There is a small proportion of cases in which the system has become
accustomed to the retroflected position of the womb, and if the
abnormal condition is rectified, a great many painful symptoms spring
into prominence, that are attributable to the interference. This is
particularly the case in women who are in those years that we term
“change of life,” and for this reason they should be let severely
alone.
Excluding the above class of cases, the question arises in other cases
whether the uterus can be replaced without violence, or whether it is
fixed or grown to its surroundings by inflammatory adhesions. It is
not always an easy matter to dispose of this question at once, because
the enlarged and congested body is often so firmly wedged down between
the posterior pelvic wall and the vagina, that any attempt to dislodge
it is accompanied with such acute pain that one feels constrained
to desist for a time. When there is great pain or sensitiveness,
the patient should take to bed, so as to give the pelvic organs
every chance to get rid of the inflammatory irritability. Hot-water
compresses should be applied to the lower abdominal or pelvic region,
and hot vaginal irrigations thrown into the vagina; these should be
copious, no less than a gallon of water at once, at a temperature of
107 to 110° Fahr., repeated twice daily. The bowels should be kept
loose, say several operations each day, for three or four days; after
that once a day will be sufficient.
In the course of several weeks the congestion will have subsided,
so that, in the great majority of cases, reposition can be readily
accomplished. If the resistance of the womb still persists, then it is
reasonable to infer that the organ is tied down by old inflammatory
adhesions; these, then, should be treated with galvanism, after the
manner described for removing adhesions in anteflexions.
The statistics show that, out of every five women who are suffering
from female diseases, one has a posterior displacement, either a
retroflexion or retroversion. The greatest number of these are
traceable to their last confinement. All these displacements, as
well as those that are accidental or induced by a fall, jumps or the
like, should be replaced as soon as possible, otherwise inflammatory
adhesions may complicate and greatly obstruct the replacement.