Chapter 60

DISEASES OF THE FALLOPIAN TUBES.--These are named after their discoverer, Fallopian, an Italian anatomist. These tubes begin at the part of the body of the womb that extends out like a horn. This is on the sides near the top of the body of the womb. They are two in number and extend outward on each side for about four inches; each end forms a fringe or finger shape to catch the egg, as it emerges from the ovary. Through the center there is a tube or canal, and the inner lining of the womb continues on and lines this canal, the mucous membrane of the Fallopian tubes. When this lining or membrane becomes inflamed it is called Salpingitis or Inflammation of the Fallopian tubes. Salpingitis is derived from two words: Salping, meaning tube; ltis, meaning inflammation; Fallopian was the discoverer. Thus we have Salping(x)itis, or Inflammation of the Fallopian tubes. Unfortunately in medical description it is generally called Salpingitis.

SALPINGITIS. Inflammation of the Fallopian Tubes.--It may be either acute or chronic in character.

Condition.--The tissues of the tubes become swollen when the inflammation runs into the pus stage; the finger-shaped end (outer end) is usually closed by adhesions, the pus accumulates in the tube and we have pus in the tube, or what is technically called [pyo. (pus) Salpinx (tube)] Pyosalpinx. In long standing cases the pus is absorbed or degenerates into a thin watery fluid, forming watery fluid in the tube or [hydro (water) Salpinx (tube)]--hydrosalpinx.

The tube may become attached to neighboring organs. The pus or fluid may drain occasionally into the womb and vagina. It may go into the bladder or bowels.

Causes.--It is usually caused by invading germs from the womb. Gonorrhea is the cause of the most cases.

Symptom.--This disease follows the same kind of an infection in the womb and vagina; the patient complains of pain in the region of the tube, a little to the side or sides of the womb, and the pain is made worse by motion, exercise or long standing. If it is the acute variety, the temperature rises, the pulse grows faster, and sometimes there is nausea and vomiting.

[WOMAN'S DEPARTMENT 503]

The Symptoms of the Chronic Variety are due to congestion and adhesions. There is a constant pain in the region of the tube and the patient protects herself when she walks, rides or sits down. There are difficult, painful monthly periods and too much flow. The history shows gonorrhea or septic infection, that is, disease caused by the absorption of products of putrefaction.

Treatment of the Acute Kind.--First thing is absolute rest and quiet in bed. Then prolonged hot injections in the vagina of hot water, and if you wish, one teaspoonful of listerine, etc., in each injection. Put a hot-water bag to the sore side, or fomentations of different remedies, like hops, catnip, pennyroyal, smart-weed. The applications should not be of great weight. The bowels should be kept open.

For Chronic Variety.--This frequently calls for an operation. When the symptoms are due to inflammation in the tube alone, ten per cent strength of ichthyol and glycerin tampons placed behind the lower part of the womb three times a week do much to improve the condition.

This is an unfortunate disease, and it must be closely watched for symptoms that may arise from a pus condition. There are many cases of this kind in our public hospitals, and when they are due to gonorrhea they may have been caused by the husband who had an acute or latent gonorrhea--an attack he thought cured.

DISEASES OF THE OVARY.

Inflammation of the Ovary or Ovaritis.--This is an inflammation of the ovary and it may be either acute or chronic.

In the acute form the ovary is slightly enlarged and the follicles on the circumference are distended and filled with thick fluid or pus.

In the chronic variety the ovary may be small and contain cysts; there is a destruction of the follicles and a hardened condition develops. The function of the ovary is then impaired.

Causes.--Gonorrhea, septic infection from adjacent tissues, acute fever diseases, mumps, and peritonitis. Falling (prolapse) often gives rise to chronic inflammation.

Symptoms.--Pain in the lower abdomen (pelvis), difficult and painful menstruation, too much monthly flow (menorrhagia), and painful intercourse.

Treatment.--Ichthyol (ten percent) and glycerin tampons placed behind the lower back part of the womb three times a week. The bowels should be kept open with salts. The diet should be milk or liquid. Sometimes an operation is necessary. In the department on operations this subject will be touched upon in regard to operations.

PHYSICIANS' TREATMENT.--Change of the mode of life, and proper hygienic measures will generally be all that is needed.

[504 MOTHERS' REMEDIES]

TUMORS OF THE OVARY.--Cystoma is the most common tumor of the ovary. The word "cystoma" means a cyst tumor, or cystic tumor. A cyst means a cavity containing fluid and surrounded by a covering (capsule). Ovarian cyst or tumors is often seen in print these days. Ovarian tumor takes in the cystic variety, cancer and sarcoma, two malignant tumors.

Symptoms.--These depend upon the size of the tumors. The large tumors are generally cystic. Examination of the vagina shows the pelvis filled by a tense, watery, fluctuating mass. Examining the abdomen, the abdomen is seen more or less distended by a regular swelling, and sometimes this is enormous. The abdomen is rounded and there is no bulging at the sides like there is in ascites (dropsy). The navel is not prominent. The tumor can be outlined. It cannot be in ascites.

Treatment.--In bygone years tapping was done for these tumors. If it gets large or the health fails, an operation should be performed. This is very successful in uncomplicated cases. Inside of two months the patient is about well. I know I have saved many lives of women by recommending an operation for such tumors.

For the congested ovary, treatment by tampons and medicine often helps. I have frequently given a medicine called Apis-Mel for this condition and with success. I give it in tablets of 1/100 of a grain regularly four times a day.

MENSTRUATION AND ITS DISORDERS.--Normal menstruation occurs monthly in the female. There is a flow of blood from the cavity of the womb. The time for its beginning is different in different countries, it being earlier in warm climates, ten to twelve years, and later in cold ones (fifteen to seventeen years); the average is fourteen years.

Pregnancy suspends menstruation and often nursing the child does, also. Menstruation continues longer in robust, healthy women. Change of life (Menopause) occurs usually between forty and fifty years. The healthy girl and woman comes around every twenty-eight to thirty days. This is the usual time. The flow lasts from two to eight days and the quantity is about one ounce each day. A slight feeling of weight and fullness in the lower abdomen (pelvis) should be the only symptom present in a healthy female. The blood lost should not cause any special degree of weakness.

PREMATURE MENSTRUATION. Too early menstruation.--Premature or precocious menstruation is when it occurs before puberty. This is in part hereditary, but bad associations may be a cause of this early menstruation.

Treatment.--The cause, if possible, should be removed. The nerves should be kept quiet by rest and, if needed, general tonics like iron, arsenic, and nux vomica prescribed and given.

[WOMAN'S DEPARTMENT 505]

DELAYED MENSTRUATION.--This is often caused by slow development of the generative organs. The girl may not come around until seventeenth to nineteenth year.

Causes.--It may be due to heredity. Lack of proper nourishment and proper exercise are the most important causative factors.

MOTHERS' REMEDIES.--l. Obstruction of Monthly Flow.--An herb combination for.

Poplar Bark 2 ounces Ginger 1/2 ounces Bayberry 1 ounce Cinnamon 1/2 ounce Anise Seed 1/2 ounce Golden Seal 1/4 ounce

Mix well and give a teaspoonful in a cup of boiling water sweetened with sugar two or three times a day. Excellent in obstructions of the monthly periods, debility, loss of appetite, etc. This combination is fine when used as a tonic. It is stimulating and has been known to cure many severe cases.

2. To Promote the Menses, Smartweed for.--"Smartweed is good to promote the menses. Always steep in cold water; never boil. Dose.--Two teaspoonsful every hour. Be sure to take warm."

VICARIOUS MENSTRUATION (In place of).--When menstruation is absent or suppressed, bleeding sometimes occurs periodically, from the ear, nose, any existing raw surface, leg, ulcer, and from the respiratory (breathing) tract, and also from the bowels.

AMENORRHEA.--This is absence of menstruation.

Causes.--Delayed puberty, anemia (want of proper blood) chlorosis (green sickness). diabetes, malaria, tuberculosis and acute illness may cause it. Sometimes change of climate causes it and nursing baby too long.

Symptoms.--If it is associated with atresia, that is, want of the normal outlet, of course no signs of flowing can show, but colicky, cramp-like, monthly pains appear in the lower abdomen. These increase in severity as the retained blood distends the womb.

Treatment.--If there is no opening for the vagina or cervix one must be made, by operation. If it is due to anemia or chlorosis, Blaud's pills will benefit. The following is the formula:

Dried Sulphate of Iron 2 drams Carbonate of Potash 2 drams Syrup--Sufficient quantity to make forty-eight pills.

Take one to three pills three times a day, after meals.

MENORRHAGIA.--Too much bleeding at the monthly periods. If it occurs between the monthly periods it is called Metrorrhagia, womb-bleeding at any time, especially between the periods.

Causes.--These may be constitutional or local, the latter being the most important.

Local Causes.--These are inflammation of the womb, displacements of the womb, malignant disease of the womb, fibroid tumors and disease of the ovaries.

[506 MOTHERS' REMEDIES]

Symptoms.--Sudden or gradual increase in the amount of blood lost at the monthly periods. Then secondary anemia, weakness and run-down feeling.

PHYSICIANS' TREATMENT. 1. Profuse Menstruation, an Easily Prepared Herb Remedy for.--

"Cranesbill Root 1 ounce White Poplar Bark 2 ounces Bistort Root 1 ounce Golden Seal 1 ounce Geranium 1/2 ounce Cloves 1/2 ounce Ginger 1/2 ounce Ground Sugar 1/2 pound

Mix. This compound is excellent for complaints of weak females, such as leucorrhea, bearing-down, or profuse menstruation, etc. Dose: One teaspoonful of the powder, in a half cup of boiling water three times a day. Drink the clear liquid only." Any woman suffering with, female trouble will find the above combination very beneficial.

2. In young girls and women who are not married, thirty drops of the fluid extract of Ergot three times a day. This medicine will cause the womb to contract. Hot douches can be given to married women. If the bleeding is severe it may be necessary to pack the vagina with sterile gauze. Ergotin ten to twenty drops, may be needed, given hypodermically. If it is due to constitutional causes, like anemia, a played-out feeling, paleness. weakness, etc., a tonic treatment is needed.

3. Blaud's pills will do well. This is the formula:

Dried sulphate of iron 2 drams Carbonate of potash 2 drams Syrup enough to make a mass

Mix and make forty-eight pills. Take one to three, three times a day after meals.

4. If the appetite is poor, bitter tonics such as gentian, quassia, cinchona, or nux vomica are needed.

Compound Tincture Cinchona 2 ounces Compound Tincture Gentian 2 ounces

Mix. Take one teaspoonful before meals, in a little water.

5. Tincture of nux vomica in doses of two to three drops after meals is a good stomach and bowel tonic.

6. Golden seal root made into a tea is good in some cases, especially if the tongue is much coated.

7. Oil of Erigeron or flea-bane is good for oozing bleeding. Dose: Three to five drops in a capsule every four hours.

8. Oil of cinnamon in one dose of one-half dram is good where flea-bane oil cannot be used or obtained; usual dose, one to five drops. An infusion can be made of the cinnamon bark and drank freely.

[WOMAN'S DEPARTMENT 507]

9. Cranesbill (Geranium maculata). The fluid extract is splendid when diluted three or four times with boiled water, used locally for bleeding from the womb, or as an injection for the same; or an infusion can be made of the plant and injected into the vagina. The local cause mentioned should be treated. The displacement should be corrected.

DYSMENORRHEA or Difficult Menstruation.--This term means difficult and painful monthly periods. The pain may occur before, during or after the periods.

Causes.--It may be caused by a narrow cervical canal, the canal from the inner womb to the vagina. This is often very narrow and almost closed. Again it is produced by the womb being turned back and bent on the canal, thus partially closing it. This causes the blood to be retained in the womb and then the womb contracts to expel the blood, pains being the natural result. Diseases of the womb and ovaries also cause it. Sometimes the membrane of the womb is cast off in the form of shreds or even a cast of the inner womb.

Symptoms.--The flow may be scanty, moderate or profuse, often clotted. The pain varies. It may be slight before the flow, or the first day or two, or it may be severe, agonizing and continuous for one or two days, or during the whole period and sometimes for some days after there may be pains.

MOTHERS' REMEDIES. 1. Painful Menstruation, a Good Tonic for.--"This may be relieved by sitting over the steam of a strong decoction of tansy, wormwood, and yarrow, and fomenting the abdomen with the same. Then take the following in wineglassful doses:--One ounce each of ground pine, southern wood, tansy, catnip and germander, simmering in two quarts of water down to three pints and pour boiling hot on one ounce of pennyroyal herb, strain when cold and take as per dose above."

2. Painful Menstruation, a Home Remedy for.--"Let the patient take an active cathartic; then when put to bed let a half cup of hop tea be given; and a douche of one quart of hot water into which ten drops of laudanum have been dropped, be injected." A cathartic is not necessary in all cases. If the bowels have been moving freely do not take one. The douche will give great relief providing the woman can take one while menstruating. Some women can and some cannot.

[508 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT.--If the womb is displaced it should be corrected. Any disease of the womb or ovaries should be treated. If the canal is too much closed, gradual and careful dilation between the periods, will often remove this cause in time. The bowels should be kept regular at all times.

1. For the attack.--Never take opium or alcohol for it in any form; it is so easy to form the habit and a doctor who gives it is simply dodging effective general and local treatment between the periods. If it is due to taking cold, or from any local cause, the following treatment is good: The patient should take a hot sitz bath, being well covered by a blanket, while in the tub and afterwards, and should immediately get into bed as soon as the buttocks are dried and remain there well covered. A turpentine stupe is now to be used, prepared as follows: Place a tin cup containing the turpentine in a vessel containing hot water. This will keep the turpentine warm. Dip a piece of flannel into very hot water and wring it out in a twisted towel, and after it is perfectly dry and no dripping, dip it into the hot turpentine and wring it out again to free it from too much of the drug. Apply the cloth while hot and allow it to remain until it causes discomfort. Then withdraw it or it will blister the skin if left on too long. Fomentations wrung out of teas like hop, pennyroyal, smart-weed, etc., applied and kept warm often do much good. At the same time pennyroyal tea can be drank freely. A five-cent package can be bought at any drug store. Hot lemonade will help also. The object is to produce relaxation of the tissues through the local applications and tea drinking. If there is constipation, the bowels should be moved freely with epsom salts, half ounce dose, in the morning before breakfast. If there is much pain a belladonna suppository, one-half grain of the extract, can be inserted into the rectum.

2. If the patient's nervous system is run down the "Rest Cure" will be of benefit, and medicines to strengthen the nerves. Exercise, outdoor life, horseback riding are of great benefit in toning the system.

3. Fluid extract of blue cohosh is a good medicine in this disease, especially if there is some rheumatism during the interval. One or two drops every hour will be enough.

4. Tincture of Pulsatilla in doses of three drops every hour is good for the pain, especially in blonde girls and women.

5. Tincture of Cocculus I have found to be of great benefit. Put five drops of a good pure tincture into a glass half full of water and give two teaspoonfuls every ten to fifteen minutes until relieved. This I give in cases I am called to and have not the time then to find out what the real cause may be.

DISPLACEMENTS.--Turning back or retro-displacements. This includes retro- version and retro-flexion. Retro-version means turning back, in plain terms. Retro-flexion means bending back, bending of the body of the womb, or the neck, backward. Retro-flexion is more common than retro-version.

Causes.--Some are congenital, that is, from birth, and a few are the result of some injury, falls or blows. It is more often found in child-bearing women, and this may be due to the fact that the womb has not returned to its normal size and weight, and therefore there is more weight for the ligaments to hold up. The ligaments often relax and do not support the womb as thoroughly as before.

Symptoms.--Backache, a sense of weight in the lower abdomen, difficult menstruation, leucorrhea, sterility, or repeated abortion and constipation. The constipation is often due to the womb lying on the rectum.

[WOMAN'S DEPARTMENT 509]

Treatment.--This is to replace the womb and keep it in position. Supports of various kinds are used to keep the womb in position after it has been replaced, They must fit thoroughly and give no pain or any discomfort whatever. They are called supports or pessaries. If they are fitted properly they do much good. They should be removed often (every month) and not allowed to grow fast or cause sores in the vagina. There are the ring support and the stem variety and others. The stem variety can be taken out and replaced by wearer at any time. They are made to buckle around the abdomen. They are bungling but effective. The ring kind should be introduced by a competent person who should see that it is of correct size and shape, and worn with comfort. Sometimes these supports fail to cure when adhesions and other diseases exist; it may be impossible to wear them.

Operations.--One operation is to break up the adhesions, the body of the womb brought forward and sewn (sutured) to the abdominal wall. Another operation is to shorten the round ligaments in the inguinal (groin) canal. These are the usual operations, and they are quite successful.

FALLING OR PROLAPSE OF THE WOMB.--The womb may come down and remain in the vagina (incomplete falling). When the womb escapes at the vulva it is called a complete falling (prolapse or procidentia).

For the Incomplete Kind.--Replace the womb and wear a support for months.

For the Complete Falling.--Replace the womb. The patient should remain in bed with daily, hot, prolonged vaginal injections of water for a few weeks. The injection daily of white oak bark tea, of the strength of one ounce of the bark to a pint of hot water, is often of great benefit.

If these measures fail to cure, an operation may be necessary.

MOTHERS' REMEDIES. 1. Falling of the Womb. Unicorn Root for.--"Make a strong tea of unicorn root, and take a half teaspoonful three times a day, This is an excellent remedy for falling of the womb," This is very easily prepared and not bad to take, and in addition to this use an injection of witch-hazel or golden seal.

2. Falling of the Womb, a Fine Herb Combination for.--"Peach leaves, mullein leaves and hops made into a tea, and a pint used twice a day as an injection often cures when other remedies fail." We all know that this combination of herbs is healing and especially in female trouble. The hops, especially, are very soothing to the affected parts.

3. Falling of the Womb, a Physician's. Treatment.--"Knee-chest position. Get down on the knees and put chest and chin to the floor. Retain this position about three minutes several times a day." This is a splendid thing to do, and is recommended by all physicians.

[510 MOTHERS' REMEDIES]

4. Falling of the Womb, a Never Failing Remedy for.--"Ague root (Aletris Farinosa) is a valuable agent to prevent tendency to miscarriage and falling of the womb. It is especially useful for the purpose of restoring the activity of the generative organs giving them vigor and healthy action. Dose of the tincture is from six to ten drops three times a day and of the powdered root five to eight grains." This is an old tried remedy, and is frequently used by physicians alone or in combination with other remedies.

5. Falling of the Womb, White Oak Bark for.--"A mild infusion of white oak bark, or of alum or tannin, used in quantities of a pint, as a douche, will often give immediate relief."

LEUCORRHEA. (The Whites).--This is an over-secretion from the glands that pour out their contents into the vagina or the cervical canal of the womb.

Causes.--It is dependent upon many causes. Tear of the neck of the womb (cervix), displacements, inflammation of the womb and vagina, a run-down condition of the system from any cause. The character of the discharge varies.

From a Torn Cervix, the discharge is thick and mucus-like in character.

In Inflammation of the Canal of the Cervix.--A thick mucus discharge also comes from this trouble.

Inflammation of the Body of the Womb.--The discharge is thin and watery. If the Inflammation is Caused by Gonorrhea the discharge would partake of the pus-like variety.

Symptoms.--Local: is of course mainly the discharge or the irritation often produced by it, especially if it is thin. It then irritates the parts. The patient will be run down. It will be hard to do anything, frequently the patient is very nervous and irritable.

MOTHERS' REMEDIES. 1. Leucorrhea, Slippery Elm for.--"The immediate cause of leucorrhea is either congestion or inflammation of the mucous membrane of the vagina or womb, or both. It is not a disease, but a symptom of some vaginal or uterine disorder; hence, general or specific tonics may be needed but appropriate injection as auxiliary treatment will very much assist in cure. The patient should bathe frequently and freely expose herself to the sunshine, and have good ventilation in the house. If the vaginal passage is very tender and irritable, an infusion, or tea, of slippery elm bark is very soothing and may be used freely with a vaginal syringe. Whatever injection is employed, should be preceded by the free use of castile soap and warm water to thoroughly cleanse the parts." Always lie down after an injection.

[WOMAN'S DEPARTMENT 511]