Femina, A Work for Every Woman

by John A. Miller

ANTEVERSION OF THE UTERUS.

In anteversion the uterus has so far changed its normal shape that the cervix of the organ is stretched out or extended in a line with the axis of the body. This occurs when the uterus is unusually swollen from inflammatory enlargement. The normal location of the body does not materially change in these cases. It is a little more depressed on the fundus of the bladder and the cervix is correspondingly elevated, so that the latter stands considerably higher than in health. If the bladder is empty, and the patient bears down or does anything that increases the intra-abdominal pressure, the body of the womb is forced down, upon the anterior vaginal wall, which prolapses into the vagina, while the cervix is raised, so as to point upwards and backwards. When the bladder is full, the body of the uterus is naturally raised, and the cervix correspondingly depressed. And this is attributable to a rigidity or stiffness about the organ, that is characteristic of a chronic inflammatory enlargement of the uterus. Sometimes the organ is permanently fixed by inflammatory adhesions, that lessen or prohibit these movements.

The symptoms of anteversion are what may be expected from an enlarged congested organ. This enlargement is due either to a subinvolution of the uterus or to an inflammation of the intermuscular substance, a chronic metritis. One of the most annoying symptoms of the anteverted uterus is the feeling of looseness in the pelvic cavity. This is partly due to the relaxed state of the surrounding tissue, and partly to the abnormal size of the womb. The patient feels the organ roll from side to side, as she changes her position. This causes unnatural sensations and mental suffering that disturbs the nervous system and induces hysterical complications. And the patient complains about something moving in her abdomen.

The inflammatory adhesions that sometimes tie down the organ in an anteverted position, compromise the normal expansion of the bladder; this induces an irritation, which causes a frequent desire to urinate.

The treatment must be directed to the removal of the cause. This disease is really only a symptom or condition of chronic corporeal metritis or subinvolution, and as such, it is only amenable to the measures that will cure this disease. The employment of rings and pessaries to remedy this evil is contrary to good sense and of no permanent value.

The intelligent employment of electricity, so as to stimulate the absorption of the hypertrophic enlargement of the uterus and cause the absorption of the inflammatory adhesions, will often give permanent and positive results.

ANTEFLEXION OF THE UTERUS.

This was considered at one time the most frequent of all uterine displacements, not because it existed formerly oftener than at present, but because the natural or normal position of the womb was confounded with that which was supposed to be abnormal.

The discovery that in the living subject the body of the uterus naturally inclines forward, so as to rest on the bladder, and that the body makes quite an angle with its cervix, altered the conception of things very materially. To-day an actual aggravated anteflexion, that occasions no impediment to the menstrual discharge, is not a proper ground for treatment, although this is as yet by no means familiar to physicians in general, for many of them have not learned to make the distinction.

The reader should carefully study Plate II, which diagramatically illustrates how the body bows over the bladder so as to show its natural anteflexion. If the angle between the body and neck of the womb becomes too sharp or acute, so that the canal of the uterus becomes compressed at the point of flexion, in a degree that obstructs the escape of the natural secretions of the uterine cavity, then the anteflexion becomes a source of disease. This degree of flexion is happily very rare, and we find it in about equal proportions due to a congenital defect, that springs into prominence when the girl arrives at puberty, for then the obstruction to the menstrual flow is first realized.