Femina, A Work for Every Woman

by John A. Miller

This is an inflammation of the entire substance of the womb, which, like all inflammatory processes, is acute or chronic.

Inflammation does not always affect the whole body of the womb, but it is quite oftener limited to one or the other layer or membrane that enters into its architectural whole. Then, again, there is the anatomical division of the organ into a body or corpus, and a neck or cervix; of these either one may be affected, without the other, so that inflammation of the cervix should be the subject of a separate inquiry.

Most of the diseases of the womb are due to inflammation. This was the opinion of J. H. Bennett, of London, as long ago as 1845, in which year the first edition of his work on “Inflammation of the Uterus” was published. Up to that time, the subject had never been practically pursued to the same logical conclusions, so that the opinions of the leading professional minds were far from unanimous on this question. But the vigor and energy with which the young author defended his views, forced attention and conviction upon the greater part of the profession, in this country and Europe.

He started out with a view to prove: “1. That inflammation is the primum mobile in uterine affections, and that from it follow, as results, displacements, ulcerations and affections of the appendages. 2. That menstrual troubles and leucorrhœa are merely symptoms of this morbid state. 3. That in the vast majority of cases, inflammatory action will be found to confine itself to the cervical canal and not to affect the cavity of the body.”

Since the appearance of the first edition of Dr. Bennett’s work, which is now forty-six years ago, there have been many careful and clever observers in this field of pathology, but there is yet to appear a successful contradiction of the truth of his inflammatory doctrine. Twenty-six years after Dr. Bennett wrote the above book, he read a paper before the British Medical Association on the same subject, in which there is no modification of his first conclusions on the importance of inflammatory lesions. He says: “1. Uterine displacements are by many too much studied per se (by themselves) independently of the inflammatory diseases that complicate and often occasion them. 2. That the examinations made to ascertain the existence of inflammatory complications are often not made with sufficient care and minuteness, as evidenced by the fact that I constantly see in practice cases in which inflammatory processes have been entirely neglected, and the secondary displacements alone treated. 3. That inflammatory lesions are often the principal cause of the uterine displacements through the enlargement and increased weight of the womb, or a portion of its tissues, which they occasion. 4. That when such inflammatory conditions exist, as a rule they should be treated and cured and then time given to nature to absorb morbid enlargements before mechanical and surgical measures are resorted to.”

If these propositions could be engrossed and a copy sent to every doctor in the land, as a safe and sure guide in his treatment of diseases of women, it would prove a great boon to the suffering women of this country. One of the notorious abuses of the profession, is the penchant for the employment of mechanical means, either by means of instruments or the surgeon’s knife. Women are wantonly subjected to painful and tedious treatments which in many cases only aggravate their original suffering, while a few simple rules of hygienic treatment would not only restore them to health and vigor, but would save them the privation of paying fees to incompetent, unscrupulous or avaricious doctors, who have only one ambition, that is, to get the patient’s money. I have known an instance where this barbarous course under the guise of scientific treatment, broke up the home of a once happy and prosperous couple, and finally when the resources were so low that the expense incident to housekeeping and a nurse could no longer be defrayed, the household effects were disposed of, and, as a last resort, the overdoctored woman was taken to a hospital, where her last hopes were lulled into an artificial sleep, while the surgeons performed an operation from which her depleted body and squandered vitality could never recover. She died.

I am convinced from observations in large female clinics in Berlin, and from my own studies in the pathological laboratory while a student abroad, that Dr. Bennett’s conclusions are corroborated by actual facts. The freedom with which dangerous operations are undertaken for comparatively trivial complaints is degenerating into a license that is criminal and which in some cases is nothing less than murder. In the absence of a high moral sentiment which should control the profession, but does not, the State must step in and say who shall practice medicine and surgery, and by limiting competition, the evil propensity to make the most of one’s opportunities will not be elevated into a fine art, and men, although unscrupulous, may be at least indifferent honest.

Acute metritis comes on suddenly, and this occurs quite often during the menstrual period. Women as a rule are altogether too careless during menstruation; they seem to forget that at this time the womb is congested and swollen, and that if the natural flow of the blood is interfered with, this congestion will turn into an inflammation. Exposure to cold, or getting the feet damp, or inordinate exercise that overheats the system, will bring this about. Sometimes there may be a tumor or swelling in the womb which occludes the cervical canal, so that the menstrual fluid cannot escape; this will also cause inflammation. A stricture of the cervical canal, occasioned by the womb being flexed, will interfere with the egress of the menstrual flow, and this also may give rise to inflammation. Vaginal injections either too hot or too cold, and particularly immediately after copulation, when the pelvic organs are still in a high state of congestion, is quite liable to excite metritis. Gonorrhœal infection is another source of inflammation, but this is invariably preceded by an endometritis, which I will consider separately.

Large, ill-fitting pessaries worn in the vagina for a supposed retroflected or prolapsed uterus, or a stem pessary, are fruitful causes of metritis.