Gynecological diagnosis and pathology . lliparous women. In some of these cases it is secondaryto a gonococcal infection, but in others no such factor is present, and inthese the cervical catarrh is very often associated with a catarrh of theendometrium. CERVICAL CATARRH 63 Passing now to symptoms, the prominent Bymptom in most cases isleucorrhoea. This is always mosl abundant just before and immediatelyafter menstruation. The discharge is as a rale thick and tenacious incharacter. It is .seldom blood-stained. In addition the patient oftensntturs from monorrhagia owing to an associated endomet
Gynecological diagnosis and pathology . lliparous women. In some of these cases it is secondaryto a gonococcal infection, but in others no such factor is present, and inthese the cervical catarrh is very often associated with a catarrh of theendometrium. CERVICAL CATARRH 63 Passing now to symptoms, the prominent Bymptom in most cases isleucorrhoea. This is always mosl abundant just before and immediatelyafter menstruation. The discharge is as a rale thick and tenacious incharacter. It is .seldom blood-stained. In addition the patient oftensntturs from monorrhagia owing to an associated endometritis. Painin the back and symptoms of anaemia and dyspepsia are frequentlypresent. Physical Signs.—Round the edges of the laceration, if such be present,or round the external OS, the finger can detect the soft velvety characterof the surface of the catarrhal patch. The diagnosis, however, is onlyconfirmed by inspection of the cervix, and this is best carried on* withthe ordinary Sims speculum, the patient lying in the Sims Fio. r>3.—Cervix removed nv Amputation, containing large Cysts RESULTING FROM ADENOMATOUS OVERGROWTH OF THE GLANDS. The characteristic red colour of the catarrhal patch is visible, and ontouching the surface slight bleeding may result. In chronic cervical catarrh, after healing of the catarrhal patches hasoccurred, the striking features on vaginal examination are the enlargementand the hardness of the vaginal portion of the cervix. Situated immedi-ately under the surface, the finger can detect hard, round, shot-likebodies—these are Nabothian follicles. Sometimes the cervix showsdistinct cysts (fig. 53). Such cases may present some difficulty indifferential diagnosis from commencing cancer of the cervix. The chiefdistinguishing character is that in a chronic cervical catarrh withNabothian follicles the surface is hard and irregular; whereas in cancerof the cervix the surface is always friable, and examination with thefinger causes bleeding
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
