Relationship between Gynecological and Neurological Diseases

An intimate relationship between the female genital organs and the nervous system has been recognized from the earliest times.Hippocrates regarded the uterus as the starting point of most nervous manifestations, and named from it one of the commonest of nervous diseases.This ancient idea was held with little modifica- tion up to comparatively recent times.In the middle of the last century such well known writers as Scanzoni, Amann, Romberg and Leu- buscher, described hysteria as a "reflex neurosis resulting from genital irritation," and agreed that "every pathological change of the uterus, ovaries and tubes may be the precursor of hysteria.' ' Even at the present time the celebrated Italian gynecologist, Bossi, is advocating by a prolific amount of literature the theory that minor gynecological lesions are the direct un- derlying cause of serious nervous and mental conditions.An exaggerated conception of a direct rela- tionship between pelvic abnormalities and ner- vous disease has led in the past to grave errors and has been the means of casting much dis- credit on the science of gynecological surgery.In the earlier days operations for lacerated cervix and later, ventral suspensions of the uterus, castrations, nephropexies, resections of cystic ovaries have been done by the thousands for the relief of nervous symptoms without suf- ficient surgical indication.In most recent times the same tendency has been seen in the excite- ment over autointoxication, enteroptosis, Lane's kinks and Jackson's membrane, etc., in which the relationship between abdominal aberrations and nervous manifestations has been often greatly exaggerated and many useless operations have been done.On the other hand the neurologists alarmed by this furor operandi, and impressed by the numerous surgical failures, have also erred and attempted to cure by long-drawn-out psychotherapeutic treatment, cases which in reality require surgery.In other words, there has been too little team work between the sur- geon and the neurologist and it is the object of this paper partly to emphasize this fact and partly to make certain suggestions by which we may come to a truer understanding of that difficult class of patients which requires both gynecological and neurological treatment.