Metrorrhagia or heavy menstrual cycle is the term now employed to signify uterine hemorrhage, unconnected with the menstrual flow.
This
hemorrhage may be active,-that is, composed of bright, arterial blood;
or it may be passive,-consisting of the darker colored, venous blood. It
may arise from the general influence of predisposing causes: from
accidents; from violence; from excessive exertions of body; from sudden
shocks and violent emotions of mind; from the presence of worms in the
intestines; from the presence of polypi or other tumors within the
pelvis; from ulcerated cancers, or other ulcers of the uterus; from any
of the causes which may produce abortion or miscarriage,-and from the
abortion or miscarriage itself; from retention of the placenta after
parturition,-or otherwise, in consequence of parturition itself; and
from the cessation of the menses after the change of life.
Those
hemorrhages mentioned in the preceding section under the head of
Sympathetic Menorrhagia, which appear during the course of severe
diseases, even if not developed at the usual catamenial period, are
still considered as resulting, in persons who have not passed the
menstrual age,-from the profound disturbance of the sexual organism; and
are therefore regarded as menorrhagic rather than as metrorrhagic. And
the same characteristic will be considered as belonging to all
hemorrhages occurring between the ages of puberty and of the change of
life,-unless some strongly marked cause, such as one or the other of
those above enumerated, can be discovered to operate independent of the
catamenial function. And while every individual case of metrorrhagia
must be treated with exclusive reference to the symptoms and conditions
found in connection with itself,-a careful study of the causes of each
case of such disorder must be absolutely essential to its successful
treatment. This will be made sufficiently obvious by recalling for a
moment the fact that the most violent and dangerous forms of uterine
hemorrhage may result from the most opposite conditions of body and of
mind; from plethoric congestion, or from exhaustion and debility; from
the highest emotional excitement, or from the most sudden and profound
nervous and mental prostration.
Causes of metrorrhagia : The Causes of Metrorrhagia require to be considered a little more in detail.
And
first, that most vague and common one of general predisposition, should
never be lost sight of. Even as we sometimes see in children and others
a remarkable disposition to hemorrhage from the slightest wounds or
other causes; so in some females, it must always be remembered, there
exists a corresponding predisposition to uterine hemorrhage. And this
constitutional peculiarity should be carefully studied with reference to
its connection with a psoric diathesis. In such cases, the
characteristic of the difficulty and of course the key-note of the only
Homoeopathic remedy, may really consist in some far-off and apparently
unimportant symptom. Our meaning here will be well illustrated by the
instance of the picking of the nose as an indication for Cina in
metrorrhagia arising from the presence of worms in the intestines,-which
has sometimes been known to have kept up for many months a constant
stillicidium of blood from the uterus. Here we can readily see the
relation between the comparatively trifling symptom of picking of the
nose and the irritation of the bowel caused by the ascarides and the
consequent uterine irritation and hemorrhage. The fact that in many
cases it is entirely impossible to trace any such physiological
connection between remote symptoms, which still seem to be
characteristic, and the disorders themselves, should not therefore
induce us to conclude that such connection does not exist.
The
manner in which violence, accidents, and physical and mental
excitement, and debilitating mental and bodily causes act, in producing
metrorrhagia, is very similar to that in which in other instances the
same influences result in menorrhagia. But it is well to bear in mind
that violence and excessive bodily and mental excitement tend to
establish arterial hemorrhage; while exhausting and debilitating
influences upon the physical organism, and depressing mental emotions
tend to produce passive or venous hemorrhage. Mental and bodily
excitement go together, equally stimulate the arterial action; while all
depressing influences, whether physical or moral, tend to paralyze the
peripheral nerves,-and thus arrest the capillary circulation. In the
former case, we may find violent and dangerous Metrorrhagia, of bright
red blood; in the latter, a passive flow of dark stringy, or perhaps
clotted blood, which from its intractable persistence is no less
alarming, since the greater the debility which results from the flow,
the more difficult it becomes to arrest the flow itself.
In
certain chronic diseases or disordered conditions of the blood, such as
are found in anæmic and in scorbutic patients; such as are seen to
result from the excessive use of salt food,-as in scurvy; and such as
follow the long-continued use of potash,-as in bread largely prepared
with saleratus, the blood is thin and watery, loses its rich color, its
fibrine is dissolved, especially by the action of the potash, and
passive hemorrhages readily make their appearance. This state of the
system, resulting in many instances from easily discernible causes, is
analogous to the hereditary condition just referred to under the names
of constitutional peculiarity and psoric diathesis. In either class of
these affections, the abnormal liquidity of the blood favors the
extravasation; and it is easily understood that the losses of
blood,-although replaced as to quantity by the absorption of water
called for by the intense thirst so commonly seen after severe
hemorrhages,-do but still further aggravate the disposition to
metrorrhagia.
In
certain constitutions there is seen in connection with the catamenia, a
remarkable disposition towards violent hemorrhage. And the same thing
is equally true in other cases unconnected with the menses. This
disposition may be termed a constitutional metrorrhagic molimen, in
which,-under the influence of appropriate exciting causes,-the blood
rushes to the uterus, and flows from it; just as sanguineous congestion
and hæmoptysis result from corresponding excitement of the pulmonary
organs. Cases of metrorrhagia of this class are mostly to be seen in
persons of a plethoric habit, who are thus almost exactly the opposite
of those above mentioned as anæmic, scorbutic and scrofulous.
The
alarming, frightful, and sometimes even fatal metrorrhagias, which may
arise from even very small polypi, have already been referred to in the
description of these forms of uterine tumor. In cancer of the uterus,
the metrorrhagia is often periodical, even in those who have long passed
the critical age; it is alarming both from its quantity and from the
frequency of its recurrence; it may be very sudden and severe from the
destruction of some important blood-vessel; it may alternate with a
limpid, serous, or extremely fetid discharge; it may form from time to
time a sort of crisis in the cancerous disease and congestion; it often
augments during the whole course of the case, but may sometimes suddenly
cease, leaving the patients entirely free during the latter part of
their existence.
The
metrorrhagias which arise from placenta prævia, from retained
placenta,-and from other causes in connection with parturition, will be
more particularly considered in the description of the difficulties of
Parturition itself.
Those
which arise from abortion may be due either to the violence or other
causes of the abortion itself, or to the prolonged retention of the ovum
and placenta. The latter has been known to have remained for weeks,
keeping up a more or less constant hemorrhage during the whole time. But
this subject will also be more fully and appropriately discussed in
connection with the general subject of Premature Delivery.
Still
another most important class of metrorrhagias is found in those which
appear after the change of life. These may arise in some instances from
disorganization of the tissues of the womb itself; but in most cases the
hemorrhage is believed to be due to the real metrorrhagic molimen
already referred to, or to the continuance of the same scorbutic or
psoric influences in the system, which have been described as producing
metrorrhagia in the earlier periods of the female life. In these cases,
the hemorrhage may be more or less constant; or it may alternate, in
various ways, with a watery or a leucorrhoeal discharge. For even in
those persons who have long passed the critical age, a certain amount of
periodicity is observable. But the subject will be again considered in
the chapter on the Change of Life.
The
attendant symptoms, although always to be taken into consideration in
prescribing for a case of metrorrhagia, need not here be recited. They
are mostly symptoms of debility and prostration in various degrees and
forms; it should be borne in mind however that some patients bear very
severe losses of blood with comparative impunity, while others suffer
very greatly from every slight hemorrhage.
The
treatment of metrorrhagia requires the utmost quiet on the part of the
patient, and the strictest attention to all the circumstances and
conditions, on the part of the physician.
This
is not a local affection, but is always constitutional, dependent upon
some general disease which, when abated, the hemorrhage is controlled,
except in case of actual rupture of the uterus, placenta prævia, and
atony or paralysis brought on by too suddenly evacuating the contents of
the uterus.
Homoeopathic
care : Ambra grisea 30,pis mellifica 30,Apocynum cannabinum
30,Arnicamontana30,Arsenicum album 30,Belladonna 30,Borax veneta
6,30,Bovista lycoperdon6,30,Cactus grandiflorus
1x,3x,6,30,Calcarea carbonica30. Dr.Bhattacharya
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