomes warm, reject it. Phosphorus is often sufficient in the vomiting following the use of Chloroform.