[3]. Vide Cases in previous chapter.

It is, however, well to draw attention to the fact that it is in cases of spinal irritation that we observe functional derangements, which are very likely to pass into actual organic diseases; and it is in this class of cases, which are essentially of a chronic character, that very long and persistent perseverance must be pursued. I would, therefore, advise all who meet with them to warn their patients beforehand that they must not be weary and faint-hearted if recovery do not come as soon as hoped for.

Case XV. Spinal Irritation, and supposed Uterine Displacement—Six Years’ Illness—Operation—Cure.

In 1860, I was requested to see a young lady, æt. 20, of whom I had the following history:—For six years she had been confined to a spinal couch, and had also been supposed to suffer from retroversion of the uterus. She had worn a spinal apparatus, attached to which was a steel spring, pressing on sacrum and pubis, and intended “to support the perinæum, and keep the uterus in position.” Had been treated with caustics and other therapeutic agents for uterine disease. I found the uterus normal in position and healthy in appearance; but on further questioning and examination, I diagnosed peripheral irritation of the pudic nerve. My opinion was strongly contested, as I was told that the young lady was very religious; but, as I explained, her illness was to be attributed solely to a physical condition, and was not at all necessarily immoral; I was then met with the objection that, in the event of marriage my operation might interfere with marital happiness and prevent procreation. I explained how, physiologically, these objections were untenable, but was then unable to adduce actual cases in contradiction of them.

Ultimately I performed my operation in the usual manner. For want of proper attention on the part of the nurse, the dressing was three times displaced; but, nevertheless, at the end of a month this lady was well enough to walk three miles.

Up to this date she has remained quite well.

Case XVI. Dysmenorrhœa—Five Years’ Illness—Operation—Cure.

D. A., æt. 23; admitted into the London Surgical Home Aug. 4, 1863.

History.—Has never been very strong; but five years ago had an attack of gastric fever. Since then has suffered constantly from great pain during the menstrual period. Occasionally loses a great deal, and passes large clots of blood. During this time has suffered almost constantly from leucorrhœa. Suffers severely from pain over region of left ovary and in the spine. Is hardly ever free from headaches. Is very restless; never sleeps well; frequently faints; and has little or no appetite. All her ills are exaggerated at the menstrual epoch.

August 7. Usual operation performed.