A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
Other symptoms are pelvic pressure, vesical and rectal, with tenesmus,
distension, and dysmenorrhoea. The pelvic pressure and tenesmus are
observed early in the development of the growth, and may be relieved as
the tumor becomes large enough to rise out of the pelvic cavity. The
abdominal distension of course comes later. Solid tumors do not often
attain to such a size as to cause great abdominal distension. The
fibro-cystic generally are inconvenient, if not fatal, from this cause.
The above are the more direct and common symptoms. A less frequent yet
important effect and symptom is oedema of the lower extremities from
pressure upon the venous trunk passing through the pelvis. In rare
cases this symptom is aggravated to a degree constituting phlegmasia
alba dolens. As the tumor rises and enlarges the pressure may embarrass
or interrupt the function of any or all the abdominal viscera.
In many cases none of these symptoms present themselves to an
inconvenient degree, and the tumor is discovered by accident. Again, we
meet with cases in which the symptoms are formidable for a time, and
then entirely subside, leaving the patient free from suffering the
balance of her lifetime. While this subsidence may take place at any
time during the growth of the tumor, it is very apt to take place at
the menopause.
The clinical history of the fibrous tumor may be very much modified by
the intervention of various circumstances. As organized bodies they are
subject to those affecting the organs of the body. We must regard them
as adventitious growths acted upon by organs in a state of disease and
reacting in turn upon them. They may become inflamed, undergo
suppuration and gangrene, and produce symptomatic fever, hectic fever,
prostration, gastric, hepatic, and nervous derangement in a degree
sufficient to prove fatal.
When situated near the mucous membrane, nature sometimes turns these
organic changes into a means of cure by destroying the portions of the
capsule near the uterine cavity and permitting the pus or gangrenous
material to escape. They are also subject to pressure from the
development of other tumors, and either disappear, become inflamed and
adherent, or cause great trouble to adjacent organs. Their clinical
history is sometimes modified by complication with pregnancy.
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