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id="id06258" >INFLAMMATION OF THE CERVIX.—This is an inflammation of the mucous membrane lining the canal of the cervix (cervical canal), known as Endocervicitis; it may be acute or chronic. The acute form is seen most often as a part of a general infection involving both womb and cervix, and will be described later. The chronic form is a very common condition and it is difficult to treat.

Cause.—Injury and tear of the cervix.

Symptoms.—Leucorrhea, profuse and frequent menstruation, pain in the back and loins. On examination a string of thick mucus is seen at the external opening (os) of the cervix; and of women who have borne children there are usually signs of tear and rawness of the cervix present; (Endometritis usually produces a thin watery discharge, while gonorrhea produces a thick, pus-like discharge).

Treatment.—Hot vaginal douches, containing one dram of sulphate of zinc to one pint of water, used every night for ten minutes. Hot water with witch-hazel, about four drams to the pint, is also good. Tincture of iodine applied locally twice each month. White oakbark tea used as an injection once a day for this trouble; also good for vaginitis.

INFLAMMATION OF THE LINING OF THE WOMB. Endometritis.—Endometritis is an inflammation of the lining membrane of the womb, with a tendency to extend to the lining membrane of the fallopian tubes and to the peritoneum. These are the acute and chronic varieties.

Causes.—It may occur during an acute skin disease eruption, like that of scarlet fever, and occasionally upon exposure to cold during menstruation. The most frequent exciting causes are the microorganisms, like the gonorrhea poison, etc.

Acute Variety.—The whole mucous lining is inflamed. In severe cases the whole mucous lining is destroyed and the deeper muscular tissues of the womb are invaded.

Gonorrheal Variety. Symptoms.—There is general pain in the lower bowel region, in spells at first, later constant, with rapid rise of temperature and pulse. A purulent (pus) discharge appears early from the cervix, usually about the second day, and difficult and burning passing of urine are early symptoms. There is inflammation of the vagina accompanying it in about fifteen per cent of the cases, while inflammation of the fallopian tubes, pus in the tubes, and local peritonitis are common results.

[ WOMAN'S DEPARTMENT 499]

MOTHER'S REMEDY. Inflammation of the Womb. 1. A Good Tonic for.—"For inflammation of the uterus or ovaries try a hot sitz bath every day for a week, and then every other day. In case of hemorrhage this bath is invaluable, and will relieve when all other means have failed. It can be taken during the hemorrhage, or at frequent intervals between times. Remember, one should always lie down after a sitz bath. If desired you may give aconitum tincture. Dose:—Two drops in a half glass of water, tablespoonful doses every ten to thirty minutes according to the severity of the case." If a woman has taken a severe cold, then the aconite should be given, but under no other condition.

PHYSICIANS' TREATMENT.—Dr. Child advises that the cervix be dilated, and the interior of the womb, cervical canal and vagina swabbed out with a ten per cent silver nitrate solution. Subsequently vaginal douches (1 to 5000) corrosive sublimate solution followed by a salt solution, one dram of salt to a pint of water, should be given for at least one week. Keep the bowels open.

SEPTIC PUERPERAL ENDOMETRITIS.—This is an inflammation of the inner lining of the womb that occurs after child-birth during the first few weeks, and is due to a poison.

Symptoms.—The attack usually begins with a chill, preceded by a regular increase of the temperature and pulse. The face looks flushed at first, but it soon becomes pale and the patient has an anxious look, as the disease goes on. There is very little pain, if any. The discharge that always follows labor is diminished or stops and has no odor, if there is any discharge.

The death rate is from five to twenty-five per cent.

Treatment.—Never scrape out (curette) the womb for this disease. The womb should be washed out with a hot salt solution, one teaspoonful of salt to one pint of water, and then packed with ten per cent iodoform gauze. This solution should also be injected hot into the rectum and frequently. The bowels should move freely, and if necessary injections may be given for that purpose.

The strength must be kept up by a liquid diet. Milk, brandy and strychnine, if necessary; 1/100 of a grain of strychnine can be given every four hours. Milk should be given every half hour, about two ounces at one time: or more if it agrees well.

The gauze should be removed gradually, beginning on the third day and ending on the ninth day.

In this disease the interior of the womb is smooth and contains no broken down or foreign tissue. In the next disease, Putrid Endometritis, it is far different, for this is caused by the presence of dead material, such as parts of the after-birth, left in after labor, or sloughing tumors. This material becomes putrid (rotten), and thus causes the disease called "Putrid Endometritis."

[500 MOTHERS' REMEDIES]

PUTRID ENDOMETRITIS.—An inflammation of the inner lining of the womb caused by putrid (rotten), decaying material.

Symptoms.—A chill is sometimes present at the beginning. The fever is high, pulse bounds and feels hard and strong, the face is flushed but there is little or no pain. The discharge from the womb, unless it is blocked by a clot, is foul smelling. The flow after childbirth is scanty, sometimes suppressed. The womb and ovaries are not very tender.

Treatment.—The first thing to do, of course, is to get the dead material, such as parts of an after-birth, clots, shreds, etc., out of the womb, and then scrape the rough surfaces. This must be done carefully and with perfectly clean tools and liquids of every kind. Then wash the womb thoroughly with the hot salt solution. One teaspoonful of salt to one pint of boiled water. After this pack the womb with ten per cent iodoform gauze, which may be bought in this strength. Remove this from the womb about the third to the ninth day. The bowels should be kept open.

Diet.—Should be of milk or at least of liquids only. The patient can be given whisky or brandy and 1/60 grain of strychnine every four hours if needed.

MALIGNANT DISEASES OF THE WOMB.—Cancer or carcinoma is a malignant disease of the neck (cervix) of the womb.

Causes.—The immediate cause is not yet known. Tears and erosions (scraping off and making raw) are supposed to act as direct causes.

Symptoms.—Bleeding is the early and very important symptom. After the change of life (menopause) is over if bleeding occurs and continues it is a very bad sign and the womb should be examined immediately. Later, a watery bloody discharge appears, with pain, loss of weight and general weakness. Pain is not an early symptom. It appears when the disease has spread to the nearby tissue.

Treatment.—The only thing to do is to operate and the earlier the better. The womb and all its belongings should be removed. If this is done early it is very successful. If the case is too far advanced, the only thing to do is to make the patient as comfortable as possible.

For the pain, morphine or opium should be given.

For the discharge, hot water and corrosive sublimate (1 to 2000) is the strength to be used. This should be used daily as an injection into the vagina.

Cancer of the Body of the Womb is found in only about two per cent of womb cancers.

Treatment.—An early operation is then necessary. The chances of obtaining a cure if operation is done is better even than in cancer of the neck of the womb. There is less chance for the adjoining structures to be affected so early and readily.

[ WOMAN'S DEPARTMENT 501]

FIBROID TUMORS OF THE WOMB or Fibromata, Frequency.—Some observers state that twenty to forty per cent of all women over thirty-five years have one or more of these tumors. They are not malignant. They are more common in women who are sterile, unable to become pregnant. They appear early in life and attack all classes. They appear oftener in the body of the womb than in the neck. When in the body of the womb the back wall is the common site. A covering of loose fibrous tissue surrounds the growth. Few blood vessels appear in the tumor, nourishment being received from the surrounding tissues. Their growth is slow, except during pregnancy, when they grow rapidly. There are three varieties named according to their location and the structure covering: or surrounding them. 1. Interstitial; 2. sub-mucus; 3. sub-peritoneal or sub-serous.

1. Interstitial.—They are in the substance of the womb wall. They are usually many and vary in size.

2. Sub-mucus (under the mucous membrane).—They project into the cavity of the womb, are covered by mucous membrane and are attached to the womb by a broad base or pedicle. This is sometimes cut off spontaneously, and then the tumor is expelled from the womb.

3. Sub-peritoneal.—They are under the peritoneum, which forms its outer cover.

Causes.—Are not known. They are more frequent between thirty and forty.

Symptoms.—Difficult monthly sickness, too much blood flowing from the womb, unable to become pregnant, sometimes, and abortion. Bleeding comes more from the sub-mucus variety generally. Pain is caused by the size and weight and by pressure upon the bladder, rectum and the nerves. Death rarely results except from the complications.

MOTHER'S REMEDY. 1. Ulcers of the Womb, Common Wood Cactus for.—"Common wood cactus tea. Take wineglassful three times a. day." Should remove all thorns, chop fine and boil in sufficient water; add gin to make dose more pleasant.

Treatment.—Operation is needed when the symptoms are pressing. The sub-mucus variety may make an early operation necessary on account of their location.

Symptoms Calling for an Operation.—Size of the tumor; from the pressure symptoms; persistent bleeding from the womb. Sometimes it is necessary to remove the entire womb, especially in the interstitial variety, for the walls of the womb may be filled with the tumors.

[502 MOTHERS' REMEDIES]

SUBINVOLUTION OF THE WOMB.—This simply means that the womb, after miscarriage or child-birth, fails to return to its normal size and weight.

Causes.—This is frequently due to getting up too soon after labor.

Symptoms.—Menstruation or too much flow of blood (menorrhagia), dull, heavy feeling in the pelvis, backache or leucorrhea.

Results.—The womb frequently becomes misplaced.

Treatment.—Proper supports should be put in after the womb has been placed in its proper position.

If seen early enough some cases can be cured by tampons of ichthyol used three times a week and prolonged hot water injections at bed time. Cotton soaked in ichthyol and glycerin are frequently of benefit three times a week used as a tampon. The patient should not be on her feet much, or be active. Witch-hazel water can be added to the hot water injection if so desired.

DISEASES OF THE FALLOPIAN TUBES.—These are named after their discoverer, Fallopian, an Italian anatomist. These tubes begin at the part of the body of the womb that extends out like a horn. This is on the sides near the top of the body of the womb. They are two in number and extend outward on each side for about four inches; each end forms a fringe or finger shape to catch the egg, as it emerges from the ovary. Through the center there is a tube or canal, and the inner lining of the womb continues on and lines this canal, the mucous membrane of the Fallopian tubes. When this lining or membrane becomes inflamed it is called Salpingitis or Inflammation of the Fallopian tubes. Salpingitis is derived from two words: Salping, meaning tube; ltis, meaning inflammation; Fallopian was the discoverer. Thus we have Salping(x)itis, or Inflammation of the Fallopian tubes. Unfortunately in medical description it is generally called Salpingitis.

SALPINGITIS. Inflammation of the Fallopian Tubes.—It may be either acute or chronic in character.

Condition.—The tissues of the tubes become swollen when the inflammation runs into the pus stage; the finger-shaped end (outer end) is usually closed by adhesions, the pus accumulates in the tube and we have pus in the tube, or what is technically called [pyo. (pus) Salpinx (tube)] Pyosalpinx. In long standing cases the pus is absorbed or degenerates into a thin watery fluid, forming watery fluid in the tube or [hydro (water) Salpinx (tube)]—hydrosalpinx.

The tube may become attached to neighboring organs. The pus or fluid may drain occasionally into the womb and vagina. It may go into the bladder or bowels.

Causes.—It is usually caused by invading germs from the womb. Gonorrhea is the

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