An apology seems in order for this apparent intrusion within the domains of gynecology; but the internist is so frequently consulted in reference to dysmenorrhea associated with conditions pertaining to his province, that perforce he must be adept in relieving the menstrual anomaly by virtue of general treatment.
The organic forms are herein not considered. Morbid states of the ovaries, ducts and uterus comprise definite clinical entities, often requiring surgical intervention, and yet there seems to be an associated cause in the congested endometrium itself which frequently persists after operation. How often are we chagrined to find our patient unrelieved by fixation of the uterus or dilatation of the cervical canal!
Many nulliparas who have not suffered social infection are victimized by a primary or an acquired congestive form of dysmenorrhea. Even the constitutional states may be included in the same category. Tuberculosis, rheumatism, chlorosis, gout and other diseases are
SPITZIG BL. THE USE OF CITRIC SALTS IN CONGESTIVE DYSMENORRHEA: AND THE RELATION OF THE LATTER TO THE VAGOTONIC STATE. JAMA. 1915;LXIV(9):733–734. doi:10.1001/jama.1915.02570350027008
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