Publisher's Synopsis
Excerpt from The American Gynaecological and Obstetrical Journal, Vol. 11: July-December, 1897
I need not go into the clinical history or lay stress on the one symptom which induces us to resort to the curette for diagnostic purposes, that is, haemorrhage. If we are to accomplish positive results we must get hold of these cases in their incipient stage, con sequently we should always look with suspicion on atypical uterine haemorrhage. We know that ordinary menorrhagia is gen erally a symptom of hyperplastic endometritis, or of decidual re mains, and we also know that atypical haemorrhages after the meno pause are extremely important; but we must remember that even after the menopause we may have such haemorrhages due not to cancer, but to senile erosion, or endometritis. Those who are ac customed to curette judge a good deal by the condition of the uterus at the time of the operation, and by the material removed. The macroscopical appearance of the hypertrophied mucosa is so charac teristic as compared with the soft, brain-like material of adeno carcinoma or sarcoma, that we feel pretty certain from the gross appearance, in connection with the clinical history, what the condi tion is with which we have to deal. I need not allude to the appear ance of retained decidua, or of the pseudo-decidua of ectopic gesta tion. A description of the histology belongs rather to the pathol Ogist, but the practical surgeon is sometimes very much puzzled by the pathological report; he can not understand exactly what is the criterion of malignant disease.
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