Chronic inflammation of the womb (metritis) and its treatment / by Vincent Dickinson.

  • Dickinson, Vincent.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Chronic inflammation of the womb (metritis) and its treatment / by Vincent Dickinson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    are found both in the epithelium and connective tissue. When an opportunity for development is furnished by re- tained blood or serum the germs invade the tissues deeply, increasing with enormous rapidity. Boulangier has gone so far as to make a special class of endometritis for each special variety of microbe, as the gonococcus in blenorrhoea, the streptococcus after parturition and abortion, and the staphylococcus in other forms of pyo- genic infection, but it suffices to make two divisions : (i) gonorrhoea, due to infection with gonococci; (2) pyogenic, due to infection with other kinds of microbes. Histology.—The exact histology of chronic catarrhal en- dometritis is derived mainly from scrapings obtained after curetting. In the cervix it has already been alluded to, and in the uterus there is general hypertrophy of the mucous membrane and glands. It is said that in very chronic cases the epithelium becomes squamous and the mucous membrane resembles more a layer of connective tissue. Symptoms. — In addition to the subjective symptoms of pelvic and lumbar pain, there is a triads which taken together is said to be diagnostic of endometritis, namely leucorrhcea, haemorrhage, and dysmenorrhoea. Of these, the first is by far the most important and constant, and it must be borne in mind that, while in many cases the introduction of a speculum reveals clearly the presence of a secretion of very characteristic appearance, yet it is not always the case, and it becomes necessary to obtain other evidence of the existence of a purulent secretion from the interior of the uterus. The old method was to leave a tampon saturated with a 20 per cent, solution of glyceroleof tannin in the fundus vaginae for forty-eight hours, which, on removal, shows the presence of a characteristic muco-purulent secretion. Dr. Puech, of Montpellier, however, describes a more simple and more satisfactory procedure. When a spray of hot water is allowed to play upon the cervix through a speculum, it is observed to change colour; it becomes paler, owing to the production of a kind of local anaemia due to the con- traction of the uterine muscular tissue under the influence of