Vol. 60, 1909 - University of North Carolina at Chapel Hill

XXXIV THE CHARLOTTE MEDICAI, JOURNAL.
powerless to act. The change is evidently trentment, and assuming also that the treatsome
interaction with sulphur, and taking ment prescribed is correct, failure can rethis
view he has tried giving sulphur and suit only from want of proper application
bismuth in two mixtures, the former pre- of treatment, or want of perseverance in
ceding the bismuth, generally, lie admits, treatment, or, what is more likely, from
with little or no result. !)oth
He gives an occasiot.al dose of bismuth Failure from lack of perseverance is largesimply
as a test, and when it is turning the ly due to ignorance on the part of the pafeces
black he gives it as treatment, and tient. Infected women, as the author has
has generally found it successful. But the indicoted in the case of men, must be edutrouble
is that it is so often not turned cated up to the point of fully realizing the
black. gravity of the disease, and the importance
The writer mentions lavage of the rec- of being, if possible, absolutely cured. Once
turn. Plenty of boiled water to drink should this is achieved, one could imagine they
be allowed, and if the indications point to would persevere with treatment as long as
the need of alcohol, he uses it in appropri- is desired. Failure from imperfect applicaate
doses. tion of treatment is a more difficult matter
The Prevention ol Pelvic Disease In to deal with, as it seems quite impossible
Women.— II ardie, in The Australasian Med- for the patient herself to carry out tlie medical
Gazelle, in writing on infections by the ical instructions in a satisfactory manner in
gonococcus says let us suppose that a wo- her own home. Yet she naturally objects
man has contracted the disease, and that to another doing what she can do but imils
treatment has to be considered. What perfectly herself. Here is a dilemma, the
the author advocates for man applies with solution of which bristles with difficulties all
equal force to woman, applies, indeed, with round. If the medical man suggests a nurse
greater force, because of the greater diffi- or private hospital, objections are at once,
culty in establishing a cure, and the greater and for obvious reasons, raised, and if, as
risk of subsequent complications. Here an alternative, he proposes to take on himagain
the practitioner is not often consulted self work that really belongs to another, he
until the disease has extended into the uter- accepts the position not from choice, but
ine cavity. He is convinced that, unless from a sense of duty.
the symptoms are very acute, many women Briefly put, gonorrhea is a common cause
have gonorrhea without consulting a medi- of pelvic disease in women, because in some
caiman at all, and seek advice only for cases it receives no treatment whatever, besome
of its remote effects. This is p 11 the cause in others it is too far advanced before
more to be deplored, as, if neglected, it is medical advice is sought, or if not too far
almost an impossibility to cure the disease, advanced there is imperfect application of
If the case be seen in the early stage, it treatment, and because the patient, being
is always essential that the disease should ignorant of the issues involved, gives up
be treated thoroughly, and yet under ordi- attendance and treatment when the cure of
nary conditions we know that this is not, her disease is more apparent than real,
and cannot well be done. We all know Some of these obstacles the medical man
how this is usually done, by the patient cannot, for the present, overcome, but if he
visiting her medical attendant at irregular conveys to those patients who suffer from
intervals, and doing her best to carry out gonorrhea a realization of its possible conhis
instructions at her own home. The sequences if neglected, the time will come
treatment may possibly be successful, but by a process of direct and indirect educaprobably
not. No doubt the acute symp- tion by way of compound interest, when
toms disappear, and the discharge may women, who become the victims of it, will
also apparently disappear. Taking it for seek advice early, and will not give up
granted that she is cured, the patient gives treatment until authorized to do so by their
up treatment, and no more is heard of her medical adviser. Knowledge of the possiuntil,
in the course of time, it may be years, ble sequelee of gonorrhea on the part of
she may seek advice for some pelvic disease women seems to be the key-note, if not of
that is removable only, and perhaps not its prevention, at least of the successful
even that, by the surgeon. In the mean- application of treatment in the future, betime
she may have given gonorrhoea to an- fore it has invaded the inner pelvic organs,
other. This is a highly unsatisfactory state We are sometimes asked by a man or
of matters, and the author asks us to con- woman who has had gonorrhea or syphilis
sider if anything, and what, may be done whether, and when, he or she may safely
to obtain better results, marry. So far as syphilis is concerned.
Assuming still that the case is in the Hutchinson considers marriage allowable
acute stage, and that the disease has not after a period of two and a half years, proaffected
parts beyond the reach of medical vided the patient has received a thorough ;