Uterus, diseases of the. First must be recalled the structure of this organic part which is found only in the feminine sex; it is attached to the bones of the pelvis, placed between the bladder and the rectum; its thickness is about an inch and a half; its length between its opening and its fundus is about three inches, and its interior cavity would barely hold an almond. It is difficult to insert a probe into the cervix, which dilates so much during childbirth.

In pregnant women not only does the size of the uterus increase to contain the fetus and the after birth, but even its sides thicken, and the blood vessels lengthen and swell. Its spongy tissue also engorges with blood, and where the placenta attaches, the openings widen and previously transparent blood vessels redden. The cervix is kept closed during the term of a pregnancy but during childbirth or miscarriage the cervix becomes softer and wider. In the space of sixteen days after childbirth the cervix regains its normal size.

Diseases of the uterus connect 1st to the nearby organs, such as the vagina, the fallopian tubes, and the ovaries, but especially to those of the uterus under discussion here: 2nd they refer to diseases of function, of menstruation, of pregnancy, of miscarriage, of childbirth, of discharge, all of which are usually set under different headings.

As to maladies of the uterus proper, they relate 1st to the contents of the cavity; 2nd to the cervix; 3rd to its position; 4th to its shape; 5th to afflictions of external cause; 6th to those of tissue; 7th to increase in size; 8th to shrinking in size; 9th to its performance; 10th finally to discharge.

I. In the cavity of the uterus 1st are contained its various humors; 2nd menstrual blood or any discharge which is retained by the closing of the cervix, by the slowing of evacuation where congested blood begins to putrefy, or by poor quality, can cause a great number of symptoms which can only be relieved by opening the cervix which may be tight, and by modifying the interior part. 3rd foreign bodies inserted in the womb are covered by a crust of calculus. 4th things which form in the womb such as clots which must be removed by dilation of the cervix and use of instruments. But 5th, a sarcoma occupying the uterine cavity may not be pulled out through the cervix, and since it is not possible to pare it away either, one must attempt to prevent growth by an exterior bandage and by applying antiseptics.

II. If during menstruation, childbirth, or evacuation of discharge, the cervix is closed or narrowed by inflammation, a tumor or by a cervical spasm, and is then incapable of passing the humors, one should try to induce flow by topical and internal medicines. But if there is a growth and the cervix is closed by a membrane, there results an incurable sterility and cessation of periods. If on the other hand the uterus is continually open (confirmed by the insertion of a finger) there result a white, lumpy discharge, an immoderate flow of menses, and frequent miscarriage conditions which require cleansing practices, and applications of balsamic and astringent lotions.

III. The uterus never swells in women who are not pregnant, but in pregnant women the swollen womb separates the mesentery and the intestines; it can go directly above the pubic bone or it can go to one side or the other, or sometimes press on the pubic bone, unless this can be prevented by postural manipulation or by the prudent hand of the midwife or by some sort of strapping. When the uterus is low and compresses nerves, arteries or the iliac veins, this causes numbness, varicose veins or swelling of the feet. Compression of the rectum or of the bladder results in difficulty at stool or upon urination, but these problems dissipate upon changing position and after delivery. One can prevent swollen feet and varicose veins with external strapping.

If at the time of delivery the cervix comes down too far it can cause difficult labor, only to be remedied by pushing it back up smartly by hand and by placing the woman in labor at a steeper incline.

Sometimes in women who are not pregnant the uterus prolapses as result of a white, lumpy discharge, excessive menstrual flow, childbirth, and frequent miscarriage. The uterus also prolapses after a great shock, after a very violent cough or after vomiting, tenesmus or upon lifting a heavy weight. One finds in these cases the cervix surrounded by a great swelling which must be immediately be put back in place. But if the prolapse of the womb is chronic one must above all clean it up, and after replacing it in its normal position, it must be kept there by some means of strapping, and the patient herself put to bed. The lower part of this organ then must be modified and tightened by strengthening bands. Sometimes the womb tips over during a difficult labor, producing an expulsion of the placenta. If the growth is surrounded by a tough ring of tissue it must be removed without delay. When it is chronic it needs the same treatment as the prolapsed uterus lest it should necrotize and the patient die.

IV. Sometimes the shape of the womb can deformed by a hernia on one side, or by some external compression or by scar tissue. These problems can be treated by the removal of the compressing agent and by suitable strapping.

V. Injury of the uterus in pregnant women can presage miscarriage and death. Bruising of the uterus occurs almost only in pregnant women. In women who are very overweight, compression of this organ can cause infertility, but there are times when an external growth may push the womb aside or deform its shape. In these cases the remedy is to remove the agent of compression.

There are no examples of rupture of the womb in non-pregnant women, but in those who are pregnant, if the fetus ruptures the womb by a violent movement and drops into the lower abdomen, only the cutting of this part will save the mother and child. Such an incident can be prevented by artificial support or strapping. Too frequently, tearing of this organ can be attributed to the midwife's improper handling of the womb or the placenta. Treatment may be achieved by lavages of balsamic medicine or a poultice on the belly accompanied by strapping.

VI. Too great a loosening of the uterus , following usually from frequent delivery or miscarriage, or from morbid humors retained in the cavity, or from excessive menstrual flow, discharge or white lumpy discharge, produces infertility. If this loosening occurs at the cervix and during delivery, it causes inversion of the uterus .

In this last case difficult labor results and the retention of the placenta, a feeling of heaviness, and frequent uterine hemorrhages. To prevent these problems and treat them, it is necessary to place bands on the belly and light strapping. Inflexibility of the cervix in women delivering their first child and in older women is a sign of a difficult delivery, which one relieves with softening ointments and unguents. When this inflexibility is a result of a spasm, antispasmodics are indicated. But real hardening of the cervix and thickness, ascertained by touch, are untreatable. Too wet, too soft, too cold a womb than usual brings on a great quantity of humors and false periods which often result in infertility. Treatment requires hot bands applied to the belly and light strapping. I do not recommend an air cure because it is too dangerous.

Great and continuing dryness of the uterus , where the origin is an inflammation or erysipelas, indicates the same remedies as these problems. When the womb at this level of dryness has prolapsed it is appropriate before returning it to its natural position to moisten it with emollients, humectants and whatever is not too oily. If this organ is too hot as a result of inflammation or erysipelas, or some bitter or bilious humor, it does not need a particular treatment; in the case of a light affliction it requires a cooling treatment, internal as well as external. If too cold because of a slowing down of activity, it causes a less abundant menstrual flow which is also paler in color. It thus often even happens that women become subject to discharges and miscarriages. As a treatment, there is recourse to warming agents and bandages. Any weakening in contraction of the uterus stemming from lack of vitality requires the usual curative methods with the use of uterine stimulants.

Pain which is felt in the uterus , however it comes about, is accompanied by attacks of anxiety, and often sympathetically the bladder and the lower abdomen are affected. Treatment should pay attention to the cause. If it is not possible to make the pain go away, it is appropriate to use uterine analgesics. The weight of the womb produced by retention of humors and accompanied by a tumor requires the evacuation of the agents which cause the swelling. But if the is pain is not accompanied by swelling, but by a slowing down of the contraction of the womb, then it should be treated as a weakness of this organ.

VII. The uterus which owes its swelling to pregnancy is a natural state. But a swelling which is caused by air formed by the breaking down of material contained in the uterus must be removed by dilating the cervix, and antiseptics should be prescribed to prevent recurrence of the problem. The lymphatic material collected in the uterine cavity is discharged in the same way by applying strapping to the lower abdomen; any swelling caused by blood contained in blood vessels after the cessation of periods or discharge is more difficult to treat. If a putrid fever ensues it must be treated by use of ointments and strapping the belly. Any swelling resulting from dropsy or edema, apart from strapping and the use of settling agents, requires internal diuretics and stimulants.

If the inflammation causes swelling, the patient complains of burning and dryness or pain and discomfort in the lower abdomen and the perineum. Sometimes the patient experiences painful urination, pain in the hips and groin, vomiting, suffocating, colic and other sympathetic ailments. The cure for this condition is no different from that of other inflammations. Erysipelas of the womb is difficult to distinguish from inflammation. It just happens that the heat of the organ is greater, the urine infected and pulse more rapid. When these diseases begin to degenerate into abscess or suppuration, the pus must be drawn by dilating the cervix and treating the ulcer as a purulent sac. Necrosis of the womb can be determined by unexplained cessation of pain, by a feeble and thready pulse, by a cold sweat, a cadaverous face, and the flowing of fetid and bloodstained humor. This is a problem without remedy. Fibroids and cancer of the uterus grow slowly especially in older women. They produce a sensation of weight in the lower abdomen which seems to roll from side to side with movement. Often the nipples are flaccid and fibrous. On the whole depending on their size these growths cause a great number of irregular symptoms. If one assesses this cruel state in the womb one must immediately prescribe resins and solvents to the uterine area to soften it. Tubercles, sarcomas, warts, condylomas of the cervix are known and are treated like diseases of the vagina.

VIII. A womb that is eaten up by disease and removed in part, or the natural absence of this organ necessarily causes infertility. The shrinking of this organ in old women and before puberty is normal. The ulceration of the uterus , whatever the cause, may be palpated which causes pain. It is accompanied by a putrid fever, a flow of pus, bloodstained discharge, blood, and of thick and fetid urine. Care is the same as for a fistula or a purulent sac.

Infection of the uterus produces cruel suffering in the genital area, pain in the groin, in the hips and at the top of the head, torpor, cold in the extremities, languor, anxiety, vomiting, cold sweats, death. A palliative treatment requires frequent antiseptic lavages, and interiorly all remedies which retard the progress of infection. There remains the ulceration of the uterus , or irreducible scar tissue which impedes enlargement of the uterus necessary for pregnancy. Infertility or miscarriage is the result.

If the contraction of the uterus is too feeble then menstrual blood and discharge usually collect in its blood vessels. This lack of strength impedes the ability to expel the fetus effectively during false or actual labor. One may supplement this weakness by uterine measures which pinpoint this organ. If the orifices of the vessels of the uterus lack flexibility, they produce excessive flow of periods, discharge and white, lumpy discharge. This condition requires uterine binding, along with suitable bandages.

Spasm, the spastic convulsion of the uterus , either in the fundus or the cervix, stops the monthly flow and discharge and causes either miscarriage or a difficult delivery: different problems but which require the same uterine remedies, both antispasmodics and painkillers.

In general, any sickness of the uterus has through the lymph system an effect on the entire body. Because of the position of this organ and its connection to other body parts and its common origin of nerves, veins and arteries, stem all the phenomena attendant upon uterine problems: constipation, tenesmus, difficulty of urination, ischuria, pathological hunger, aversion, nausea, vomiting, sensation of heaviness in the abdomen, labored breathing, suffocation, head ache, pain in the groin, swelling in the groin, loss of sensation and other symptomatic ills which vanish upon the recovery of the patient or which diminish for a while by means of painkillers, uterine and nervous treatments.

As far as excessive discharge is concerned or excessive periods or lack of periods, see Periods and Discharges. Loss of blood in pregnant women usually signifies false labor which can only be prevented by prolonged bed rest, refreshments and bandages to moderately compress the vessels which are close to opening up.