Femina, A Work for Every Woman

by John A. Miller

Other causes are criminal abortion, complicated with blood poisoning from the unclean probes or instruments, that the abortionist has employed on previous operations without thoroughly cleansing and disinfecting them; the application of strong caustics to the cervix of the womb, as well as injections into the cavity of the uterus. Meddlesome doctoring by means of the unskillful and unnecessary use of instruments, like the probing of the womb without proper antiseptic precautions, or the scraping, stretching or operating on the womb without the essential antiseptic precautions which a scientific comprehension of the subject demands, has frequently caused this affection.

It occurs very often as a part of the general inflammation produced by the absorption of putrid or septic matter during the childbed period. This indicates a lack of cleanliness on the part of the attendants during confinement; inflammations of this nature constitute one of the types of puerperal or childbed fever.

The most prominent symptom is pain. This is greatly aggravated on the slightest pressure, or on moving or turning in bed. Upon a digital examination, the womb is found enlarged or swollen, and when the organ is tilted up on the examiner’s finger, there is a sharp lancinating pain radiating from it in all directions.

The first symptoms of pain are always accompanied with fever, and this may have been ushered in or alternated with a chill. The pain may be first felt rather deeply in the pelvis, and this is increased by a frequent desire to pass urine and a straining of the rectum. It may further become complicated with a looseness of the bowels, or an obstinate constipation. Nausea and vomiting is a frequent symptom during the course of the disease, and if the metritis is developed during menstruation, the flow may suddenly stop, but, on the other hand, the hemorrhage may become alarmingly profuse. Standing, walking, coughing and straining at stool excite the most excruciating pain, so that a recumbent quiet position is the only comfortable way for the patient to maintain herself, with the head as low as possible to insure the most easy recumbency.

The treatment for acute metritis depends somewhat on the cause in each individual case. There are, however, two indications that require to be met, and these are common to all inflammations, namely, to relieve the pain and check the inflammatory process.

The former is quickly relieved by introducing into the vagina a Femina vaginal capsule in the usual manner; repeating every six to eight hours, until the pain is sufficiently alleviated to occasion no suffering; then one capsule should be employed every night until cured or until restlessness requires that something must be done to calm the patient.

If the metritis is due to suppressed or checked menstruation from cold or exposure, then, and only then, are hot fomentations over the entire abdomen the most appropriate application, and if the patient is plethoric, I advise a half-dozen leeches to the inguinal region of one or both sides to be of unequaled value for checking the disease.

Until my experience and observation in German hospitals, I was in the habit of employing hot applications for all acute inflammations of the abdominal organs. These were either in the form of hot-water fomentations or flaxseed poultices. Hot applications undoubtedly give relief, but I doubt whether they ever cut short or abridge the inflammatory process in any case. I am inclined to believe that in a great many instances hot fomentations have the tendency to encourage suppuration, and that an abscess is often the result of their use. I have seen decidedly better results from cold applications, and the colder the better, so that I now employ them universally in all acute inflammations of the pelvic organs except in the noted exception in which the inflammation is due to a sudden check of the menses from exposure. As a preventive of inflammations, after delicate operations on the uterus, I apply the rubber ice bag with invariable success.

The most suitable rubber bag for this purpose is a size of six by twelve inches; it should be filled with broken pieces, and then securely tied. I prefer to envelop the bag in a thin layer of flannel, so as to take off the cold, clammy sensation which the rubber imparts to the skin. There should be two of these bags, in case of accidentally tearing one, and so that the reserved one may be in readiness when the other is removed. The cold does not only check and control the inflammation, but it also benumbs the nerves, so that it greatly relieves pain. I keep these ice bags applied over the region of the womb, until all the acute symptoms disappear. The vagina, however, should be irrigated with medium hot borax water, once a day, so as to remove any irritating discharge from the uterine cavity.