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Chronic Inflammation of the Womb.
Among the causes which predispose to this affection are various general conditions as well as certain local affections of the sexual organs ; among them may be mentioned, prolonged mental emotion ; excessive physical exertion ; imperfect nutrition ; prolonged nursing ; frequent confinements ; insufficient repose after delivery. These influences do not necessarily cause the disease, but simply by exhausting the strength or impairing the health of the patient prepare the way for an inflammation of the womb, if this organ be exposed to certain unnatural influences. Among these exciting' causes maybe mentioned, violent or excessive intercourse; attempts to prevent conception ; attempts at abortion ; injury to the womb during labor ; exposure during menstruation.
Symptoms. - The symptoms which may be induced by this condition vary with the cause as well as with the general condition of the patient. At times the inflammation may exist for a considerable period without giving rise to any notable impairment of function, and perhaps without attracting the woman's attention to her condition. One of the first symptoms usually manifested is pain in the back and dragging sensation in the loins and pelvis, increased by muscular effort and exercise. In an early stage of the affection there usually occurs a profuse glairy or white discharge ; this discharge is usually stringy, and by this characteristic may be usually distinguished from the leucorrhcea which occurs from disorders of the vagina. Not infrequently the discharge from an inflamed womb is streaked with blood, especially for two weeks after the completion of the menstrual flow. Sooner or later there occur inevitably derangements of the menstrual [function ; the discharge may be too abundant or too scanty, too frequent or too seldom ; but in nearly all cases menstruation is painful. The monthly discharge not infrequently contains clots ; sometimes a cast of the cavity of the womb may be expelled. Upon these symptoms there follows derangement of the sexual functions, intercourse being accompanied by pain ; this form of uterine inflammation may occur in women who have long ceased to menstruate, and is then usually indicated chiefly by the leucorrhcea. After the local affection has continued a certain time, the patient begins to manifest symptoms of constitutional affection.
There is marked loss of appetite and impairment of digestion, the results of which are soon manifest in her imperfect nutrition. She becomes nervous, irritable, even hysterical. One of the early and persistent signs is headache, located usually at the top of the head.
A not infrequent occurrence is the manifestation of many of the usual signs of pregnancy ; vomiting often occurs, darkening of the area around the nipples, enlargement and unusual sensations in the breasts. When to these are added, as is by no means seldom the case, a distension of the abdomen from the accumulation of gas in the intestines, and irregularity or suppression of the menses, it is not surprising that many women, even those who have been pregnant, should mistake the cause of the difficulty. In fact, however, pregnancy is less probable during the existence of this disease, since the inflamed condition of the womb renders this organ incapable of nourishing and retaining the ovum. Though pregnancy is rarely completed so long as the womb is inflamed, yet abortions during the early months are by no means uncommon. These may constitute, indeed, one of the symptoms of the disease. Cases are known in which repeated abortions or sterility were the first symptoms which drew attention to the existence of the inflammation.
Treatment.-The treatment of this affection must comprise two distinct objects. First and chiefly, the avoidance of those personal habits almost inseperable from our usual modes of living, and second, the application of remedies to the womb itself. If it be possible to accomplish the first of these aims, the second will be often unnecessary. The unfortunate feature in the case is that the causes which predispose to and favor the continuance of the disease are often so intimately associated with the woman's life as to make it impossible to remove them. It is absolutely necessary, though practically often impossible, that the patient should avoid hot rooms, long hours in bed and other violations of hygienic principles so commonly committed. Regular evacuations of the bowels and bladder must be secured, and sexual passion but rarely indulged.
This condition of the womb, with its accompaniments of ill health, is usually followed by dyspepsia, which in its turn aggravates the original difficulty, and requires treatment. In short, it may be accepted as a rule, that the disease of the womb will persist until the general health of the woman is improved by fresh air, good diet and proper exercise. Not less important is the avoidance of mental strain, emotional or otherwise. In most cases the end will be soonest attained by complete change of residence, air and social surroundings.
The local treatment - the applications to the womb itself- can be made by professional hands only. Yet benefit may be derived from the application of hot water to the genital organs ; this may be best accomplished by using a hip-bath of lukewarm water, containing a little borax, morning and night. If the leucorrhcea be profuse, injections of lukewarm water containing a little alum or borax may be employed three or four times a day ; in these cases the water should be, as already said, lukewarm, and not hot, as was directed for the treatment of acute inflammation of the womb. The improvement of the general health, though most rapidly and effectually accomplished by a change in the habits of life, can be materially hastened under other circumstances by the employment of certain tonics. Among others the following may be taken:
Sulphate of magnesia, - - One ounce.
Sulphate of iron, -. - Half a drachm.
Dilute sulphuric acid, - - One drachm.
Water, ___ Half a pint.
A tablespoonful of this may be taken in a glass of water every morning upon rising.
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