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
A woman of Sterling, Illinois, called on me December 13, 1875. She was
thirty-five years old, married, and had never been pregnant. On the
first of the preceding June she noticed a circumscribed hard lump two
inches below and to the left of the umbilicus. She was the subject of
serious uterine and sympathetic symptoms, for which she had at
different times had treatment. She had profuse menorrhagia,
leucorrhoea, and great sense of weight in the pelvis. Upon examination
I found a hard, round, movable tumor extending up to within two inches
of the umbilicus, filling up the whole of the right iliac, the
hypogastric, lower half of the umbilical, and more than half of the
left iliac regions. The contour of the tumor was somewhat uneven,
though not distinctly nodular. The cervix was long, pointed, and thrown
backward and to the left. The sound entered the small uterine mouth and
passed upward, backward, and to the left five and a half inches. The
diagnosis was a fibrous tumor of the right anterior wall of the uterus.
I prescribed thirty drops of Squibb's fluid extract of ergot, to be
taken three times a day. She went home, but did not commence taking the
medicine until the 20th of December. On the 26th of December J. B.
Crandall was called to see her, and describes her condition as follows:
"The patient was in a state of great nervous prostration and worn out
by severe pain and loss of sleep. The pains commenced soon after taking
the second dose of ergot, and were excruciatingly severe for about
three hours, after which they continued less severely for two days and
nights. She had more or less hemorrhage from the uterus after taking
the ergot. Her pulse was feeble, 110 to 120 to the minute. The skin was
hot and dry, and she complained of great pain and tenderness over the
uterus and lower bowels. The feet were drawn up, and the face wore a
pinched and peculiar expression." Under these circumstances the doctor
administered anodynes, tonics, and nourishment, to the great relief of
the patient. On January 11, 1876, the patient began to pass from the
vagina small masses of fibrous substance, from the size of a chestnut
to that of an English walnut. The substances thus discharged were firm
and gray in color, and were exceedingly fetid. This discharge continued
up to the 21st of January, when the uterus was very much diminished in
size, the tenderness had subsided, and the patient appeared
comparatively comfortable. Up to that time she had taken but three
doses of ergot--on the 20th of the preceding month--and the doctor
ordered it to be resumed again. This time the ergot produced no pain,
and after three or four days was discontinued. From the 21st of January
there were no more pieces discharged, but up to February 1st a
yellowish, thin, offensive fluid passed from the vagina in considerable
{262} quantities. On the first day of February the ergot was again
ordered and continued two weeks, when, as no results ensued, it was
finally dropped.
Public-domain text, read in full here on John Shaqi.
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