Femina, A Work for Every Woman

by John A. Miller

Preventive measures of circumscribed or local peritonitis are to be found in avoiding the causes that have been referred to as inducing the affection under consideration, among which, criminal abortions are the most fruitful. It seems to me that if women were cognizant of the dangers that threaten them, they would not only be more careful in observing the ordinary rules of health, but they would voluntarily shrink from committing crimes that not only stain their souls with the blood of their own kindred, but also entail disease and death, that unexpectedly waft their spirits into the presence of their Creator, whose laws they have outraged. How often have I been told by women who lay prostrated on their death bed, “O doctor, I did not know that the induction of an abortion was a crime and dangerous, because the person who performed the operation told me that it was neither dangerous nor criminal.” Alas! poor woman, there is no greater crime, and nothing more pernicious to your health and life; would that others would only learn and profit from the inexorable fate into which your delusions enticed you.

TREATMENT.

The treatment in this affection, when prompt and intelligently administered, offers every chance of success. In the acute stage of pelvic peritonitis, we must resort to remedies that promptly counteract the inflammatory action. The internal administration of opium or some morphine preparation is invariably demanded, not only to relieve the pain, but also to completely check or constipate the bowels, so that their peristaltic action is entirely suspended, for their motion would irritate the peritoneum. Dr. McMunn’s elixir of opium in one-half to one teaspoonful doses should be given every four hours, until the pain is relieved and the bowels controlled.

Rubber ice bags should be applied to the lower abdominal region. This course of treatment will generally limit and check the inflammatory process in a few days; then the bowels should be gently moved every day, with an enema of warm water impregnated with a little soap; after which, complete quietude in bed for another week or two, will complete the cure.

Chronic perimetritis must be treated according to its complications; should there be a gonorrhœal infection, then what was said of the treatment of this complaint elsewhere, applies with equal force to these cases. The patient’s strength must now be an object of jealous solicitude. The diet must be of the most nourishing nature, and milk or egg punch should be the principal food, at regular intervals of four hours, alternating with strong soups or beef teas, to which a raw egg thoroughly beaten should first be added.

Vaginal and uterine catarrhs, if they exist, require the attention that is recommended in the preceding pages.

Warm compresses or fomentations and daily hot sitz baths are of great value in chronic perimetritis, for they stimulate the healing process and the absorption. The bowels must now be daily moved, and here I prefer the patient to employ simply warm water enema in tolerably large quantities slowly injected, until a quart or more of the fluid has been thrown into the rectum; these enemas will not only move the bowels, but also stimulate the healing process. If the patient lies on the left side while these injections are taken or given, the enema flows higher up, and it should be retained for a reasonable length of time. These enemas should only be taken every other day, and between days a suitable dose of purgative elixir. Tincture of iodine can be applied to the groins every second day, or iodoform suppositories introduced into the vagina. Mud baths are also very beneficial in removing old inflammatory adhesions.

If the exudation suppurates and an abscess forms, it should be freely opened as soon as possible. This can generally be best accomplished through the vagina, but if there be a tendency of the abscess to point towards the groin, then this situation would be preferable, although I prefer, in even these cases, to make a counter opening in the vagina, for this precludes the possibility of the abscess sacking or burrowing further into the tissue. The cavity of the abscess should be thoroughly rinsed out with a 2 per cent carbolic acid or a 1 to 2,000 corrosive sublimate solution, and if there is a tendency in the abscess to close before its cavity is healed out, a rubber drainage tube should be inserted, so as to give the pus all the possible facility to escape. If the abscess breaks into the bladder or into the rectum, then a counter opening into the vagina will greatly insure and expedite recovery.

Sometimes the ovaries and tubes become diseased as a result of the perimetritic inflammation; this, then, becomes a subject of special inquiry and treatment. It should hardly be necessary to remind the reader that sexual relations are to be suspended while there is the least sign of the affection to be discerned. Although old adhesions and displacements, the result of old chronic pelvic peritonitis, are often naturally and permanently removed through a supervening pregnancy, the intelligent use of the galvanic current will also accomplish that end.