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is due to stenosis or anteflexion so quickly and surely as dilatation. If the fundus, upon examination, is found resting upon the bladder, it would be almost impossible to introduce a probe on account of the flexion. In such a case you gain two ends by rapid dilatation; first, you widen out the cervical canal and thus facilitate fecundation; and second, you will straighten the flexion and thus as a consequence overcome the obstruction to pregnancy. In numerous cases it will be discovered that the obstruction is of many years standing. Here the general disorganization in the lining membrane of the uterus, fallopian tubes and ovaries, resulting from the long continued hyperemia, renders fecundation doubtful, even after the removal of the cause. But by securing a channel which will give the menstrual fluid free flow, curing the cause of the dysmenorrhea there is every reason to expect that pregnancy will ensue as time and nature will rectify other conditions with the beneficent aid of the properly selected Homœopathic remedy.
In the use of intra-uterine medication dilatation is absolutely necessary, not only for proper and efficient treatment, but for intelligent examination and diagnosis. It is very necessary often to make a digital examination of the interior of the uterus, and the operation of rapid dilatation makes the effort of examination easy; especially is it so in comparison with dilatation by tents. And then, too, where there are strong suggestions on account of the menorrhagia and other symptoms of a foreign growth in the interior of the uterus, the operation of rapid dilatation gives us the means and a condition of things is created which makes it possible for a correct diagnosis. If a growth of
any kind be discovered, the laxity of the tissues of the cervix (especially if there has been continued menorrhagia) resulting from depletion, renders so easy the operation of dilatation that usually the cervix can be dilated and the substance or growth if present removed at the single operation. This fact, in comparison with the old and excessively tedious and often painful to an extreme, dilatation by tents, should be argument enough for rapid dilatation. As for its facilitating and making efficacious the use of intra-uterine applications, inspections, etc., the using of the curette, etc., rapid dilatation offers every advantage over any other means. Immediately after menstruation should be chosen as the time for operation, as the danger from hemorrhage is much less. The best aftertreatment is quiet, hot water injections and the indicated remedy.
CASES.-Out of thirty-two cases I have operated on by this method, I select but three from my note book; first, because this article is much longer than I first intended it; and second, because these are recent cases.
CASE I.-Mrs. F., aged 20 years, married two years, never pregnant. Some dysmenorrhea for several years before marriage, which increased to extreme severity after marriage. Health otherwise good. Came to me August, 1889. Examination revealed anteflexion and stenosis of cervical canal and external os. Operation-rapid dilatation and straightening of flexion. In order to more thoroughly complete the latter I withdrew the instrument and reintroduced it, and opened the blades opposite the flexion. At the next
CASE IL-Miss Kate G., aged 23. Came under my care September of this year. Has suffered so extremely for five years past from dysmenorrhea as to become nervous, irritable and mentally affected. As the case has had the best of Homoeopathic medication I refused absolutely to see it unless an examination is permitted. This is at last consented to. Examination in presence of married sister reveals the cervix very long, narrow and pointed, and the os externum so small that I can only introduce a fine probe. I found no flexion, but the fundus was much enlarged. Under the influence of chloroform I introduced the small and followed with the large dilator, the handles being very slowly brought together and kept there for fifteen minutes. The result showed that the uterus was shortened and there was an entire obliteration of the conical condition. She was kept in a recumbent position for five or six days and hot water injections used for three or four days. No medicine excepting Belladonna 30th for three days. She has since menstruated regularly and painlessly and is in perfect
CASE IIL-Is exceedingly interesting and rather peculiar; is a boom for Homoopathy here and is booming the writer also, as the lady is very prominent and does not hesitate to talk about her case to her lady friends. Modesty perhaps should
forbid my mentioning this case, and I should not do so if it were not for the fact that by reporting it in all its interesting detail some brother may thereby get a hint that may some day help him "out of the woods." Mrs. L., wife of the president and manager of one of our largest manufacturing interests, came to me by the advice of Mrs. Rev. Henry, wife of the rector of Grace Episcopal Church of this city, April 7, 1890. I copy from my note book, giving her own words:
"I have been married five years, am 26 years of age, commenced menstruating at fifteen; never had any trouble with my menses, came regularly and were neither scanty, too free nor in the least painful. As you see I am the perfect picture of physical health; weigh 184 pounds and do not have an ache or a pain excepting when I am unwell; then I suffer torments. The first month after marriage I suffered considerably, the second month intensely, the third month worse than ever, and the fourth month gave birth to a fully developed fetus which the doctor said was at least three months. My recovery was rappid; in sixty days I came unwell again suffering as much if not more than ever; again, when twenty-eight days had passed, notwithstanding, I was under the care of one of the best physicians in Brooklyn, N. Y., I suffered as bad as ever. Immediately following this monthly flow I had every reason to believe I was pregnant, I was nauseated continually, and no food of any description would remain on my stomach. And now comes the strange part of my experience. At the time for my regular monthly sickness I came unwell as before, when pregnant, and for sixty-two consecutive days I continued to flow, some of the time slightly, much of the time excessively;
every three or four days I would pass large clots. My physician had counsel twice, still the flow was not stopped. I be came so sick and emaciated that my friends became alarmed. Counsel was again called and to save my life an abortion was produced. My recovery was exceedingly slow, my menses did not return for nearly a year; and then it was the same old story. Now my health is perfect with the exception of this terrible suffering every month. Pain commences two or three days before the flow sets in; then clots commence to pass and the flow is very dark and offensive." This in brief is the history of this most interesting case, a case that presented a perfect picture for the Homœopathic remedy. She would not listen a moment to any suggestion that indicated medicine, and the examination at once revealed a condition of things that only surgical interference could correct. The uterus was found to be very much hypertrophied, the fundus retroverted and enlarged, but there was no flexion. The cervical canal, notwithstanding the frequent miscarriages, was very narrow, so much so that it was with difficulty I passed a small sound, there being a complete stoppage at the os internum. I fully expected to find a polypus, but upon freely and fully dilating the cervix, with the patient under chloroform, I found no growth of any description. It was at once clear to my mind that the menorrhagia was due to hypertrophy consequent upon the stenosis.
This patient during the following ten days received treatment as follows:
Aconitum 3d for three days, then Belladonna 30th. Hot water injections twice a day until all congestion and soreness had disappeared. Then impaction of os ex
Signa-Apply every two or three days, commencing five days before the menstrual period. I prescribed Cimicifuga rac. 60th. She suffered some pain at menstruation; the next month none, and up to the present time none. She has not become pregnant, is anxious to become so and believes she will go to full term all right. So do I.
In conclusion let me say that the operation of rapid uterine dilatation should not be resorted to recklessly.
More blunders have been made in Gynecological Surgery during the past ten years, than in any other field of practice. Physicians who have never made a special study of diseases of women and their surgical treatment, attempt operations and even make applications that are ruinous and often make permanent invalids of what were curable cases. Supports are placed where there is no displacement, anterversion is held to be a pathological condition and a pessary is at once used. The uterus of many a woman is cauterized when there is no ulceration, and that double-dyed abomination, the pessary is inserted that there may be a show of doing something. And then, too, hardly a day passes but that some Eminent Gynecologist denies the assertions and the operations of some other Eminent Gynecologist. How long has it been since Noeggrath of Wiesbaden, entirely disapproved the theory and practice of Emmett of New York, that in the laceration of the cervix was to be found the true solution of so many of the obscure female diseases, and
IN removing foreign bodies from the eye, it should never be done with a sharp pointed instrument. As irreparable damage may be done. If no blunt pointed instrument is at hand, a tooth-pick will answer the purpose and when the particle has been removed, in most cases, nothing more need be done. This is not the case, however, when the foreign body has become deeply imbeded in the cornea or conjunctiva, here much skill is required, and must be followed up by after treatment when the body is successfully expelled. It will be necessary to put the patient under an anesthetic, or at least to use Cocaine. The lids being held apart by a speculum. A broad needle must be passed under the conjunctive or cornea and behind the foreign body. Then by pressing the body in this way from behind and using external manipulation the object
In some cases of injury the iris is reached and there may be a prolapsus of it, here, the protruding part must be drawn out and cut off. However, if the iris protrudes into the cornea, and not externally, don't cut it off, but use internal treatment. If it should be necessary to draw it out Atropine should be given to dilate.
In injuries from burns, and great trouble may result from creitrieal tissue drawing the lid down, this may be prevented by using sweet oil, or vaseline on the scars and keeping it on the stretch.
Injuries from seeds, the Bicarbonate of Soda or Potash in a weak solution, should be used to neutralize. In some very severe cases it will be found necessary to remove the eye if lime should get into it. Do not apply water but apply sweet oil, or cream; if nothing else, milk would do, then the lime can be removed. The adhesions which will take place must be broken up and the bed surfaces must be kept apart, if possible, or the surface would grow together.
An English quack was recently brought before a police court for practicing without due qualification, who, in defending the use of the characters M. D. and F. R. S. after his name said they meant "Money Down" and "Fosterer of Real Science." The indi
vidual's genius, however, says a contemporary, did not save him, for he was fined twenty pounds, M. D. -Ex.
Texas Association, Fort Worth, May, 1891. ACUTE CONJUNCTIVAL DISEASES.
SOME GENERAL HINTS REGARDING THEIR TREAT
BY C. F. BRADEN, M. D., O. ET A. CHIR, SAN ANTONIO, TEXAS.
N no ills affecting mankind are the results attending the application of ice compresses more marked than in the acute forms of conjunctival diseases.
Taken in their earliest stages, application of cold readily controls the swelling that would naturally follow, and thus prevent what would otherwise become a serious feature of the disease. In the various forms of conjunctivitis, marked by intense circumcorneal chemois, there is danger threatening the cornea from a shutting off of its nutrition. The aim, then, of our treatment must be to allay
this chemosis and rescue the cornea from its danger. Cases that are not seen early may have so far advanced that the cornea has already suffered and, becoming opaque, evidences treatened suppuration. In such a case we are confronted with a perplexity hard to surmount. If ice be used we will do more harm than good, because its action reduces the sensibility of the part, depriving it of functional activity and lessening its nutrition, thus destroying, that, which it is our effort to mantain. In such
of Argentum nitric. locally are not advisable in cases where there is intense chemosis and should rarely be used until the swelling has been mitigated by cold
More can be done by the persistent application of cold, with strict cleanliness, removing the secretions at short intervals, than by energetic astringent solutions. Lately a new antiseptic, Pyoktanin, has been introduced and in ophthalmological practice has been followed with good results. It replaces any drug known, for local use, to cleanse the eye from infections secretions. It may be applied to strength varrying from 1-500 to 1-5000, 1 to 1000 being generally adopted in the various forms of conjunctivitis. With this remedy to secure a thorough cleansing of an eye, and the indicated remedy internally, with heat or cold as called for, we are prepared to combat various forms of ophthalmia, and our success will compare with that any our old school brethren may desire to place in competition.
For the SOUTHERN JOURNAL.
BY DEAN F. SMITH, M. D., NEW DECATUR, ALA.
cases heat would be indicated, as it stimu-VERILY some things die hard. In our
lates the nutrition; but it must be used with great caution, and should it manifest deleterious effects it is to be abandoned. With our Homœopathic therapy, however we have means by which such alarming conditions are in a great many cases controlled. The Calcarea hypophos. is the remedy when the cornea is endangered. Strong solutions
State the law puts the whole censorship of the medical profession in the hands of the Alabama State Medical Association. A few years ago, by a rule of that association, the physicians not of the Allopathic school were granted the right to practice medicine only as "irregular physicians."