Gynaecology for students and practitioners . ever, be clearly understood that epimenorrhoea is not a disorderin any way distinct from menorrhagia, for the conditions giving riseto them cannot be differentiated. In most marked cases of profusemenstruation, epimenorrhoea and menorrhagia are both present. In cases of profuse menstruation some modification often occurs inthe endometrial changes, as will be seen by comparing Fig. 97 withFig. 66, which represents normal menstruation. These changes consistin the formation of large blood-lacunse which may extend throughthe thickness of the mucous memb
Gynaecology for students and practitioners . ever, be clearly understood that epimenorrhoea is not a disorderin any way distinct from menorrhagia, for the conditions giving riseto them cannot be differentiated. In most marked cases of profusemenstruation, epimenorrhoea and menorrhagia are both present. In cases of profuse menstruation some modification often occurs inthe endometrial changes, as will be seen by comparing Fig. 97 withFig. 66, which represents normal menstruation. These changes consistin the formation of large blood-lacunse which may extend throughthe thickness of the mucous membrane down to the muscle. PAINFUL MENSTRUATIONDYSMENORRHGEA 181 A certain amount of pain usually accompanies menstruation evenin women of normal health : only a very small proportion of thewomen of civilized races menstruate painlessly. A degree of painwhich incapacitates the patient for a shorter or longer time fromfollowing her usual avocations is definitely abnormal and may bedesignated dysmenorrhosa. Excessive pain in menstruation may be. Fig. 97. Corporeal Endometrium from a case of Fibromyoma uteri WITH Menorrhagia. Showing the formation of large blood-lacunse extending through the whole thickness of the mucosa down to the muscle. due to some disturbance of the menstrual process itself, or to somedisease of the uterus or other pelvic organs, which is a source of painindependent of menstruation, and incidentally makes the menstrualprocess abnormally painful also. In the latter case dysmenorrhoeais secondary, and should be regarded as a symptom of the morbidcondition to which it is due. In the former case the dysmenorrhoeais primary or essential, and in the menstrual intervals the patient isfree from all symptoms ; it is clearly of much greater clinical import-ance than the secondary form. Sources of Pain in Menstruation. We must first consider withregard to the primary form what are the factors in the menstrualprocess which may possibly become sources of pain, and wdth rega
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
