Femina, A Work for Every Woman

by John A. Miller

During the menstrual period, the anteflected uterus becomes greatly congested and swollen, and, having already grown considerably larger from the chronic inflammatory conditions which the anteflexion has induced, it impinges on the bladder, so as to interfere with its free expansion. This occasions a frequent desire to void urine, and this becomes a very distressing symptom in a certain proportion of cases.

Treatment for this affection is not within the sphere of the original purpose of this work, for the efforts at home treatment must be aided by mechanical methods of the physician. From what we are taught of the physical cause of this affection, the fact seems self-evident that the acute or sharp flexion must be modified to give permanent relief. The employment of rings, pessaries, sponges or medical applications are nonsensical, and the method of introducing a stem in the uterine cavity, for the patient to wear for an indefinite length of time, is not without great danger. Even though a woman cannot give herself all the proper treatment, it must be a great satisfaction to her to be informed of the proper methods that should be adopted.

The vagina should be thoroughly rinsed before each and every treatment of the uterus, so as to guard against the possibility of infecting the cavity of the uterus.

If the manipulations that are required for the purpose of carrying out some of the mechanical or surgical treatments of uterine diseases, were always preceded with thorough cleanliness, which implies asepsis, or without putrescence, then all these operations would be shorn of their greatest danger, namely, that of exciting inflammation and suppuration.

If a probe of the usual curve can be readily introduced into the supposed anteflected uterine cavity, then there cannot be sufficient flexion to constitute an obstruction, hence the flexion is not the cause of the disease. In genuine anteflexion, the cervix and body of the uterus are doubled up on each other, often like the letter V, the cervix representing one line of the V, and the body the other; bi-mammal palpation in the hands of an expert clearly establishes this conformation.

When the diagnosis is established, the treatment should be as follows: The patient is inclined on a table, either on her back or side, a Sims’ speculum is introduced into the vagina and the cervix exposed. The posterior lip of the cervix is now seized by means of a tenaculum forceps, and gently drawn downwards and backwards, which greatly reduces or obliterates the angle or flexion between the cervix and the body of the womb, this greatly facilitates the introduction of a uterine electrode. After two or three treatments, the forceps are no longer required because the electrode can then be readily introduced into the uterine cavity without them. The other electrode is spread on the abdomen. (See this illustrated on Plate V.) A current of electricity is now passed through the uterine tissues for ten minutes; this is gauged all the way from sixty to one hundred milliampères. The operation is repeated only once a week, and the cure is effected in six weeks to three months. Great care must be exercised during the treatment, to avoid exposure and undue exercise.

Those forms that are due to inflammatory deposits and strands outside of the organ, should be preceded with an electrical treatment twice a week, somewhat modified from the preceding course. This is done by employing a vaginal electrode, properly protected and gently pressed against the adhesions. The other electrode is applied to the small of the back. A current some fifty milliampères stronger is passed directly through the adhesions; when these are absorbed, the intra-uterine electrode is employed, as in cases that are not complicated with them.

RETROVERSION OF THE UTERUS.

This consists in a posterior inclination of the uterus, so that the body of the womb approaches the posterior walls of the pelvis, while the cervix of the womb is raised against the base of the bladder.