Now, if the malady continues to thrive on the wounds made by these procedures, if old cicatrices break out again, if too a permanent cure is out of the question, there is ground for supposing that the product of illness, the ulcer, may be cauterized, burnt and cut away, but that the cause, the diathesis, the tendency to it, can only be removed by internal medication. * * * * *
One day an official in Dresden brought his wife to me, who was 41 years of age. The couple, all of whose children had died soon after birth, longed once more for children. The woman had aborted several times, and both were intelligent enough to see that everything could not be right with the sexual organs, and even begged for a gynæcological examination. The result was in a few words: inflammation of both lips of the uterus, a thickening of the cervical canal with a swelling of the posterior uterine wall as hard as cartilage, and retroversio uteri. Menstruation too early, dysmenorrhœa, blood dark, tarry, passing in clots. Yellowish, fetid leucorrhœa. Stools retained, appetite changeable; pains in the broad ligaments on both sides during rest as well as on exertion. The so-called "facies uterina"—weeps much. Frequent exclamations on the distastefulness of life since the death of all her children, and on account of her present childlessness. Should I register in my journal in the beginning of a scirrhus? I wrote simply: metritis chronica; intumescentia labiorum orificii et colli uteri.
Prognosis, not unfavorable as far as regards the swelling, after my already well-tested experience with Aur. mur. nat. But how about the removal of sterility acquired in her 41st year. I was more cautious about this. The cure took six months, and was not only accompanied by absorption of the affected parts, but the woman became pregnant in good time and gave birth to a boy with comparative comfort. Thus would the wishes of the worthy couple have been fulfilled, if their joy had not been banished once more by the death of the child in four weeks from an attack of eclampsia.
Anteversion With Prolapsus.
I now come in conclusion to a gratifying case, which I relate partly because we make ourselves guilty of sins of omission in certain instances through neglect of the needful investigation. A woman in her twentieth year, quite healthy, had been delivered with forceps for the first time two years before, nominally on account of deficient labor pains. There was nothing unusual about the confinement. Immediately after the first getting up, she began to have constant pain in the right side of the uterine region, and soon a feeling "as if something would fall out of the parts." The family physician paid no attention to these persistent complaints for a whole year, until finally a constantly increasing leucorrhœa demanded an examination. He now expressed himself as unable to make a diagnosis alone, and the lady was referred to a celebrated gynæcologist in Leipsic. Cauterizations were now undergone at the professor's house at short intervals, and further treatment of a similar character was to be carried out at the patient's own house, which was, however, discontinued when the patient was referred to me. Examination showed: metritis following upon sub-involution of the uterus, anteversion with prolapsus of the whole organ. Both uterine lips were swollen, and on examination with the speculum a greenish-yellow discharge was seen to flow from the uterus. All local treatment was discontinued, the woman received for the first time in April, 1876, Aur. mur. nat., and in June, 1876, again became pregnant; the treatment with gold was continued until the 8th month of pregnancy, in consequence of which the uterus was found in its normal position on examination twelve days after her safe confinement on March 30th. The menses, which up to this time had been very painful, returned for the first time on the 25th of April, and were quite free from suffering.
But now let us ask, whether we have in the salts of gold a simile for the diseases of the female sexual organs under the comprehensive name of chronic metritis. We find in the homœopathic proving, inflammatory affections of the internal organs; fainting depression and emaciation; great anxiety, sadness, dizziness, whimsical mood, weariness of life, morbid desires, and headache; nausea, vomiting; pressure in the gastric region; cardialgia, contractive, drawing pains in the abdomen. Stitches in the left hypochondrium, pinching and burning in the right, the abdomen sensitive to touch, with distension; dull pains in the abdomen; drawing and stinging in the whole abdomen; eruption of small papules above the pubes; decreased excretion of urine, pressure on urinating, burning on urinating; redness, burning, swelling and moisture of the labia, discharge of yellow mucus, menstruation too soon and lasts too long; amenorrhœa; labor-like pains, as if the menses would appear; symptoms which certainly correspond to the whole picture of chronic metritis and its results.
The mode of administration which I have used for Aur. mur. nat. is in trituration. Generally I have had the patient herself divide into three parts a 10 gr. powder of the 3d trit., and take one of these dry just one hour after each meal. But I have also used the 1st and 2d trituration. The effect cannot be seen before four weeks, hence I seldom make a further examination before that time. Many women notice a remarkable increase of the appetite during the use of gold. After the administration of the 1st trit. I have observed frequent, dark stools. An increase in the urine with a thick, gray sediment is often seen. * * *
Uterine Diseases.
Uterine diseases, according to my experience of many years, make more marriages unfruitful than all the other known or fancied hindrances to child-bearing. They can exist many years even with a blooming appearance, without apparently disturbing the general health, and on that account are often overlooked and mistaken by physicians themselves, who are not concerned about gynæcological examinations, or else make only superficial investigations, not having their eyes at the ends of their fingers. I beg, therefore, if this communication should give rise to a more extensive use of Aur. mur. nat., above all things, a thorough gynæcological examination, not leaving this to the so-called surgeons and midwives. If women complain of gastric troubles, dizziness, pain in the loins and back, disturbances of urination or defecation, with a more or less pronounced hysterical appearance, and withal purposely or unwittingly deceive themselves and the physician; if, added to these, leucorrhœa and a sensation as if everything would drop out of the abdominal cavity, one may say of the patient that her uterus is diseased, and may base upon that his proposal for an examination, which will give the correct information of the nature of the malady. As a rule, every deep-seated, morbid alteration in the uterine tissues entails suffering upon the nervous system, which, being in such close relation with the uterus, not seldom apparently suffers the most.