Femina, A Work for Every Woman

by John A. Miller

There is only one sure method of cure that proved in my hands a success, and that consists in the entire removal of the diseased mucous surface.

Dr. Düvelius of Berlin made the discovery and demonstrated the fact that the mucous glands of the uterus project into the muscular tissue of the organ, and that if the diseased mucous membrane is removed or scraped off, down to the muscular layer, a healthy membrane is regenerated from the terminal glandular ends that remain imbedded in the muscular tissue. This seems to have been proved by experience, for I have performed this operation in several obstinate cases of uterine catarrh, and in several instances the woman became subsequently pregnant, which proves at least that the regenerated mucous membrane is capable of performing its physiological function, as though it never had been interfered with. With proper antiseptic precautions and in skillful hands, there is absolutely no danger in this operation, but the technique should be thoroughly understood by the operator.

The etiology or causation of uterine catarrh resolves itself into predisposing and exciting causes. Predispositions are defined as that constitution or condition of the body which disposes it to the action of disease under the application of an exciting cause. Persons who possess a thoroughly healthy constitution may be exposed to exciting causes without the slightest danger of contracting diseases, to which others who are predisposed fall victims. The predisposing causes of endometritis are a naturally enfeebled constitution; the existence of a scrofulous or tuberculous habit; impoverishment of the blood from chlorosis; prolonged mental depression; improper and insufficient food; prolonged lactation; frequent parturition under unfavorable surroundings; any indiscretion after delivery which interferes with the regeneration of the womb; styles of dress that depress the uterus; want of fresh air and wholesome exercise.

Professor T. G. Thomas, in his work on Diseases of Women, asks the question why most of these influences should produce this affection more than others. His answer is that “they do not do so.” “Sometimes they cause chronic pneumonia; at other times granular lids, and again at other times chronic endometritis.”

The exciting causes laid down by the same eminent authority are “displacement of the womb; excessive or intemperate coition; the use of intra-uterine pessaries; puerperal endometritis; exposure or fatigue after confinement; efforts at production of abortion and prevention of conception; vaginitis either simple or due to gonorrhœal infection; painful obstructive menstruation; exposure during menstruation; sudden checking of the menstrual flow; and tumors in the uterine cavity or walls.” Some of the causes here enumerated are much more fruitful of the disease than others. A woman whose constitution has been weakened, and whose digestion is deranged, by habits of indolence and luxury, whose style of dress so depresses the abdominal viscera that her uterus is pressed down into the vagina, is particularly liable to develop a catarrhal inflammation from connubial approaches. When these are not without pain, then there is some predisposition that should be inquired into and righted.

Uncleanliness is not spoken of by authorities as among the causes of uterine catarrh, yet it is a very frequent one. I have succeeded in curing so many catarrhal affections of the vagina and uterus by simply advising the use of vaginal irrigations with borated warm water, that I am convinced that a lack of personal cleanliness is a very prolific cause of this affection. The accessible generative organs, both of the female and male, should be the object of thorough rinsings so as to reduce the possibility of infection to the least degree. All mucous membranes have their natural secretions, and these are on light provocations abnormally increased. The vagina is always the seat of more or less bacterial fermentation or decomposition, and if this is retained for any length of time, it becomes not only putrid and offensive, but also a direct source of infection to the mucous membrane of the womb. This is more so in a married woman, who is exposed to the carelessness of her male consort, who has not been apprised of the dangers of septic infection, that may be innocently communicated to the wife by negligence of his own person. The wife is exposed to all and every impurity that the male has on his person, and thus she is in constant danger of having her internal organs infected, from the outer organs of the male.

There is no doubt that many women become infected from this source, and that obscure and stubborn catarrhs of the vagina and womb are strictly traceable to personal uncleanliness of the male. From the researches of Dr. Noeggerath of New York, it would seem that in a great many cases of pelvic diseases in women, the affections can be traced to a latent gonorrhœa in the male. This phrase means a gonorrhœa in the male apparently cured, which even two years after the supposed cure infects a healthy vagina, causing a discharge and a complication of the uterine mucous membrane. I have seen some cases that fully corroborate the views of Noeggerath, so that before we put the blame of uterine disease solely on the shoulders of the wife, let us find out how much the husband is to blame.

Specialists in particular, but doctors in general, often forget that a woman has other organs besides a womb and ovaries; there is a relation of cause and effect between valvular lesions of the heart or diseases of the lungs, that obstruct the return of the venous systemic circulation to the right cavity of the heart, and catarrhal diseases of the pelvic organs.

Biliousness or an affection of the liver, that interferes with the portal circulation, or the pressure of tumors or swellings on the uterine veins, are also among the causes, while the accumulation of feces or habitual constipation is often overlooked as too trivial to deserve professional notice, and yet its removal is often the only successful means to cure the patient.

The various eruptive and infectious diseases, like smallpox, scarlatina, measles or typhoid fever, may excite in their course a uterine catarrh, that will remain behind as a chronic complaint, after the acute affection has subsided.