Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

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    these cases; but as the disease is one not of the general but only of the pelvic peritoneum, and as the rectum is only involved in one small portion, it is desirable to keep the pelvic organs from becoming congested: it has been the author's practice to give a saline cathartic, like the hospital white mixture, every morning; with a dose of calomel gr. j or ij in pill from time to time : an action of the bowels daily is desirable, otherwise the hard scybalse which collect m the rectum give rise to great pain and discomfort with increase of fever by pressure in the neighbourhood of the inflamed surfaces. A glycerine or simple water enema will usually succeed, and if carefully given should produce no local disturbance. (?) Operative Treatment.—If pus is thought to be present, aspiration should be performed to verify the diagnosis, and an opening into the purulent collection by the vagina or by the abdomen, and drainage, must be resorted to, tbe after-treatment pursued being as in similar surgical cases: if a serous collection only exists, aspiration will be sufficient. As to opening the abdomen during acute peritonitis, much difference of opinion exists, but if there is a distinct cause discovered, such as rupture of a Fallopian pregnancy, bursting of a pyosalpinx, whether after labour or not, or if there is sufficient indication of septic fluid being present in the peritoneum, opening of the abdomen, antiseptic washing out and subsequent drainage of the peritoneal cavity is a justifiable, and indeed a proper, course to adopt. (B) Chronic Peritonitis.—The adhesions in these cases rarely become entirely absorbed, hence there is permanent interference with the circulation and displacements of the uterus and ovaries have frequently to be dealt with. Continual pain, worse on walking or during menstruation, are the chief indications for treatment, which may be divided, into: 1. Means for absorption of the adhesions; 2. Operative. 1. Application of lin. iodi and lin. belladonna? over the abdomen regularly every night; hot vaginal douches at iio°-i2o° F. night and morning; and painting the vaginal fornices every three or four days with lin. iodi through a speculum, are all useful remedies. As the majority of these cases are in a low state of health and the circulation languid, anything which will improve these conditions will tend to cure the patient; tonics and abdominal massage are therefore of the greatest use. Electricity has not been found of much value. These measures must be continued over a long series of weeks or months, and a visit made to Kreuz- nach or Schwalbach before resort is made to : 2. Operative measures. Opening the abdomen and freeing the uterus, ovaries and tubes from their adhesions, is often followed