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.