TEAR OF THE CERVIX (Laceration).--This is a tear in the lower part of the
cervix. There may be one or more. The left one-sided tear is the usual
form. Next comes the tear on both sides (bilateral). Tears on front and
behind are not frequent. Tears are found in about thirty per cent of women
who have had children.
Causes.--The majority of cases are caused by labor, and is due to a cervix
that is not perfectly dilated. Very hurried, quick labors cause it
sometimes, but the greatest injuries are due to the various operations for
delivering the child through a cervix that is not fully dilated.
Symptoms. Immediate and remote.--On the immediate, when the tear is
severe, there is bleeding; later, sub-involution, that is, the womb does
not return to its normal size and weight.
Remote symptoms.--Leucorrhea, thick and mucus in character; profuse
menstruation and inability to become pregnant. When the tear has extended
through the internal opening the woman win not be able to carry the child
to full term, even if she becomes pregnant.
[498 MOTHERS' REMEDIES]
Treatment.--Tampons of ichthyol (ten per cent), mixed with glycerin,
introduced twice a week against the cervix and permitted to remain
forty-eight hours will often afford relief.
The tear should be repaired after child-birth, if possible. If not then,
and if it does not heal, it should be repaired later when the tear extends
through the internal (opening) or in case of extensive raw surface on the
cervix.
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 cause of the most cases.
Symptom.--This disease follows the same kind of an infection in the womb
and vagina; the patient complains of pain in the region of the tube, a
little to the side or sides of the womb, and the pain is made worse by
motion, exercise or long standing. If it is the acute variety, the
temperature rises, the pulse grows faster, and sometimes there is nausea
and vomiting.
[WOMAN'S DEPARTMENT 503]
The Symptoms of the Chronic Variety are due to congestion and adhesions.
There is a constant pain in the region of the tube and the patient
protects herself when she walks, rides or sits down. There are difficult,
painful monthly periods and too much flow. The history shows gonorrhea or
septic infection, that is, disease caused by the absorption of products of
putrefaction.
Treatment of the Acute Kind.--First thing is absolute rest and quiet in
bed. Then prolonged hot injections in the vagina of hot water, and if you
wish, one teaspoonful of listerine, etc., in each injection. Put a
hot-water bag to the sore side, or fomentations of different remedies,
like hops, catnip, pennyroyal, smart-weed. The applications should not be
of great weight. The bowels should be kept open.
For Chronic Variety.--This frequently calls for an operation. When the
symptoms are due to inflammation in the tube alone, ten per cent strength
of ichthyol and glycerin tampons placed behind the lower part of the womb
three times a week do much to improve the condition.
This is an unfortunate disease, and it must be closely watched for
symptoms that may arise from a pus condition. There are many cases of this
kind in our public hospitals, and when they are due to gonorrhea they may
have been caused by the husband who had an acute or latent gonorrhea--an
attack he thought cured.