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
Digital examination in a case of cervical catarrh usually reveals an
altered condition of the cervix. The vaginal cervix may be somewhat
enlarged and soft in the early stages of the disease, or cystic and
sclerotic in the later stages. The external os is usually enlarged,
often admitting the tip of the index finger even in those who have not
suffered with laceration of the cervix. The prolapsed mucous membrane
is present, and the erosion may be readily felt around the external
os, being easily distinguished from the smooth, less velvety squamous
mucous membrane of the vaginal aspect.
Speculum examination shows a congested vaginal cervix and a patulous
external os around which is the red erosion already described. Escaping
from the external os is seen the thick cervical mucus, which is often
so tenacious that it may be lifted from the cervical canal with forceps.
The diagnosis of cervical catarrh is usually very easily made from a
consideration of the signs described. The important thing in any case
is to determine the cause of the inflammation of the cervical mucous
membrane, in order that the proper treatment may be directed to it.
=Treatment.=--As has been said, cervical catarrh is always secondary
to some local or general condition, except in the case of direct
gonorrheal infection. The gonorrheal cases must be determined by the
history of the disease and by the distinctive signs of gonorrheal
infection which will be described later.
In every case of cervical catarrh a thorough examination to determine
the local cause of the disorder must be made. If, as will usually be
the case, such a local cause is discovered, the treatment should be
applied to it, and the inflammation of the mucous membrane may be
disregarded, with confidence that it will disappear when the exciting
cause is removed. Many cases are treated by local applications,
the whole attention of the physician being wrongly directed to the
secondary condition, while the exciting lesion, such as laceration of
the cervix, subinvolution, or a flexion or version, is neglected. Such
treatment, of course, results in but temporary benefit.
Besides such cases of chronic local inflammation dependent upon a
distinct local lesion, there are many others in which the catarrh is
but a local manifestation of a general state of depressed or poor
health, or of a distinct dyscrasia like tuberculosis, syphilis, or
scrofula. Local treatment in such cases, to the neglect of the general
health, is wrong.
If the advice here given--to seek for the primary cause of the cervical
catarrh and to cure it--is followed, it will be found that there are
but very few cases that depend for cure upon local applications. Simple
local treatment by douches, etc. may, however, be valuable aids in
hastening the cure of the disease after the exciting cause has been
removed.
The treatment may be considered under two heads, the general and the
local treatment.
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