FIBROID TUMORS OF THE UTERUS. 153 



an event is either the result of sloughing and suppuration of the 

 capsule, with subsequent bursting of the resulting abscess, in which 

 case the danger to life is very great, or else the extrusion comes to 

 pass by the less dangerous method of spontaneous enucleation. A 

 tumor juts from the os ; at its apex an opening forms by sloughing 

 of the mucous membrane, and through this opening, which enlarges 

 more and more, the tumor is gradually pushed by the uterine con- 

 tractions. It sometimes happens that pregnancy occurs notwith- 

 standing the presence of a fibromyoma. Childbed in such a case is 

 beset with peculiar dangers. 



TREATMENT. Very little reliance is to be placed upon medical 

 treatment of a fibromyoma with a view to its dispersion, arrest, or 

 atrophy. Iodide of potassium, bromide of potassium (first proposed 

 by Simpson), chloride of calcium (Rigby), arsenic and phosphorus 

 ( Gu&niot), seem to effect very little ; while the brine-baths, particu- 

 larly those containing bromine and iodine (Kreuznach, Minister am 

 Stein, and Adelheidsquelle in Bavaria), seem sometimes to bring 

 about a certain reduction in bulk of the tumor. Hildebrand claims 

 that by means of subcutaneous injections of ergotine, employed 

 originally to control the bleeding, not only the haemorrhage, but 

 also the tumor, was made to disappear; but, in spite of other 

 corroborative testimony, the value of this treatment is not yet es- 

 tablished. Some fibromyomata are curable by surgical treatment ; 

 and by following nature's suggestion of spontaneous enucleation, 

 not only submucous tumors, but even interstitial ones, have been 

 removed through the vagina by a surgical operation, though at 

 considerable risk to life. As a last resort, indeed, to save life, when 

 the rapid growth of the tumor was obviously about to kill the pa- 

 tient, extirpation of the tumor, either with or without the womb, 

 has been successfully accomplished. 



The surgical treatment of pedunculated submucous tumors is 

 more satisfactory ; and we not seldom meet women, who have been 

 brought almost to death's door by persistent haemorrhage from 

 fibrous polypi, restored in a few months after their removal to a 

 state of blooming health. 



As a rule, however, we must renounce the expectation of actually 

 curing a fibromyoma, and content ourselves with enjoining a quiet 

 mode of life, with little physical exertion or excitement, forbidding 

 frequent sexual intercourse, and with practicing small local blood-let- 

 ting upon the vaginal portion, with regulation of diet ; also with the 

 recommendation of a treatment during the summer-time by baths 

 calculated to retard the growth of the tumor. Regarding the treat- 

 ment of the bleeding, we refer to the article upon menorrhagia.] 



