Even the promised statue of Miss gynaecologist. On the other hand, should .the
Nightingale, which should indeed shine gynaecologist undertake the treatment, then it
forth among Englaiid's heroes, cannot be is his duty to thoroughly acquaint himself with
a source of unmlsed satisfaction t o nurses, the general physical. and biological properties
because of the frugal expenditure allowed of the S rays, and also the necessary special
for it. technique. ...
No, the only vital, the only fitting " The indications for the Rontgen therapy
inemorial t o Miss Nightingale is one t h a t are as follows : (I) Fibroids occurring before or
shall embody her spiri;, shall perpetuate during the climacteric, with or without prcssure
her energy, shall disseminate her principles, complications, such as those affecting the heart,
bladder, or rectum ; (2) in haemorrhage due to
shall raise u p women t o follow in her foot- fibroids ; (3) for climacteric hamorrhage; (4) for
steps. Her spirit was a n indomitable, a metritic bleeding before or after the climacteric ;
militant spirit, not a meek tractable one. (5) to relieve dysmenorrhea and other climac-
H e r energy was destructive of man's teric troubles.
meddling in things he did not understand, " The age of the patient is a particularly im-
and constructive on lines of. woman's public portant factor. The older they are-that is, the
duties; Her principles are : Knowledge, nearer they approach 50 years of age or more-
Training, Authority for the woman in the the more favourable is the result ; it is attained
work which is hers. Women will be pre- more quickly and is more lasting. The younger
pared to follow where she led, only by the patient is below 45, proportionally longer
knowledge, culture, fearlessness, self- is the treatment and the greater the uncertainty
reliance. of the result. One is also more likely to meet
T h e trde memorial to Miss Nightingale with a recurrence. In my opinion women under
will be a n -educational memorial, and to 40 should not be rayed for the treatment of
such a foundation hot only nurses, but all these conditions.
truth-loving and humanity-loving women Further considerations are the size of the
and men should gladljr contribute according tumour, the position, and the rate of growth.
t o their ability. The smaller the fibroid, the more favourable is
L. L. DOCK, R.N. the influence, although, as my own cases show,
__ctt_ even a tumour reaching as Ear as the ribs i s
by no means a contraindication for the trcat-
MEDICAL MATTERS, ment, providing it is not of too long duration.
T H E X-RAY TREATMENT O F UTERINE I t is hardly possible to cause the disappearance
FIBROIDS. of a large hard tumour which has esisted for
Dr. G. Fedor Harnisch, of Hamburg, pre- ten to twenty years, although this may occa-
sented, in the Section of Electrd-Therapeutics sionally diminish and the complications may br:
and Radiology, at the recent meeting of the relieved. Generally speaking, however, the
British Medical Association, an interesting large, old myomata do not lend themselves to
paper on the X-ray treatment of uterine favourable treatment. The length of raying
fibroids, which is published in full in the British for the skin is also a serious consideration. As
Medical Journal. He said, in part :- regards the situation of the myoma, the inter-
" In undertaking this treatment it is neces- stitial and the intramural are the most easily
sary to have a complete mastery of the Rontgen influenced. Most authorities agree that the
technique, not only generally, but also in its treating o submucous and pedunculated
application to deeper situations. Just as im- fibroids is absolutely contraindicated. I saw
portant is the correct selection of suitable cases. excessive bleeding follow in one of these cases
This has now been generally agreed upon as a after transient improvement had been attained.
result of the work done by many investigators An immediate operation was necessary. . . .
during the last few years. In every case it is " Special stress must be laid on the rapid
.absolutely necessary that a gynaecologist should improvement of the general health. In some.
have made a thorough examination,' in order to cases I saw rapid disappearance of nervous
eliminate a mistake in diagnosis, which would, symptoms, mental depression, misery, and dis-
of course, entail unnecessary treatment. In content. The constipation which frequently
certain cases it is advisable microscopically to accompanies the large tumours improves with
examine the tissue removed by the curette or to extraordinary rapidity. The heart strain is
dilate and investigate the uterine cavity. In relieved, incidental vomiting, nausea, and feel-
other words, the radiologist should have the ing of heaviness disappear. The hlcmoglobin
diagnosis and later condition confirmed by a percentage of the blood increases."
previous page next page