THE prevention of cervical laceration includes every hygienic and therapeutic measure which can possibly be needed during the entire period of gestation; hence, the whole Materia Medica is tributary to the obstetrician. Still it may not be amiss here to refer to several points most likely to present themselves in the usual run of cases.
I am, however trading upon new ground. Clinical experience in this direction is, as yet, so meagre that it offers no guide to therapeutic study. And added to this, is the lamentable truth that our Materia Medica is deficient in clear and well- characterized symptoms of the cervix uteri. Gynaecologists, instead of following Dunham’s advice to institute provings on females, have too frequently discarded Homoeopathy, and has resorted to local devices suggested in Allopathic works.
What I shall offer, then, will be chiefly suggestive to be accepted and tried, or to be rejected, according to the judgment of the reader.
My predecessor has presented a graphic description of the causes of cervical laceration, some of which may be met with therapy or mechanical device.
The professional care of the enceinte woman usually dates from her distressing morning sickness. It is now recognized that this symptom is often, if not always, an evidence of disease of the cervix, disturbed uterine vascularity, etc.
It constitutes an early evidence of disease which may lead to the accident we desire to prevent. We should, therefore, pay careful attention to this symptoms, and combat it with medicines, or in the event of their failure, with mechanical means. One of the most promising medicines for morning sickness, reflex from a hard tumefied cervix, is sepia.
The physiological softening of the lower uterine segment, which suddenly develops about the seventh month and progresses thence until full term, may be interfered with in various ways:
If by undue congestion: SEPIA, NUX VOM., Sulphur, Aloes, etc.
If by weak heart, which favors venous stasis, the cervix appears patulous, congested, even livid, or oedematous; Digitalis, Lachesis, Lycopus, Arsenic, Apis, Lilium Tig., puls., Gels, Naja, Elaps.
It has been determined that heart-diseases are regularly and progressively aggravated by successive pregnancies. Since, therefore, weak heart may permit uterine engorgement, why should we not treat the heart when diseased, both with a view to stay its tendency to grow worse during gestation and labor, and also with the view of counteracting its baneful effects upon uterine nutrition?
If softening is interfered with by swelling or induration of the cervix: Conium, CARBO ANIMALIS, SEPIA, Phytolacca Iod., kali Iodium Thuja, ArsenicumIodium, FerrumIodium CalcareaCarb., Nat.Carb., Aurum Mur., Aurum Mur., Natronat., Hydrastis, Alumen, Cantharis, Mitchella, Platina, ArgentumMet., Hydrocotyle, Kreosote, Nux Vom.
Years ago Dr.Lippe stated that on being engaged to take charge of a lady in labor, she remarked that the must certainly bring instruments, for they were always necessary and according to her former physician, always would be necessary, because she had an indurated cervix. Dr.Lippe gave the patient Sepia, and she was delivered in due time without instruments.
In many cases Carbo An. will doubtless suffice.
CONIUM is suggested when there are stinging pains.
PHYTOLACCA deserves a trial when the hardened neck is dark red.
KALI IOD. claims attention in syphilitic or in scrofulous cases with swollen and contracted neck.
ARUM (Preparations of Gold) particularly the Aurum Mur. Natronat., may be needed especially, when there is much vascular engorgement, with melancholy, weariness of life.
PLATINA is preferable when there are shooting pains.
ALUMEN is required when the cervix is swollen, painful and narrowed.
MITCHELLA answers for a dark-red sore and swollen cervix.
HYDROCOTYLE should not be neglected when there is unnatural redness of the cervix, hot and red vagina with pricking and itching at the vulva; scaly eruptions on the skin.
HYDRASTIS will undoubtedly assist if the cervix is red, shining, or engorged and ulcerated, with gluey or ropy mucous Leucorrhoea.
The Salts of Iron, since they notably disturb the circulation, and include the uterus in their sphere of action, may serve a purpose here too. Ferrum Iod, has been proved to affect the uterus, inducing prolapsus, bloating of the abdomen, deep-seated intra-pelvic soreness, and a confirmed symptom on sitting she feels, as if she was pushing something up into the vagina.
ARGENTUM MET. may possibly come into service if the cervix is corroded and spongy.