The treatment of chronic metritis has been, up to within a very recent period, anything but satisfactory in its results. This was owing to an inadequate knowledge of the real nature of the disease, which was marked by so many symptoms that were in themselves obscure and hard to separate as such, from the main affection.
This confusion of the true nature of the pathological process, resulted in a great many vague therapeutical resources, so that the treatment is even yet far from uniform and thorough. Many of the recognized resources laid down in the text-books, on diseases of women, are not only useless, but absolutely injurious, and, in order to save the reader time and money, I will make a brief mention of the most prominent of them.
Depletion, or the abstraction of blood in chronic metritis, effects no permanent benefit in the inflammatory process. I am convinced that, in the long run, the patients grow worse, because this treatment lowers the vitality and reduces the recuperative forces, which are so important, in the treatment of all chronic complaints.
Scarifications or puncturing the cervix with a sharp lance or pointed knife, will not sufficiently impress the morbid process, so as to stimulate it into a healthy action.
Some authors speak very highly of cauterizations and blisters upon the neck or lips of the womb; this I have repeatedly tried, and in not a single instance was it of the slightest use, but it aggravated the symptoms, and in one case it excited a severe, acute metritis that proved almost fatal.
Specialists, as a rule, fall into routine practice, and exercise neither originality or intelligence in practice, outside of the text-book on their shelf. They inject strong fluids or caustics into the cavity of the womb with a view of checking the inflammation in that manner. This treatment is dangerous and delusive. If the patient endures the treatment, she may be stimulated for a time with the idea that something very curative is being done, but my experience has been that the disease only becomes worse, because the womb is too delicate and sensitive an organ to improve under these repeated irritating assaults.
There is a home treatment for mild cases which I recommend to my patients, with satisfactory results. It consists principally of dissolving one teaspoonful of the Femina uterine lotion in a cupful of boiling hot water, after which this should be added to a gallon of warm water of a temperature of 105 degrees F.; these irrigations are to be taken every night, and if the water can be borne hotter the temperature may be gradually increased to 107 degrees F. A napkin should be worn and the bed warmed with a hot water bag before retiring. Ten to fifteen minutes later a Femina vaginal capsule is to be introduced high up into the vagina, by first quickly dipping the capsule into warm water.
In obstinate cases I have used electricity with the greatest success. This is administered by means of a broad dispersing electrode applied on the abdomen, and another electrode, covered with a sponge, is carried up the vagina, to the womb. In this manner I employ an intensity of sixty to one hundred and fifty milliampères, for ten to fifteen minutes. This is repeated several times a week, and from three to six weeks, and with other hygienic treatment the patient recovers.
When women are in moderate circumstances, and can spare neither time nor money to visit the office, for the length of time that is required for the electrical treatment, I follow the plan of the Berlin clinic, which originated in Vienna, with Prof. Carl Braun, and is strongly recommended and practiced by Dr. Martin, in Berlin. This consists in an amputation of the cervix, or, in other words, the abnormally elongated and enlarged uterus is trimmed down, and the diseased membrane is scraped out. While the cervix is recovering from the operation, there is also a diminution in the size of the body of the organ, and the chronic inflammation subsides with it. This operation is not dangerous to life, and in my experience I have as yet never had a bad symptom to interrupt the recovery. In obstinate cases, it is, perhaps, one of the most useful surgical measures that was ever devised, and we owe it to the genius of Professor Braun, that all obstinate cases of this nature are amenable to successful treatment.