SYMPTOMS – The most constant and alarming symptoms, and that which most commonly compels attention to the disorder, is, frequently recurring and distressing haemorrhage. The flow is very free; usually, but not always, painful; very weakening; and returns every two or three weeks. Other prominent symptoms are enlargement of the womb, sensation of weight, dragging-down, aching, or pains in the pelvis; tenesmus and irritation of the bladder or rectum; uterine colic; the usual symptoms of pregnancy; Menorrhagia; and profuse or foetid Leucorrhoea, Anaemia, palpitation of the heart, want of appetite, indigestion, irritability of the stomach with retching, constipation, debility, prostration, and unrest, are frequently present. Occasionally, the womb seems to resent the presence of a Polypus, and by contraction similar to those which take place in labour expels it, breaking its attachment and casting it out as a foreign body. Such a termination, however, is not to be expected, and as the profuse haemorrhages may occasion very serious constitutional symptoms, the sooner a Polypus is removed the better.
MEDICINAL TREATMENT – The following medicines have the reputation of being able to accomplish the removal of Polypi- namely, Calc-C., Conium, and Thuja, – but we are not satisfied as to the indications which point to their employment.
MECHANICAL REMOVAL – When a mucous Polypus is detected it should be seized firmly by means of a pair of forceps twisted off, and the point of origin cauterised with Nitric Acid. Removal by torsion is greatly preferable to excision, for alarming haemorrhage often follows the use of the knife or scissors. When a Polypus projects from the os uteri, its removal is easy; but when it lies higher up in the cervical canal, or springs from the fundus of the womb, the canal, or, in the latter case, the womb itself, must be dilated, the Polypus seized and twisted off, and Nitric Acid applied. Fibroid Polypus is more difficult to remove, as it usually grows from the fundus of the uterus, has a firmer hold, and requires the application of the wire eicraseur. Of course, the care and skill of a professional man are always necessary.
ACCESSORY MEASURES – To control the haemorrhage and to restore the impoverished constitution, the Section on “Profuse Menstruation” should be consulted.
22. – HYSTERIA
DEFINITION – The word Hysteria is derived from the Greek word hysteria – a womb, from the supposed connection of the symptoms with that organ; but it will be directly shown that the uterus and its functions are not essential to the conditions included under the term. The various phenomena thus designated may be defined as a nervous disease of a general and not of a local origin, caused by some source of irritation supervening upon a condition of depressed nerve power from emotional causes, and may arise in conjunction with uterine irritation, or entirely independently of such cause. It consists, essentially, of a defective or perverted will, heightened or altered general sensibility, and, usually, some impairment of the general health, but is not necessarily dependent on the female organs of reproduction.
In proof of this the following statements may be adduced:- Hysteria is not limited to the unmarried condition, but often exists in the married, even in the happily married – in pregnant women, in nursing mothers, and in women who have passed the critical age. It often exists, in its highest expressions, in persons whose monthly period and general uterine functions present no anomaly whatever; various functional and organic diseases of the organs in question often exist without any hysterical symptoms; women who have been born without a uterus have been hysterical; and, again, it is well known that Hysteria sometimes exists in the male sex.*See papers by Professor Charcot on “Hysteria in the Male,” in Medical Press and Circular, January, 1886.
CAUSES – Debility is a great factor in the production of Hysteria. Indeed the absence of any post-mortem signs of disease leads to the conclusion that this is generally the sole predisposing cause. Where the supply of blood to the nerves is defective in quantity, or quality, the most favorable condition exists for the production of Hysteria; for the nerve-centres being thus predisposed, any trivial irritation may excite the characteristic phenomena. While, therefore, Hysteria is a disease of a nervous character, it may be called into activity by any affection or even that operates powerfully on the system, like suppressed, irregular or profuse menstruation, Leucorrhoea, pregnancy prolonged nursing depressing emotions, fright, the loss of a husband, child, or friend; disappointed love, sensational novel reading, loss of sleep, and a luxurious mode of life. a predisposition to the disease may be transmitted from the parent, or it may be fostered in the daughter by the force of the example of a nervous mother or elder sister.
SYMPTOMS – Hysteria is remarkable for the wide range and indistinctive character of symptoms, and the multitudinous diseases it may mimic; we may mention especially, – loss of voice, stricture of the oesophagus, laryngitis, a barking cough (more annoying to the hearer than to the patient), Pleurisy, heart disease, difficult in urinating, Neuralgia, diseases of the spine or joints, and many other inflammatory diseases. In these cases the patient deceives herself, and endeavours by extreme statements of her sufferings to mislead others. An observant medical man, however, need never be deceived. In some cases there is indigestion, a more or less definite affection of the head, chest, or abdomen, or other condition of impaired health of constitutional delicacy. But some cases of Hysteria exist in which there can be detected no other than a nervous derangement. In must not, however, always be inferred, because we designate an affection “nervous,” that the symptoms complained of are not real. The element of exaggeration enters so largely into the hysterical constitution, whether that constitution be original or acquired, that we know persons of this temperament who possess so refined a sensibility to pain and disease that they suffer consequently, under similar circumstances, far more than others of an opposite temperament.
Common Types : The most common forms which Hysteria assumes are, according to the late Dr. Anstie the following, although such a many sided malady occasionally takes on various other characters. One of the most frequent types of Hysteria is that in which a young girl, harassed by a general feeling of ill- health from too rapid growth, or menstrual difficulties, or both; depressed, perhaps by an injudicious system of “cram work” in education; or worried about religion, becomes somewhat anaemic, languid, and feeble in her movements. By degrees the power of volition begins to share in the bodily languor, and the effort of making up the mind to any course of action, especially such an action as is only prompted by the plainest duty, becomes hateful. From time to time, however, she astonishes both her friends and herself by the exhibition of surprising energy in the performance of any work of body or mind which is made palatable by emotional stimulus. She has not any convulsive paroxysms, or other violent manifestations of her uncomfortable state, but she rather given to causeless tears, and equally causeless laughter. On the whole, however, the spirits are much depressed. Two symptoms are rarely absent-flatulence, and occasional attacks of palpitation, with pain in the left side; there is also generally headache. As the case proceeds, the mental rather than the bodily symptoms predominate; the imperfect self-control becomes more manifest; there is tendency to helpless dependence on those around, and an imperious craving for sympathetic petting and fuss; and if that sympathy be injudiciously and excessively given, the moral degeneration is apt to become steadily greater; the patient more and more limits her mental life to such thoughts and feelings as can give her some emotional pleasure, she becomes careless of duty, and very commonly also careless of truth.
Our next portrait is a young, fresh, healthy looking girl, well grown, without a trace of anaemia, indeed not unfrequently with rather a high colour. She may or may not have any derangement of the monthly function. She is usually excitable and sentimental, and suffers frequently from violent palpitation and sudden flushings. Sometimes she loses her voice for days and weeks at a time. But frequent attacks of rumbling wind and sudden distention of the belly constitute her chief distress. When these attacks longer than usual, the “wind seems to rise to her throat,” and the sensation of “globus hystericus” becomes flexed there. Occasionally the attack ends with a crying fit, and the discharge of much pale urine; but this is not always the case. Such a patient is often a good hard working girl; with no perpetual indolence of will, but only suffering temporary lapses into defective volition and want of self-control, which lapses may often accounted for by fatigue from over-exertion. Even this kind of person is made worse if she be surrounded by friends who continually makes a fuss about her health. Such patients are commonly found among overworked maid-servants, and generally they do not get the chance of being injured by excessive sympathy.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."