Vaginismus.
By George W. Sherbino, M. D.
Presented by Sylvain Cazalet
Mrs. E—., age 24,
came from southern Texas to consult me : has been sick since last
confinement-which was long and tedious-two years ago. The labor occurred
at 8th month, and was followed by several severe hæmorrhages. She is
now emaciated, weak, debilitated, and wholly unable to attend to her
household duties. Her former medical attendants diagnosed bi-lateral
laceration of the cervix, and said nothing but a surgical operation
would give permanent relief. She came to me with the firm conviction
that the operation would have to be performed before she could get well.
She said there also was a painful tumor as large as a hazel nut in the
vagina, and when walking or standing on her feet this tumor with some of
the vagina would protrude. There was a constant “bearing down
sensation” when on her feet.As she came from other
hands I knew it would be more satisfactory to make a thorough
examination, which I accordingly did. I found almost complete prolapse
of the vagina, on the posterior surface of which, about an inch from the
ostium vaginæ there was a tumor as described, on either side of which
was a fissure, which with the tumor were exceedingly sensitive to touch.
Vaginismus was so marked that when my index finger touched the tumor or
fissure the vagina would grasp it spasmodically, and the pain was so
excruciating that the tears would roll down her cheeks. A thorough
examination with a speculum could only be made white under the influence
of anæsthetics. There was some erosion of os, but I failed to detect
any laceration. I promptly informed her that I thought she could be
cured without the knife, at least it would only be used as a dernier
resort. Menstruation was irregular, profuse and painful, the pain
commencing with cramps in the stomach and abdomen. At this time the
vaginal tumor would become inflamed, sore, and attended with a sensation
of smarting, not unlike a fresh cut. Her features were pinched and drawn
and the face freckled and yellow. Her weight was one hundred and ten
pounds.For the extreme pain
and suddenness of its appearance, and the throbbing headache, I gave her
Belladonna 200. This gave her great
relief. She next complained of a severe neuralgic pain which had
troubled her at times, more or less, for years. It extended from the
left side of the spine downward over the crest of the ilium to the
inguinal region. This pain was frequently present during the first days
of menstruation, Berberis 200, a few
doses, followed by S. L.
Helonias
was
next called for by “the great soreness, and a sensation as if the
uterus was very large, and constantly pressing against the rectum. She
was sure there was displacement”. For the constant bearing down and
prolapse of the vagina, she received Lilium,
Sepia, and an occasional dose of Sulphur,
according to the indications.Her next two subsequent
menstrual periods were more regular, and comparatively free from pain.
Her general health was improving in every way as satisfactorily as I
could expect, but the tumor, vaginismus and its consequent troubles were
as persistent as ever, so that I almost despaired of being able to
fulfill my promise, without surgical interference.The next menstrual
period occurred in two weeks ; was too profuse and tasted nearly a
week. She said she began to feel as she had years ago at such times.Her feet were cold and
damp, and it was with great difficulty that she could keep them
warm ; was extremely sensitive to cold ; the least cold wind
chilled her through and through.In my anxiety to
relieve her vaginismus I had evidently overlooked her previous history.
I now gave her Calcarea 1000 one dose, followed by S. L. An improvement
began at once. Menstruation became regular ; the spasms of the
vagina were relieved, the tumor was no longer sensitive to touch, and
gradually disappeared.
Calcarea
was
repeated once or twice a month, as the symptoms called for ; and
she has no further trouble. The vagina and uterus are in normal
condition, so far as she knows. She is now fleshy, weights 151
lbs ; has been keeping boarding house all winter, and enjoys better
health than at any previous time in her life.This case is
instructive for the following reasons :(i) It shows the power of the dynamized drug and
the single remedy.
(ii) It was difficult to resist the temptation to remove the growth by
surgical means.
(iii) Perhaps I could have cured the vaginismus by forcible dilation,
and perhaps not.
(iv) I left all these procedures as a dernier resort, which
fortunately were not needed.
(v) Is this not the right way after all to build up a new organism.DR. GEORGE W. SHERBINO, M. D.,
ABILENE, TEXAS.
Source :
Medical Advance, 1886.
Copyright © Sylvain
Cazalet 2001