If the manipulations that are required for the purpose of carrying out
some of the mechanical or surgical treatments of uterine diseases, were
always preceded with thorough cleanliness, which implies _asepsis_, or
without putrescence, then all these operations would be shorn of their
greatest danger, namely, that of exciting inflammation and suppuration.
If a probe of the usual curve can be readily introduced into the
supposed anteflected uterine cavity, then there cannot be sufficient
flexion to constitute an obstruction, hence the flexion is not the
cause of the disease. In genuine anteflexion, the cervix and body of
the uterus are doubled up on each other, often like the letter V,
the cervix representing one line of the V, and the body the other;
bi-mammal palpation in the hands of an expert clearly establishes this
conformation.
When the diagnosis is established, the treatment should be as follows:
The patient is inclined on a table, either on her back or side, a
Sims’ speculum is introduced into the vagina and the cervix exposed.
The posterior lip of the cervix is now seized by means of a tenaculum
forceps, and gently drawn downwards and backwards, which greatly
reduces or obliterates the angle or flexion between the cervix and
the body of the womb, this greatly facilitates the introduction of a
uterine electrode. After two or three treatments, the forceps are no
longer required because the electrode can then be readily introduced
into the uterine cavity without them. The other electrode is spread
on the abdomen. (See this illustrated on Plate V.) A current of
electricity is now passed through the uterine tissues for ten minutes;
this is gauged all the way from sixty to one hundred _milliampères_.
The operation is repeated only once a week, and the cure is effected
in six weeks to three months. Great care must be exercised during the
treatment, to avoid exposure and undue exercise.
Those forms that are due to inflammatory deposits and strands outside
of the organ, should be preceded with an electrical treatment twice
a week, somewhat modified from the preceding course. This is done
by employing a _vaginal electrode_, properly protected and gently
pressed against the adhesions. The other _electrode_ is applied to
the small of the back. A current some fifty _milliampères_ stronger
is passed directly through the adhesions; when these are absorbed,
the intra-uterine electrode is employed, as in cases that are not
complicated with them.
RETROVERSION OF THE UTERUS.
This consists in a posterior inclination of the uterus, so that the
body of the womb approaches the posterior walls of the pelvis, while
the cervix of the womb is raised against the base of the bladder.
[Illustration: PLATE IV.
Retroflexion of the Uterus, or the Womb, bent backward.