ACUTE AND CHRONIC INFLAMMATION; UTERINE CATARRH.
THERE are two forms of disease which may be termed inflammation of the uterus. The first is the subacute form, or inflammation of the mucous lining membrane of the uterus alone. This is analogous to catarrhal inflammation of the vagina; and like that, may be either acute or chronic. The acute variety is distinguished by the names endometritis and blennorrhagia; while the from is more generally termed uterine catarrh.
The second variety of the inflammation of the uterus is the inflammation of the deeper tissues, or parenchyma of the organ, and is commonly called metritis. This may be acute, active inflammation, with more or less congestion, or it maybe chronic, with a lower but much more persistent grade of inflammation. In either form the cervix is usually the principal seat of the disease; and the final tendency of both acute and chronic inflammation of the deeper tissues of the womb is generally towards ulceration; as that of the corresponding inflammation of the mucous coat, is to blennorrhagia or uterine catarrh.
The three different conditions of female life, the virgin, the mother during the period of child-bearing, and subsequent to that period, are exposed in various degrees and from various causes, to these different forms of uterine inflammation. The catarrhal variety is the one to which the virgin uterus is most liable; but even this from is comparatively rare in such persons, especially while yet young. The various accidents and changes incident to the period of child-bearing, are promotive of inflammation of the substance of the womb. While the functional and constitutional disturbances which attend the cessation of the menses, may be considered about equally instrumental in promoting those forms of inflammation of the uterus which ultimate themselves in leucorrhoea, and those which tend to result in induration or in some general or special form of ulceration.
ENDOMETRITIS; BLENNORRHAGIA; ACUTE SUPERFICIAL METRITIS.
The acute from of inflammation of the mucous lining membrane of the uterus, thus variously named, is ushered in by some precursory symptoms indicating a general febrile condition, and by others which point to the coal development of the disorder. Thus we find general debility, headache, feverishness and even chilliness, followed by severe pains in the region, “very low down, as it is sometimes expressed, which often extend into the surrounding parts. In the more violent cases, the inflammation involves the vagina, and may even show evidences of its presence, in the swollen and sensitive condition of the mucous surfaces of the external parts. This is a true catarrhal inflammation, and the catarrhal discharge of uterine leucorrhoea may make its appearance in a very few days or even hours after the thirst onset of the precursory and inflammatory symptoms.
“At first the discharge is serous and bloody, but it soon becomes thick, yellowish, or greenish, ropy, fluid or purulent; after drying up, it leaves yellow or greenish stains on the linen and stiffens it as if it had been starched; afterwards the discharge becomes whiter, milky and mixed with transparent pieces of thick mucus. If this change of the discharge sets in, the inflammatory condition is almost entirely dispersed, which may take place at the end of thirty-six or forty days, or even sooner, when the discharge becomes chronic, or reappears again at the time of the menses, after sexual excesses, over-eating or drinking, or even without any apparent cause. As a general rule, the more acute the inflammation the thicker and darker the discharge. In uterine leucorrhoea the discharge has always an alkaline reaction, while vaginal secretions always react like acids. Examined by the microscope, the discharge looks homogeneous, thick, containing globules resembling those that float in pus or healthy mucus.
“As regards the course of this affection, we may distinguish four periods. The first sets in with a rather sight itching at the vulva, in the interior of the vagina and sometimes in the uterus, with a sense of heat in the uterus, pains in the small of the back, and in the back; increase of the sexual desire and frequent urging to urinate. In the second period, which may set in about the third or fourth day, a serous discharge takes place, which is at first scanty, but soon becomes more by profuse, assumes a greenish or yellowish, rather dark appearance and is accompanied with increased burning urination. In the third period, which generally commences about the ninth day, the inflammation becomes less intense, the discharge is still very copious, thickens, becomes more and more whitish and then decreases with diminution of flow of urine. In the fourth period, when the inclines to become chronic, the discharge disappears and reappears again, repeatedly and frequently without any known cause. Jarh.
As a already remarked under the head of vaginal leucorrhoea, some constitutions are much more predisposed to the catarrhal form of disease than others; that is, in some it will make its appearance under the influence of provoking causes, which in others would have no such effect. Thus all the influences, which may directly of indirectly lead to acute inflammation of and consequent catarrhal discharge from the mucous lining membrane of the womb, may be regarded as either predisposing or provoking. Many of these causes of either class, are identical with those which result in acute inflammation of the mucous lining membrane of the vagina. And indeed very many cases of this form of metritis are nothing more than the extension of the mucous inflammation from the vagina to the uterus. This is an extension of organic disease from below upwards, from the vagina to the uterus; there is also a very numerous class of cases of acute endometritis, which result from extension of organic functional disease from above downwards, as from the ovaries to the womb. This will be more fully explained in connection with the disorders of the ovaria and the consequent menstrual irregularities.
But as very many of these morbid influences are so gradually developed as to result in chronic mucous inflammation or uterine catarrh, without evincing any very noticeable acute symptoms, we reserve a more particular enumeration of the causes of inflammation of the mucous coat of the womb in general, till, in the succeeding section, we come to the consideration of the chronic variety.
In the diagnosis of acute endometritis or uterine blennorrhagia, care must be taken not to mistaken for this idiopathic disease, any morbid appearances or consequences resulting from menstrual engorgement or from accidental injuries or pressure. For although in either of these latter cases the irritation and consequent discharge may simulate a true blennorrhagia, still, as lacking the constitutional permanency of the latter disease, they will, in most cases, readily subside on the abatement of the immediate provoking cause. The discharge itself which results from the inflammation of the mucous surfaces of the cervix and fundus uteri, is easily distinguished by its alkaline reaction from the slightly acid secretion poured out by the vaginal membrane. But while in ordinary cases of uterine leucorrhoea, the cervix are found to be composed of the products of both vaginal and uterine mucous inflammation.
For the purpose of Homoeopathic treatment, the exact diagnosis between vaginal and uterine leucorrhoea i less essential; since the remedies are to the give in accordance with all the symptoms, both attendant and constitutional. And as we shall presently see, these latter, if they indicate the extension of the inflammation and consequent discharge throughout a smaller or a larger portions of the mucous surface of the generative apparatus, at the same time unerringly guide to the selection of the appropriate remedies. And thus it happens, that whether view we many adopt of the exact pathological condition of these interior organs be perfectly correct or not, if we but select the remedy which corresponds to all the symptoms, and especially to the subjective and sensational as prior and superior to the objective and structural, we shall most certainly witness the recovery of our patient. For physiology no more truly precedes pathology, than do the subjective symptoms precede the objective, and the sensational symptoms anticipate the structural disorganizations and even the functional derangements. And herein is involved the entire philosophy of the Homoeopathic treatment, and the secret of the Homoeopathic cure. For with such means as alone can do it, the axe is laid to the root of the evil, fons et origo mali, and instead of beating about the bush, and by rude instruments lopping off the branches that are ready to fall, in hope of arresting the progress of decay, we follow the clue given us by nature herself. Guided by these cries for help, we follow the physiological, sensational and vital indications, and acting as it were “under instructions” of the jaw of the similars, we are enabled to assist nature in her struggle; instead of weakening her by fighting, inspired by zeal without knowledge, the phantom of an imaginary disease. We recognize the impurity of the stream, this is pathology, or the result of disturbed physiological action. But to attempt to purify the fountain, that is to cure the real disorder itself, by correcting the impurities of the streams, is the futile method pursued by the chemical, the pathological and the Allopathic school, by all in fact who practice on the principle contraria contariis. In the Homoeopathic school, on the contrary, we week to assist nature, and under the guidance of the natural, viral and truly physiological law of the similars, we learn how to cleanse the streams be purifying the fountain; and in the Homoeopathic medicines we are furnished with only possible and efficient means for the only sufficient end, the complete restoration of health.
