I
CAUSES, SYMPTOMS AND TREATMENT OF
DISEASES OF WOMEN,
With Advice regarding the Health of
YOUNG WOMEN AND GIRLS
II
OBSTETRICS OR MIDWIFERY
INCLUDING NURSING THROUGH PREGNANCY AND
CONFINEMENT; PREPARATION, DIET,
CARE OF CHILD, ETC., ETC.
"Sickness is the vengeance of nature for the violation of her laws,"--C.
Simmons.
Our busy life, our manner of dress, with all its attending demands are
causing havoc with the health of women who are under its terrible strain.
The number of women undergoing operations in our public and private
hospitals from day to day bears witness to the ravages of the strenuous
social life and mute testimony of the neglect of the laws of nature. Good
health is the fruition of eternal vigilance and a blessing that money
cannot buy. The conduct and health of our women represents the life of our
nation; individually, in a measure at least, health governs the happiness
of the home. Steele says: "All a woman has to do in this world is
contained within the duties of a daughter, a sister, a wife, and a
mother." But how many girls grow to womanhood untaught; enter wifehood in
ignorance, and assume motherhood wholly unprepared for the duties that are
thrust upon her. It would be out of place in a work of this nature, a
family table book, to take up all the questions involved in such a
subject; we can only leave with you a word of warning. Before puberty the
girl should be taught to lead a life that will make her strong and healthy
to prepare her for the coming strain upon her system. Once she has reached
puberty parents should remember, above all things, that HEALTH is far more
important than high grades in school. Do not offer prizes for high marks
and otherwise add to the pressure of the present school system. Relieve
her of worry, do not add to it. A cheerful mind, plenty of fresh air and
sunshine is more important at this period than school work. We have paid
special attention to "Causes" in this department; may we ask you, Mother
and Daughter, to read "CAUSES" of disease and thus render unnecessary in
later life, drugs, medicines, headache tablets and, perhaps, operations.
[490 MOTHERS' REMEDIES]
The Pelvis. It is so called from its resemblance to a basin, is stronger
and, more massively constructed than either the skull or chest cavity; it
is a bony ring, interposed between the lower end of the spine, which it
supports, and the lower extremities, upon which it rests. It is composed
of four bones, the two innominated, (nameless), which bound it on either
side and in front, and the Sacrum and Coccyx, which complete it behind.
Further description will be given in the department of Obstetrics. The
cavity of the pelvis contains the bladder, the rectum, and some of the
generative organs peculiar to each sex and some windings of the small
intestine; they are partially covered by the peritoneum (lining membrane
of the abdominal cavity).
Anatomy of the Female Genital Organs.--The external genital organs, to
which the term vulva is usually given, consist of the mons veneris, labia
majora, labia minora, clitoris, vestibule, meatus urinarius, hymen, fossa
navicularis, fourchette and perineum.
Mons Veneris.--This is a rounded eminence surmounting the pubic bones, and
is composed of fatty tissue, covered by skin and hair.
The Labia Majora.--There are two more or less prominent longitudinal folds
of cutaneous (pertaining to the skin) tissue, covered by hair and mucous
membrane, which is continuous with the mucous membrane of the genital
organs and urinary tract. They join at each extremity, forming the
anterior and posterior commissures (uniting together). Between the
posterior commissure (union) and the margin of the bowel is a space of
about an inch in extent, the Perineum. It is important to remember this
part, for it is often torn in labor, to a greater or less extent.
The labia are the analogue of the scrotum in the male.
The Labia Minora.--These are two smaller folds situated within the labia
majora, extending from the clitoris, downward and outward for about one
and one-half inches on each side of the vaginal opening. At their
convergence at the clitoris each lip (labium) divides into two folds and
these surround the glans (clitoris) forming its covering (prepuce) above
and the bridle (frenum) below. These lips (labia) are composed of mucous
membrane covered by a thin epithelial layer. They contain a network of
vessels and numerous large mucous crypts (small sacs or follicles) which
secrete a quantity of (fatty) matter.
[WOMAN'S DEPARTMENT 491]
The Clitoris.--This is an erectile structure, the analogue anatomically of
the cavernous body of the penis, and is an elongated organ partially
covered by the anterior extremities of the labia minora and connected on
each side with the rami (slender process of the bone) of the pubic bones
and the ischia (two bones) by a band. The clitoris is surmounted by a
small tubercle (a small nodule) of spongy erectile tissue, the "glans
clitoris," Two cavernous bodies of erectile tissue enclosed in dense
fibrous tissue compose the body of the organ.
The Vestibule.--This is the smooth surface of triangular form situated
between the clitoris and the entrance to the vagina. The labia minora
bound it on either side. It contains the opening of the urethra.
The Hymen is a thin fold of mucous membrane of half moon in shape
(semi-lunar) and is spread across the lower opening of the vagina.
The Glands of Bartholin are small oblong bodies, two in number, situated
on each side of the commencement of the vagina above the deep fascia band
like tissue. Each gland has a single duct and by this duct opens the inner
surface of the adjacent labia minoris just external to the hymen. They are
made up of mucous glands and a colorless tenacious fluid is secreted by
them, which lubricates the vagina. These glands sometimes become diseased.
Hence the description.
The Vagina.--This is a membranous canal and extends from the vulva to the
uterus (womb) and connects the external and internal organs of generation.
It is four to six inches in length, the anterior wall being from one to
two inches shorter than the posterior. It lies in the cavity of the pelvis
in front of the rectum, behind the bladder and follows first the line of
axis of the cavity of the pelvis, and afterwards the axis of the outlet.
The vagina consists of an internal mucous lining (membrane) continuous
above with the mucous membrane lining the womb and below with the covering
of the labia majora. The next covering (inward) is a muscular coat
consisting of two layers--an external longitudinal and an internal
circular. There is a layer of erectile tissue between the muscular coat
and mucous lining. The lower end of the vagina is surrounded by a band of
striped muscular fibers comprising the sphincter muscle of the vagina
(sphincter vagina).
The internal organs of generation, more commonly called the pelvic organs.
These comprise the womb, fallopian tubes and ovaries.
[492 MOTHERS' REMEDIES]
The womb is the organ of pregnancy, and receives the fruitful egg (ovum),
supports it during its development and expels it at the time of labor
(parturition). In form it is pear-shaped, weighs from 12 drams to 3 ounces
and is situated in the pelvic cavity, between the bladder and the rectum,
with its base upwards and its apex, smaller end downward. Its upper broad
extremity is called the fundus--base of the organ, and the lower,
constricted, narrowed portion is called the Cervix (neck or constricted
portion). The body of the womb gradually becomes narrower from the fundus
to the Cervix.
Its anterior surface is covered on its upper three-quarters by the
peritoneum, while the lower fourth is connected with the bladder. The
peritoneum covers the whole of the posterior surface. The womb is held up
(suspended) in the pelvis by ligaments; two anterior, womb and bladder
(utero-vesical), two posterior, womb-sacral (utero-sacral), two lateral
broad ligaments, and two round ligaments. The womb sacral (utero-sacral)
which holds the womb well up in the hollow of the sacrum and the round
ligaments which keep the womb well forward enter most actively into the
support of the womb. The round ligaments are strong muscular fibrous cords
and serve to hold the womb forward. When pregnancy exists they increase in
size with the womb, and keep the fundus forward in its excursion upwards
into the abdominal cavity, and after confinement, become smaller with the
womb, guiding the womb back again to its regular position. The broad
ligaments are little more than reflection of the peritoneum serving to
support the vessels that nourish, as they go to and from the womb.
The womb has three coats, enclosing a central cavity. This cavity of the
womb is small by comparison with the size of the organ and it communicates
with the Fallopian tubes by two minute openings at each side of the body,
and with the vagina below, through the mouth or opening of the womb.
The external coat of the womb is called servos, derived from the
peritoneum; the middle or muscular coat, which forms the chief substance
of the womb, consists of bundles of unstripped muscular fibers intermixed,
with loose connective tissue, blood vessels, lymphatics and nerves; the
internal or mucous coat is continuous through the fringed extremity of the
fallopian tubes, with the peritoneum, and through the mouth of the womb
(os uteri) with the mucous membrane of the vagina. This mucous membrane is
lined in the body of the womb by epithelium arrayed in columns (Columnar
Epithelium) which loses its ciliated (eye-lash) movement character during
pregnancy. In the lower half of the Cervix, the epithelium (this kind of
cell lines all canals having communication with the external air) is of
the stratified (arranged in layers) variety. The appendages of the womb
are the fallopian tubes, the ovaries and their ligaments and the round
ligaments. The fallopian tubes convey the ova (eggs) from the ovaries to
the cavity of the womb. They are two in number, one on each side, situated
in the free border of the broad ligaments and extend from each horn, an
excrescence of the womb that looks like a horn, of the womb outward to the
sides of the pelvis; each is about five inches in length, and has a small
canal beginning at the womb in a very small opening called the internal
mouth (ostium internum). This canal gradually widens to its ending, the
abdominal mouth (ostium abdominal) by which it communicates with the
peritoneal cavity, the timbrae. A series of fringe-like processes
surround this mouth or opening and this farther end is known as the
fimbriated extremity. The tube has three coats, serous or external or
peritoneal; the middle or muscular, continuous with that of the womb, and
an internal or mucous coat continuous also with the lining of the womb and
peritoneum (covered with ciliated Columnar Epithelium).
[WOMAN'S DEPARTMENT 493]
The Ovaries.--They are analogues, anatomically, of the testes in the male.
They are two egg-shaped bodies situated one on each side of the womb on
the posterior aspect of the broad ligament, below and behind the fallopian
tubes; each is connected by its anterior margin to the broad ligament;
internally to the womb by the ovarian ligament, externally to the
fringe-like extremity of the fallopian tubes by a short cord-like
ligament. They are white in color; about one and one-half inches long,
three-quarters of an inch wide and one-third of an inch thick and weigh
about two drams each.
The ovarian ligament extends from the inner side of the ovary to the
superior angle of the (Uterus) womb. The round ligaments, two in number,
are about five inches long and are situated between the layers of the
broad ligament, one on each side of the womb in front and below the
fallopian tube. They pass forward and outward from the womb through the
internal abdominal ring, along the groin canal and out at the external
abdominal ring.
I have given a lengthy description of these organs; I think it will repay
a careful reading. To understand a disease one should understand the
organs that are subject to the disease.