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Tumors of the Uterus.In most cases the development of fibroid tumor of the uterus, which usually begins between the age of 30 and 45 years, is attended by certain complications which attract the attention long before the tumor itself becomes large enough to cause any increase in the .size of the abdomen. Among these complications are inflammations and displacements of the womb ; derangements of the bladder and rectum ; piles and menstrual disorders. Doubtless many of the symptoms which so usually accompany fibroid tumors of the womb as to be considered characteristic of this affection are really due to these ordinary complications. Symptoms.-Among the most prominent symptoms are : Profuse menstruation, the interval between the periods being usually shortened. Leucorrhcea, the discharge often tinged with blood. Pain in the back and pelvis, and pain during menstruation. Irritation of bladder and rectum. These symptoms need not all occur in one and the same case ; nor are they always present in the same relative degree. The differences seem to depend largely upon the position which the tumor occupies in the uterus. Thus those tumors that are situated in the part of the uterus lying next to the bowels do not usually occasion the same amount of leucorrhcea or difficulty with the bladder and rectum as the others ; yet these attain the greatest size. Those that project into the cavity of the womb, on the other hand, while early attaining the same dimensions,occasion, nevertheless, more marked and annoying symp toms in the early stage of their development. It is extremely difficult for a non-professional person to arrive at a definite and decided opinion as to the existence of a uterine fibroid, because there are several other conditions which may readily be mistaken for this affection, especially in the early months of their existence. Among these are pregnancy, ovarian tumors, peri-uterine inflammations, and certain disorders of the bowels; indeed, instances have been known in which the results of habitual constipation have been mistaken for a fibroid tumor of the uterus. These mistakes result in part at least from the profound conviction entertained by almost every woman who has attained the age of 30 years, that she has or soon will have a tumor. It is the experience of most physicians that the vast majority of women who suffer from any derangement of the sexual organs are fully convinced before consulting a medical adviser that they are going to have either a tumor or a cancer. With regard to this prevalent dread, it should be remarked that fibroid tumors of the womb have been but very rarely known to cause death, and that the cases in which they attain such size as to seriously incommode the patient, or even attract her attention, are very few indeed. For it must be remembered, that probably 40 per cent, of women who attain the age when the change in life may be expected have fibroid tumors of the womb ; and it is no exaggeration to say that nine out of every ten of these have never suspected the existence of such a growth. And there are cases in which the physician, while suspecting the existence of a fibroid, is unable to make a definite decision, because the growth never attains a size sufficient to make it perceptible. The symptoms which ordinarily arouse the woman's suspicions that something is wrong are menorrhagia or metrorrhagia, leucorrhcea and painful menstruation. Menorrhagia, or profuse menstruation, may of course occur from various causes ; indeed, some women are not at all uniform in the amount of their menstrual discharges. Yet the occurrence of several successive profuse menstruations without apparent cause, and especially if the period between the monthlies be shortened, may indicate the existence of a fibroid tumor. Yet it must not be forgotten that this series of events may occur from other causes ; that they do not, therefore, proves conclusively the existence of a fibroid. If such a tumor be actually present there will usually follow, within a few months, a more or less profuse leucorrhcea (if this have not previously existed), and slight enlargement in the lower part of the abdomen. It may happen that the patient's general health is meanwhile somewhat impaired, though this seems to result rather from anxiety and mental worry than from the direct influence of the tumor upon the patient's nutrition. As the tumor increases in size these symptoms become more and more marked ; the monthly flow becomes very long and so profuse that the woman is much exhausted by the loss of blood - indeed, it is sometimes necessary to adopt certain measures for the repression of this flow as a means of saving the woman's life. The enlargement caused by such a tumor can, after it has attained a certain size, usually be distinguished without difficulty from the increase in size due to pregnancy ; the fibroid tumors are usually located on one side or the other of the abdomen, present a different shape and are harder. Yet it is not so easy to distinguish between these tumors of the womb and tumors of the ovary. As has been already stated, fibroid tumors of the womb rarely cause a fatal result. The most disastrous effects to be expected from them are the physical annoyance occasioned by their size and the exhausting effects of the profuse menstruation and leucorrhcea which so often accompany them. It is, fortunately, to be expected in the majority of cases, that after attaining a certain size the tumor will cease to grow, after which time the symptoms usually diminish somewhat in severity. It is further well established that the growth of these tumors is arrested at the change in life, even if they have been rapidly increasing in size up to that time, for this period marks the cessation of activity in all the sexual organs, the womb included. At this time the supply of blood to all the sexual organs and their appendages is much decreased ; as a result of which the fibroid tumors no longer receive the necessary amount of nourishment, and therefore not only cease growing but usually undergo a certain decrease in size. Indeed, throughout their entire course they are affected by whatever influences the womb itself. Thus they become larger during menstruation and pregnancy, and they may constitute a serious obstacle to delivery by dropping into the pelvis and becoming wedged there by the advancing child. Treatment.-The treatment of fibroid tumors of the uterus may be summed up, so far as medicines are concerned, in one measure-the use of ergot. Numerous other remedies have been, it is true, employed and recommended, but nothing else can be relied upon to give definite results. Among other things, electricity has been employed by inserting the poles of the battery directly into the tumor by means of needles. Possibly the future may decide that this measure is effectual in this, as in other desperate cases, but at present our reliance is upon ergot. The effect of this drug is to cause contraction of the blood vessels which supply the uterus and the tumor with blood ; in other words, to starve the tumor. It must be admitted that in some cases of long standing ergot, like everything else, is ineffectual. Yet, it is equally certain, that in the majority of instances, before the tumor has attained a large size, ergot does at least arrest the growth of the fibroid, and may even cause a marked decrease in size or total disappearance. It is advisable always to have the supervision of a physician when ergot is administered, for the drug may occasion a variety of un pleasant symptoms, among them nausea, vomiting and colicky pains. Indeed, it becomes often necessary to administer the drug as an injection under the skin - hypodermically, as it is called - because of the patient's inability to retain it upon the stomach. When taken by the mouth, it is well to begin with a dose not exceeding ten drops of the tincture, which may be repeated three times daily. Even this amount will sometimes cause severe bearing-down pains for half an hour after taking it. Beneficial effects of this remedy are rarely seen until it has been administered in this way for several months, yet this must be considered not as discouragement but as a stimulus to a faithful trial of the article, for it is to be remembered that ergot is the sole hope in the way of medicines. While the attempt is thus being made to remove the cause, several complications may require treatment; these arise from displacement of the uterus, and, therefore, pressure on surrounding organs, and from derangements of menstruation. Some of the uterine displacements may, perhaps, be remedied by the use of pessaries, as before indicated ; the pressure upon neighboring organs can be, in some instances, relieved by the judicious use of abdominal supporters. The excessive menstrual flow is usually the most alarming and injurious feature of the case. In almost every instance where the presence of a fibroid is accompanied by profuse menstruation, it is advisable for the patient to remain in bed for a day or two before and during the flow. It may be possible to accomplish good by the administration of dilute sulphuric acid, ten to fifteen drops in a teaspoonful of water every four hours ; or gallic acid, ten grains in water every four hours. Yet, perhaps, the best measure for controlling hemorrhage is the use of a tampon in the vagina. This may be made by saturating the cotton with a solution of alum. It is advisable, however, not to apply this tampon until after the flow has continued three or four days ; that is, until a sufficient amount for a natural menstruation has escaped. The tampon may be renewed three or four times a day until the flow is somewhat con trolled, yet all these measures in obstinate cases fail to relieve the difficulty. The hemorrhage may become so profuse and long-continued as to blanch and weaken the patient materially. In such cases, the services of the medical adviser should be at once procured, since the matter is too serious to be longer entrusted to unskilled hands. In all instances, the object must be simply to control the more unfavorable symptoms, with the hope that the ergot may be successful in at least arresting the growth of the tumor. If these means fail, there remain no other measures for relief than surgical interference. The danger and the success attendant upon operations for the removal of uterine fibroids depend almost entirely upon the location of the tumor or tumors. When the fibroid projects into the uterine cavity, the chances of its removal by the use of ergot are most favorable; and, if this fail, it is not seldom accessible to the use of instruments through the vagina without exposing the patient to extreme danger. Yet one difficulty in these cases is the fact, that uterine fibroids are rarely solitary ; if one be present there is almost an absolute certainty that others are growing in its vicinity. Hence, the removal of one tumor through the vagina does not necessarily cure the disease, nor relieve the symptoms, which may be continued by other fibroids which remain. The complete removal of such tumors can usually be secured only by an operation whereby the abdomen is opened. The results which have thus far attended this operation are not such as to encourage surgeons to undertake it. It is advisable in those cases which cannot be relieved by other means than such an operation, to employ all possible means for arresting the growth until the occurrence of the change in life, after which time no further danger is to be apprehended. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! 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