Tuesday, November 13, 2012

Cauliflower Excrescence - Treatment

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Treatment of cauliflower excrescence of the os uteri. 

— Necessity of commencing  early; treatment at its commencement; bloodletting; application of cold ;  straight syringe to be preferred; quietude necessary; recapitulation. — Treat-  ment in the more advanced stage ; symptoms attending that stage ; indications ;  remedies required, local and constitutional ; ligature; means of distinguishing  this excrescence from placental presentation ; treatment when occurring at the  time of labour. — Carcinoma uteri, not always begins in the cervix. — Definition  of scirrhus ; symptoms; danger of confounding the symptoms with those of dyspepsia; character of the pain. — Ulcerated carcinoma ; symptoms; doesjnot  of necessity prevent impregnation. 
 

If the treatment of this disease be begun sufficiently early, the female's life may be greatly prolonged ; and not only so, but may  be rendered tolerably comfortable, as the complaint, throughout its whole progress, is attended with a very inconsiderable degree of  pain The want of this success is in most cases to be attributed to  delay on the part of the sufferer herself, in not applying for advice  until the most favourable period has passed over ; however, to use  a homely maxim, " if we cannot do all we could wish, it is our  duty to do all we can." Now, what is the disease we are anxious  to relieve ? Coinciding in opinion with Sir Charles Clarke, I reply,  that it is a morbid growth or enlargement of blood-vessels. The  action of those vessels is capable of being excited by anything  which increases the force of the general circulation. Here, then, is your f rst indication, viz., to prevent or to moderate vascular  action generally, and thus, as a matter of course, to lessen the  action of the vessels forming the swelling. This indication is more  certainly fulfilled by removing blood from the arm ; ten or twelve  bounces may be safely drawn away, if the constitution be healthy,  and the pulse beating with force. 

If the strength be reduced, and the system unable to bear this  abstraction of blood, you must be content with cupping the loins,  or the use of leeches to the vulva, groins, or perineum. Recollect  I am now speaking of the treatment of the disease in its early stage. I shall have occasion, presently, to tell you of a different plan  required after it has existed for a length of time, and where it has produced its debilitating and exhausting effects upon the system. 

Upon bloodletting, judiciously employed, and, where necessary,  occasionally repeated, great reliance is to be placed ; not only for  retarding the growth of the tumour, but even for diminishing its size, for a time at least. 1 mentioned, in my last lecture, that a  tonic and contracted condition of the vagina was to be regarded  amongst the favourable signs, the pressure or resistance of which would prevent a sudden increase of the morbid excrescence.

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