He at once applies a little tincture of iodine or carbolic acid diluted with glycerine or a solution of nitrate of silver to the cervical canal. The woman is now informed that this application must be repeated two or three times a week, for which she must call at the office that number of times every week, for an indefinite period. At each visit she is subjected to the same routine humbuggery for local medication, but does she get any better? In my early professional experience I innocently and ignorantly tried these methods myself, and I say no! But, as a matter of fact, this constant irritation and poking around and into the womb will inflame any healthy uterus, and much more one that is already slightly irritated, so that patients lose their hope and become convinced themselves that they are no better, but feel worse than when they first commenced treatment.
This inefficient treatment, like the examination, is conjectural and mechanical and therefore incomplete and unscientific. The cause of her entire trouble is never approached. The woman suffers for years from constipation, which also inclines her to piles, because the pressure of the hardened feces on the hemorrhoidal veins obstructs the flow of venous blood and the same pressure on the uterine veins congests the mucous membrane of that organ and gives rise to the symptoms of endometritis. All these conditions should be inquired into, and many others, before local treatment is decided on; simply running to the doctor’s office and having these medical applications made to the cervix or canal of the womb amount to nothing; this, as a general rule, does only harm, and is as superfluous as if one were to take a nasal douche of salt water or some other catarrh remedy, whenever he feels a little cold in the head.
The proper course to pursue in this and similar cases is to prescribe an appropriate diet, and regulate the bowels. It is precisely in this way that women who have made the rounds of the doctors, happen to take some patent laxative or nostrum that relieves their constipation, and accomplishes the wonderful cures of which we often hear and that were no doubt Godsends to the sufferers that were cured, after all the first-class doctors failed. By far the greatest proportion of cases of uterine catarrh are of a simple and transient nature and are only intensified by probing and local treatment.
When I first began the practice of medicine, I made the same mistake in following the advice of books and those who should have known better, for they have had ample opportunity to be convinced of the fallacy of these local measures in the great majority of cases, but some minds are incompetent to learn from experience, for that requires close observation, and logical reasoning.
I soon discovered that the catarrhal inflammations got worse, in proportion to the trouble and pains I took to treat them locally, so that I became ashamed of my ill success and abandoned the local treatment entirely, and this I shortly discovered was the means of curing them. Instead, I simply directed patients to rinse themselves with quite warm salt water, that is, a tablespoonful of ordinary cooking salt dissolved in a gallon of water. Now I prefer Femina antiseptic lotion to the same quantity of water, which has greater healing properties than either pulverized borax or common salt. I particularly advised them to keep their feet and lower extremities warm, regulating their diet and keeping their bowels open. I noticed that the patients began to improve, and that the improvement continued until they were fully restored to health and vigor. This method of treatment would not keep an office overcrowded with deluded patients, but it proved far more satisfactory to all concerned than meddlesome measures, and illustrated one of the most common abuses to which suffering women are liable.
In taking a laxative patients must feel their way as to the proper dose to take in their own individual case; constitutions differ very much in this respect, so that it is impossible to lay down one and the same rule for different persons. It is not good practice to give medicines three or four times a day in cases of habitual constipation, for it is liable to derange the digestion and interfere with the appetite. The proper method is one dose at bedtime and this should be increased or diminished until the suitable dose of the remedy has been ascertained; when this is accomplished, the dose of the remedy should be gradually lessened, a few drops every day, till it can be entirely dispensed with. If the ordinary dose fails to relieve the bowels, an additional treatment of glycerine enema at or about the time that the stool is to take place is to be employed. One or two teaspoonfuls of glycerine should be diluted with an equal quantity of water, and by means of a hard rubber piston syringe thrown into the rectum. The stimulating effect of glycerine on the nerves and mucous membrane, materially assists in relieving the torpor of the rectum, which has become insensitive to the irritation of its natural contents.
Patients who are costive must get into regular habits of relieving themselves, that is, have a regular hour every day when to go to stool, then the medicine will in time cure the most obstinate cases of constipation, otherwise it is impossible to cure it. It takes a constant amount of effort to get well, so that those who are too indolent or think it too troublesome to exert themselves, cannot hope to recover.
If there is great debility and impoverishment of the blood, then I would advise prescription No. 1, which are the iron pills, of which three pills should be taken three times a day. The moderate use of wine, either claret or Riesling, with the food, instead of tea or coffee, is very beneficial, between meals a glass of Porter to relieve the gone-in feeling, until the system has recovered sufficient strength to do without it, that is when ordinary exertions are no longer a burden.
The small percentage of cases that do not yield to the above treatment, become legitimate subjects for an honest specialist, for there may be extensive lacerations of the cervix that require surgical treatment, or an elongated cervix that should be amputated, or a granulated hypertrophied membrane of the uterine cavity that should be scraped out; all these operations are without danger if the operator has thoroughly mastered the details of antiseptic surgery and has the manual skill to do the work properly.