A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The character of the typical discharge from the body of the uterus is
usually obscured by admixture with discharge from the cervical mucous
membrane. Cervical catarrh, or inflammation of the cervical mucous
membrane, may, and usually does, occur alone, without involvement
of the upper endometrium, but chronic corporeal endometritis is
usually associated with inflammation of the cervix. If the discharge
is observed at the vulva, it will be still further altered by
admixture with the vaginal secretion. The discharge from the corporeal
endometrium is thinner and more serous than the mucus of the cervical
canal, and is more usually purulent and streaked with blood.
The discharge from the endometrium is very often increased very
decidedly immediately before and after the menstrual period.
Pain is a general symptom of chronic endometritis. The pain is uterine
in character, and is referred to the lower abdomen and the back. There
is also very constantly present reflex headache localized on the top of
the head or in the occiput.
The pain may be present at all times, but it is usually most marked
when the woman is upon her feet and the pelvic congestion is increased.
The pain is always greatest immediately before and during the menstrual
period.
General physical weakness and debility are often very pronounced, and
seem to be out of proportion to the extent of the local disease. This
same phenomenon has been spoken of in the consideration of uterine
displacements. The weak and aching back, the dragging sensations in the
pelvis, the tired legs, may all appear after the woman has been upon
her feet but a short time, and utterly incapacitate her for any kind of
labor.
Nervousness, neurasthenia, hysteria, and mental depression and
melancholia are apt to occur in this disease. Such nervous phenomena
are common to all diseases of the uterus. The mental depression is
often very marked, and is exaggerated before and during each menstrual
period.
The woman with chronic endometritis is usually sterile; or if she
becomes pregnant, abortion will probably occur. The discharges in
the uterine cavity are inimical to the spermatozoa, and the diseased
endometrium furnishes an inefficient place for the attachment of the
ovum.
Physical examination in a simple case of chronic endometritis shows
a somewhat enlarged uterus, more globular in shape than normal. The
fundus uteri is tender on pressure between the vaginal finger and the
abdominal hand. The external os is usually patulous.
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