-335 
P A T HO LOG Y. 
Madder is rarely attended with the gaftric difturbance fo 
common and fo feverein procidentia uteri. It is only when 
theexpefed ftate of the bladder has induced difeafe of its 
ftruffure, that conftitutional difturbance becomes feverely 
manif'efted. Relaxation of the vagina and prefl'ure on the 
bladder caufe this difeafe; hence it occurs after labour, 
and efpecially in thofe women who have borne many 
children : hence likewife violent coughing and the lilt¬ 
ing of heavy weights have frequently brought it on. 
Little need be done in the way of conftitutional treat¬ 
ment. The re&um fhould of courfe be kept empty; and 
moft particular attention fhould be paid to keep the blad¬ 
der a-s empty as poffible by frequent endeavours on the 
part of the patient. Of courfe all coughing and ftraining 
mull be prevented. The treatment further than this con- 
fills in removing the relaxed condition of the vagina by 
aftringent injeftions and the cold bath, and in keeping 
the bladder in its place by means of a peflary. This in- 
ftrument may be either of the oval or globular form, ac¬ 
cording as the one or the other gives lead inconvenience. 
Whichever is worn fhould be perforated by four holes for 
the purpofe of introducing ftlk, by means of which the 
inftrument rnay be difplaced when necelfary. Dr. Good 
makes two varieties of this difeafe. 
cc. Tunicis interiors; the inner membrane being pro¬ 
truded. 
( 3 . Colli; the neck of the bladder being protruded. 
4.. Oedoptofis complicata : protrufion of different or¬ 
gans complicated with each other. 
a. Utero-veffcalis; of the uterus dragging the bladder 
along with it. 
/ 3 . Vagino-veficalis; protrufton of the vagina dragging 
the bladder along with it. 
In thefe cafes, the reduflion of the feparate vifeera being 
effected, they are to be retained in litu by means of the 
peflary. 
5. Oedoptofis polypofa: polypous excrefcence in the 
courfe of the genital avenue ; foft, cornprefllble, red or 
reddifh. Two varieties. 
a. P. uteri; bluing with a flender root from the fundus 
of the uterus, and more or lels elongating into the vagina. 
( 3 . P. vaginte, polypus of the vagina ; iffuing from the 
Tides of the vagina 5 broad and bulbous. 
Of thefe two fpecies the former is an infenfible tumour 
attached to the uterus by a fmall neck ; various as to its 
fize, form, and confiftence ; being fometimes white, at 
other times brown ; fometimes hard and tough, at others 
foft and eafiiy broken. The foft ftate is the lead; fre¬ 
quently met with. The fymptoms which attend this dif¬ 
eafe are a copious mucous or muco-fanguineous difeharge. 
Sometimes adual coagula of blood are emitted, which 
often corr.efpond with the former polypous ftrudure on 
which they have accumulated. . The retention of thefe 
coagula fometimes induces putrefaftion, in confequence 
of which an highly-offenfive difeharge takes place; to fo 
great a degree, in faff, as to fimulate the fetid fmell of 
the cavernous exudations from the carcinoma uteri. Pain 
in the back and groins, with a fenfe of prefiure and bear¬ 
ing-down, are met with in this complaint; all which 
fymptoms are proportioned to the fize of the tumour. 
Frequent vomiting, the confequence of the ftomach’s 
lympathizing in uterine irritatio'11, is common to this dif¬ 
eafe; and, when the bladder alfo is thus fympathetically 
affe&ed, ftrangury is no uncommon occurrence. The 
latter diforder, however, as well as retention of fasces in 
the reffum, is often brought on by the prefiure of the 
enlarged polypus on the refpeflive canals of the urine 
and ftools. In protruded cafes, dropfy may accompany 
this difeafe. On manual examination, we find a tumour 
of little feeling projeding through the os uteri, by which 
its neck is fo completely encircled, that we can pafs the 
finger round it. This polypus is diftinguifhed from in¬ 
verted uterus by the hiltory of its commencement, and 
by its infenfibility. It might be confounded with the 
cauliflower excrelcence, had not the latter an irregula¬ 
rity of furface, an origin by a broad bafe from the os 
VoL. XIX. No. 1307. 
uteri itfelf, inftead of coming through it with a thin pe¬ 
duncle, and were it not attended by a watery difeharge. 
Thefe circumftances are fufficiently apparent to prevent 
this miftake. The polypus of the uterus affecls both 
fingle and married perfons ; thofe who are cachedic, and 
thofe apparently healthy, and who have fuffered no injury 
of the womb. The only mode of cure confifts in tying 
the neck of the polypus by means of a canula and liga¬ 
tures, and afterwards extracting the tumour by the fingers 
or a pair of forceps; (for the mode of doing which, fee 
Surgery.) The vagina is then to be vvallied with a te¬ 
pid lotion for the purpofe of keeping the parts clean, and 
aftringent lotions thrown up if any remains of the com¬ 
plaint are apparent. 
The polypoid tumour which fprings from the vagina 
or from the uterus by a broad bafe, is generally different 
in its anatomical characters from true polypus, and is 
very difficult of cure. It may be removed by a ligature; 
and, if the parts are kept clean and the ftate of the con- 
ftitution (which is oftentimes in fault) amended, the pa¬ 
tient will experience a long period of relief; but the tu¬ 
mour will almoft inevitably return. 
Order III. CARrOTiCA, [from xxp7?o<;, fruit.] Diforders 
affeding the Impregnation. Irregularity, difficulty, or 
danger, produced by parturition. 
This order contains four genera ; of which, and their 
fpecies, we (hall merely give Dr. Good’s arrangement and 
enumeration, as the fubjeds have been fully difeuffed 
under the articles Abortion, vol. i. and Parturition, 
vol. xviii. 
Genus I. Parucyejis, [from rrxpx, bad, and y.v/ia k, im¬ 
pregnation.] Morbid Pregnancy. Generic characters— 
The progrefs of pregnancy difturbed or endangered by 
the fupervention of general or local diforder. There are 
three fpecies, befides varieties. 
1. Paracyefis irritativa : pregnancy exciting diftrefs or 
difturbance in other organs or functions than thofe pri¬ 
marily concerned. Five varieties. 
a. Syncopalis ; accompanied with frequent fainting. 
3 . Dyfpeptica ; accompanied with indigeftion or fick- 
nefs. 
y. Dyfpnoica ; accompanied with difficult breathing. 
< 3 . Alvina; accompanied with derangement of the al- 
vine canal, as coftivenefs, diarrhoea, hemorrhoids, &c. 
1. Varicofa ; accompanied with venous dilatations of 
the lower extremities. 
2. Paracyefis uterina: pregnancy difturbed or endan¬ 
gered by difeafed affection of the uterus. Four varieties. 
a. A. retroverfione 5 the uterus being retroverted. See 
CEdoptofis uteri, ( 3 . 
3 . A. leucorrhcea ; the uterus fecreting, or exciting in 
the vagina a fecretion of leu-corrhcea, fo as to produce de¬ 
bility. 
y. Catamenica; the catamenia continuing to recur. 
8 . Hasmorrhagica; accompanied with hemorrhage. 
Catamenia, unaccompanied with hemorrhage, can 
fcarcely be regarded as a difeafe. Many menftruate uni¬ 
formly for the firft three or four months.of pregnancy. 
Some through the whole term. A few have never men- 
ftruated at any other time; of which feme curious cafes 
are related by Hagedorn, Hopfengartner, and other 
Dutch writers. 
3. Paracyefis abortus: premature exclufion of a dead 
fetus from the uterus. If the exclufion take place within 
fix weeks after conception it is called mifearriage. If be¬ 
tween fix weeks and ieven months, or the term of pre¬ 
mature labour, it is called abortion. 
Genus II. Parodynia, [from irxpx, bad, and cvJtv, or 
worn mo?, labour-pain.] Morbid Labour.—Generic charac¬ 
ters—The progrefs of labour difturbed or endangered by 
irregularity of fymptoms, prefentation, or Itrudure. 
There are feven fpecies. 
1. Parodynia atonica, lingering labour: labour pro- 
4 R traded 
