Femina, A Work for Every Woman

by John A. Miller

As a result of the flexion, the circulation in the organ is interfered with, so that the congested uterus feels heavy, and there is a sensation of fullness and bearing down, that greatly hinders walking. Uterine catarrh and hyperæmia place the organ in such an irritable state that prolonged and excessive menstruation is the rule. This may last for fourteen days, so that the patients become anæmic and greatly debilitated from the excessive loss of blood. The menstruation is always more painful, especially at the beginning of the flow; this pain may be interrupted or spasmodic, so that it assumes the form of a uterine colic; the lower abdominal region becomes painful and the pain radiates towards the groins. The degree of suffering is very seldom as great as that which characterizes anteflexion, because the obstruction in the latter flexions are much greater than in retroflexions.

Those women who have borne children suffer less pain during menstruation than those who have never been pregnant. It may be presumed that, in the latter class, the flexion was congenital or acquired in early childhood, which makes the obstruction or constriction more complete and obstinate, and for that reason it induces sterility. With those who have once borne and afterwards acquired the flexion, the possibility of conception is much greater.

When the enlarged and swollen body of the uterus is pushed backwards and downwards, it presses on the sacral plexus of nerves; this is a bundle of nerves that supplies branches to the legs, and from this pressure the lower extremities become lame or paralyzed either on one or both sides. The paralysis subsides after the removal of the offending body. There is quite a number of other neurotic affections that can often be traced to a retroflected uterus. These are all of a functional nature, and appear in the form of hysteria, epilepsy, St. Vitus’ dance and neuralgias of almost any part of the body. Dr. Chrobak, of Vienna, reported a case of asthma that had resisted all the treatments that could be suggested, until it was finally traced to a retroflected uterus; that being rectified, the asthma subsided.

Irritability of the bladder is not so frequent a symptom of this variety of displacement as of others; should there be inflammation complicating the bladder, then, of course, there would be considerable annoyance from this source.

Habitual constipation is often very prominent and in some of the cases it is the only sign that leads to an examination, which reveals the retroflexion. Hemorrhoids or piles, due to a compression of the veins of the rectum, are another complication included in the signs of this displacement.

TREATMENT.

There is a small proportion of cases in which the system has become accustomed to the retroflected position of the womb, and if the abnormal condition is rectified, a great many painful symptoms spring into prominence, that are attributable to the interference. This is particularly the case in women who are in those years that we term “change of life,” and for this reason they should be let severely alone.

Excluding the above class of cases, the question arises in other cases whether the uterus can be replaced without violence, or whether it is fixed or grown to its surroundings by inflammatory adhesions. It is not always an easy matter to dispose of this question at once, because the enlarged and congested body is often so firmly wedged down between the posterior pelvic wall and the vagina, that any attempt to dislodge it is accompanied with such acute pain that one feels constrained to desist for a time. When there is great pain or sensitiveness, the patient should take to bed, so as to give the pelvic organs every chance to get rid of the inflammatory irritability. Hot-water compresses should be applied to the lower abdominal or pelvic region, and hot vaginal irrigations thrown into the vagina; these should be copious, no less than a gallon of water at once, at a temperature of 107 to 110° Fahr., repeated twice daily. The bowels should be kept loose, say several operations each day, for three or four days; after that once a day will be sufficient.

In the course of several weeks the congestion will have subsided, so that, in the great majority of cases, reposition can be readily accomplished. If the resistance of the womb still persists, then it is reasonable to infer that the organ is tied down by old inflammatory adhesions; these, then, should be treated with galvanism, after the manner described for removing adhesions in anteflexions.