Prolapsus of the uterus

- BENERJEE.P,

Prolapsus of the uterus 

 Case no. 14
 12. 10. 1918.
 Mrs.-; age 38 or 39; medium complexion; fat; was suffering from displacement and prolapsus of the uterus since the last parturition which took place about three years ago. A lot of allopathic treatment was undergone, but to no effect. She was, however, using a pessary on allopathic advice, and this had only made her movements and walking etc, comparatively easier. A regular course of treatment was necessary for relieving the other attendant sufferings. Ayurvedic treatment was also had, but this too was of no use. The patient had been to Dr. Yunan of Calcutta to see if Homœopathy could do anything. But in spite of the said Doctor having given her sufficient hopes, she was unable to put herself under his treatment, as it was too much for her to bear the expenses of a long stay at Calcutta. It was for this reason that the patient abandoned the idea of having a course of treatment in Dr. Yunan's hand and applied to me on 12. 10. 18. And the first thing that I asked her to do was that she would not be allowed to use the pessary, and it was only when she agreed to this that I recorded the following symptoms:-
 PAGE 384
 A continuous burning in the body; liked lying on the cemented floor; the cold floor soothed the burning in the body; could hardly lie on a bed; it was only in winter that she could lie on a thin bed and cover herself with something; could never go without a bath; there was burning in the abdomen and on the vertex. The burning in the abdomen used to be so severe at times, that she would require some wet application for a temporary relief. The condition of the mind was bad. Kept quiet, and at times felt an irresistible desire for weeping. It was only out of delicacy that she refrained (though with great difficulty) from actual weeping, lest what others would think of her. There was burning in the uterus too, and during prolapsus, the whole pelvis felt vacant. Slow walking or moving about was possible and any rapid motion brought on an indescribable pain in the uterus; and besides, a sticky discharge used to come out. The pessary was of course keeping down some of the troubles of prolapsus, but all these came up as soon as it was discontinued on my advice. There was a very peculiar symptom-the patient could not even bear the sight of milk, not to speak of drinking it. The very sight of milk used to bring on a severe nausea. There were occasional attacks of diarrhœa, but generally she was constipated. The appetite was neither very dull nor very keen. All the troubles, physical and mental were generally more severe in the afternoon, and they were the worst in the night, but a distinct relief used to be felt as soon as she came out of the bed room. The menstrual discharge was scanty. And that is all.
 PAGE 385
 The above record seemed to indicate Pulsatilla, and I gave her the first dose in the 1000th potency on 24. 10. 18. Then sufficient placebo. A report was asked for after a month; but in case, there was no improvement in a fortnight's time, a report was to be sent at once.
 14. 11. 18. There was no change beyond a slight relief of the burning. Plenty of placebo was already given and it was to be continued.
 29. 11. 18. No relief. Pulsatilla-1000, one dose daily for 4 days.
 26. 12. 18. No change. Neither aggravation nor amelioration. Sulphur-1000, one dose only.
 15. 1. 19. No change yet. Pulsatilla-500, one dose in the week. Four doses were given, and it was instructed that it was to be stopped as soon as there was any change.
 PAGE 386
 16. 2. 19. No change yet. Pulsatilla-10 m. and placebo for a month.
 15. 3. 19. There was no change yet, and this made me really anxious. The patient was also showing signs of impatience and was pressing for permitting the use of the pessary. But the use of the pessary was impossible, if the treatment was to be continued, and I then gave her a dose of Kali Sulph in the 500th Potency.
 26. 3. 19. There was some relief on this date. The patient seemed better in the mind, and the burning was a bit less.
 7. 4. 19. The improvement was the same as on 26. 3. 19. and there was no further progress. Neither was there an aggravation. Kali Sulph-500 was repeated.
 26. 4. 19. She was feeling better in all respects and was having a copious menstrual discharge from the day before. She had never in her life had such a profuse discharge. Placebo.
 27. 4. 19. The uterus was now gradually getting partially into the pelvis during the last few courses, and this time the whole of it was in.
 1. 5. 19. There was a prolapsus again, but it was much less than before.
 26. 5. 19. Menstruation again. The discharge was sufficient but comparatively less than at the last time.
 PAGE 387
 1. 6. 19. The whole of the uterus was in this time, and it was not out even up to this date.
 13. 7. 19. Prolapsus again, and Kali Sulph-1000, one dose. Some placebo for three months.
 No further medicine was necessary, as she was quite well after this.
 Remarks:-
 (1) There was no response from Pulsatilla, in spite of all the symptoms indicating it and in spite of it having been tried in various potencies. This might have been due to Psora. But it seems that there should have been proper response after the dose of Sulphur-1000 on 26. 12. 18. As however, there was none even on the use of this anti-Psoric, two explanations are possible:-(1) Perhaps, Sulphur in some other potency might have excited re-action (but in that case too, Pulsatilla alone would never have cured this patient, as Psora was very badly predominant, as the want of re-action must show); or (2) it might be possible that there was no re-action even after Sulphur, because there was no symptomatic indication of it.
 (2) The course of cure in this case is very instructive. The improvement began first in the mind, and it came out gradually towards the surface.-From the "mind" to the "menstruation," and from the "menstruation" to the "prolapsus".