Page:Clinical Lectures on the Diseases of Women.djvu/91



Sitting is the subject of this lecture. We have several cases illustrating it. In some of them, painful walking accompanies the painful sitting; indeed, in the last disease that I shall mention to you, painful walking is more important than the painful sitting. Painful sitting is as good a name for a disease as dysmenorrhea is, and quite as distinctive; but painful sitting is not a disease, nor is dysmenorrhea—both are symptoms, and the term is used merely as an artificial arrangement of a variety of affections, just as dysmenorrhea is so used. In both cases the designation is not a term of a pathological classification, but of what is called a nosological or artificial classification. The most common kinds of painful sitting are not to be considered to-day; only those that are observed particularly in women, and only those that are somewhat recondite. Such causes of painful sitting as an abscess of the vulva, an abscess of the perineum, tender caruncle of the urethra, an inflamed gland of Cowper, are very common; and in them nobody requires to hear anything said about the painful sitting — that is a matter of course.

The first special cause of painful sitting that I have to consider is inflammation—not affecting the external organs, not affecting the vagina, but affecting the deep-seated genital organs, the uterus and ovaries. This is not an infrequent cause; and the first case I am to read to you is a