The cause of inflammation of the womb are similar in the acute and in the chronic form; and they are here enumerated in common, to avoid repetition. Among the most frequent causes, especially whose which influences unmarried females, may be ranked exposure to cold while menstruating, and consequent sudden suppression of the menstrual flow; and exposure to cold soon after the monthly period, when, although the menses have subsided, the womb still remains in highly congested and excessively sensitive condition. Great physical exertion, such as walking, during the monthly period, may result in inflammation of the womb; excessive or violent sexual intercourse; the use of cold water, or astringent or irritating injections; the extension of disease from the vagina or from the ovaries; wounds, violence, or mechanical injuries of any kind; foreign bodies in the uterus; polypi, tumors or other adventitious growths, may induce inflammations of different degrees of violence in different constitutions, and in the different conditions of female life.
Exposure to cold and taking cold soon after child-bearing are the most common causes of acute metritis; and the inflammation which results in such cases, especially if complicated with suppression of the lochial discharge, may prove rapidly fatal. This is a much more severe and dangerous complication than suppression of the menstrual flow, since it may lead directly to uterine phlebitis.
Still another form of exposure to cold, or rather the taking cold in another variety of cases, deserves especial mention here, both from the frequency of the occurrence of such cases and from the almost invariably fatal nature of their termination. These are cases, lamentably frequent in these times, in which what is called “an operation, as been performed in the early states of pregnancy, for the purpose of inducing abortion. Here the violence offered to the parts, aggravated by exposure and over- exertion in travelling, often unavoidable in such cases, not unfrequently brings on inflammation, whose approach is marked by very severe chills, accompanied by intense anguish, excessive tenderness of the abdomen, rapidly increasing prostration; and followed by death, sometimes in seventy-two hours. In such cases the inflammation of involves the serous coat of the womb, constituting a true peritoneal metritis of the most violent form and of a character very closely allied to traumatic erysipelas.
Such are the formidable dangers which attend this violation of the laws of God and man. In her hour of extreme peril, in the midst of the most intense physical suffering and distress of mind, and in the immediate prospect of eternity, the dismayed female confesses her own rime and reveals the name of person, often a practicing physician, but sometimes a male or female abortionist, who, undertaking to commit infanticide only, becomes involved in a double murder. For in the eye of the law, whoever engages in a criminal act becomes responsible for all the consequences of his undertaking, however little some of them may have been expected or desired.
There are men who assume the sacred profession of physician, not to save but to destroy life; who, in defiance of all human and of all divine law, strew their pathway, not with living flowers, but with the withered blossoms, the shattered wrecks and crushed remains of embryonic like-monsters in human form, fiendish ghouls, who devour little children; who live buy the slaughter of the innocents; and who qualify themselves for their future and eternal state, by this life-long destruction of such as are of the Kingdom of Heaven! The murderer of a single individual we execute or seclude for life; but before such a murderer by wholesale and by profession; before such a destroyer of entire generations, human justice stands appalled, and mournfully conscious of the utter insufficiency of all human means to arrest or to punish this gigantic social evil, sadly and sternly bids the unrepentant destroyer of “these little ones” full up the measure of his crimes, and await the dread summons of the Eternal Judge!
Symptoms.- The first symptoms which indicate the accession of acute inflammation of the womb, are similar to those of endometritis but more severe. Thus we find rigors followed by feverishness; heat in the pelvic region; deep-seated pain in the vaginal paroxysms of pains in the back, which dart through to the symphysis pubis and extend to the groins and even down the thighs. The constant pain is less severe; but aggravated by coughing; sneezing; and accompanied by sensation of bearing down; there is also usually a painful sense of weight in the pelvis. These are the most prominent symptoms where the cervix is principally affected.
But where the inflammation extends to the fundus, there is also pain in the hypogastric region, which is tender to the touch. In this case here often a complication of the inflammation of the substance of the womb, with that of its outer or peritoneal coat. The hypogastrium is excessively sensitive, the painfulness is greatly aggravated by the least movement or pressure upon parts; and the febrile condition is far more general and severe. The disorder extends by contiguity or sympathy, to the neighboring organs; and there is tenesmus of the rectum, difficult and painful micturition. The pains are of that sharp, lancinating character and aggravated by the least motion, which are so peculiar to inflammation of the serous tissues. The pulse is quick, full and hard; the skin hot and dry; the thirst may be extreme; the bowels constipated; the stomach irritable; the tongue dry and furred; and there is often a disposition to faint, especially on sitting up. Headache may also be present, with redness of the cheeks and flushing of the face; disposition to delirium; twitching of the tendons; and alarming collapse of the vital forces. This accession of what is called the typhoid condition, presents a formidable group of symptoms, which may appear in metritis occasioned by sudden and severe repression of the menstrual flux, with re-absorption, perhaps, of matters which should have been eliminated. In such cases the return of the menstrual flow indicates a favorable change in the condition of the patient. But the appearance of the menstrual flow, in inflammation of the uterus from other causes, whether complicated with peritonitis or not, is not regarded as a favorable sign.
The very great amount of nervous organization connected with the womb, and the intimate relation and profound sympathy of this organ with the great nervous centres, render inflammation of its substance a very grave disease. And the severe headache, vanishing of sight and even diminution of hearing, nausea, vomiting, excessive debility, fainting turns and other important constitutional symptoms which may appear in such cases, indicate the serious nature of the affection itself and the extent of its influence over the entire system. In the advanced stages of the more severe forms, we find tympanitis, hiccough, low delirium, coldness of the extremities and discharge of offensive sanies from the vagina. These symptoms, especially, if developed in spite of proper Homoeopathic treatment, indicate approaching dissolution.
The Termination, or Consequences. Acute metritis may terminate in resolution, or simple abatement of the symptoms; and this mode of termination is much often seen under Homoeopathic medication. The fever runs a rapid course, especially in its severer forms; and where its progress is not arrested by the appropriate treatment, it may destroy life in three days or even in two, or in cases of less intense severity it may prove fatal at the end of one week or more. In these continued uterine fevers, the consequences of the fever may destroy life after the original disease has subsided. Intermediate between the prompt recovery and the fatal termination of the case from the severity of the primary inflammation, are various forms of disease, which may be regarded as the consequences of the original disorder, and which may either destroy life, or establish themselves as varieties of chronic disease of the womb.
I. Hypertrophy either with or without induration we find, among the immediate consequences of acute inflammation. The hypertrophied womb usually attains to twice its natural size, or even more. This increase in size is of course accompanied with increased weight; this of course affects its position in the pelvis, and its relation with the other pelvis organs. This actual thickening of the substance of the walls of the uterus, most not be confounded with physometra, or uterine tympanitis.
A certain amount of induration usually appears in connection with hypertrophy of the womb. This is the common result of inflammation particularly of the cervix, and especially where this part of the uterus has been subjected to frequent inflammatory attacks. Induration is said to be simply the result of a bygone inflammation; but it is usually the consequent of such inflammatory action as is accompanied by hypertrophy or permanent thickening of the cervix, and so of these cases which assume the chronic form of metritis. This condition is very rare in the young and unmarried; but not uncommon after matrimony. Induration may be, as above stated, the simple result of repeated inflammation; or it may be the primary stage of scirrhous hardening and cancerous ulceration.
