A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
There is probably no place where experience is of more value than in
the manipulations and instrumental measures necessary for the diagnosis
and treatment of the various diseases of the pelvic organs--where more
depends upon the skill and care of the operator. I believe, with
Duncan, that pelvic inflammation and abscess are always secondary, and
that these tissues are not specially inclined to idiopathic
inflammatory action. But, undoubtedly, certain low conditions of the
system or certain individual peculiarities furnish such a strong
predisposing influence that a mechanical cause otherwise inactive will
be sufficient in some of these cases to produce the disease. We
probably see this expressed most fully in the low types of puerperal
inflammations which develop gradually and without apparent cause, so
far as injury at labor is concerned, and which often persistently
progress to a fatal termination. It will be said that these are cases
of septic origin; and it may be true, but I believe the poison is
developed autogenetically.
COMPLICATIONS.--Parametritis is usually associated with perimetritis,
and it may be complicated by ovaritis, endometritis, and salpingitis.
Uterine displacement also often complicates this disease; and I wish
here to emphasize the statement that no attempt should be made at
restoring the organ to its normal position until all evidence of active
inflammation shall have subsided. I have seen great harm result from
such attempt having been made on the supposition that the symptoms were
due to the displacement rather than to the parametritis.
ANATOMY, PATHOLOGY, COURSE, AND TERMINATION.--Everywhere in the pelvis,
below the peritoneum, connective tissue is found in sufficient {211}
abundance to serve the purposes for which it exists--viz. first, as a
bond of union between the pelvic viscera and organs, bladder, uterus,
rectum, ovaries, and Fallopian tubes; second, to surround, support, and
protect the numerous blood-vessels, lymphatics, and nerves from injury
during the mechanical disturbances to which the pelvic tissues are
subjected in the performance of their various functions.
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