Warm compresses or fomentations and daily hot sitz baths are of great
value in chronic perimetritis, for they stimulate the healing process
and the absorption. The bowels must now be daily moved, and here I
prefer the patient to employ simply warm water enema in tolerably large
quantities slowly injected, until a quart or more of the fluid has been
thrown into the rectum; these enemas will not only move the bowels,
but also stimulate the healing process. If the patient lies on the
left side while these injections are taken or given, the enema flows
higher up, and it should be retained for a reasonable length of time.
These enemas should only be taken every other day, and between days a
suitable dose of purgative elixir. Tincture of iodine can be applied
to the groins every second day, or iodoform suppositories introduced
into the vagina. Mud baths are also very beneficial in removing old
inflammatory adhesions.
If the exudation suppurates and an abscess forms, it should be freely
opened as soon as possible. This can generally be best accomplished
through the vagina, but if there be a tendency of the abscess to point
towards the groin, then this situation would be preferable, although I
prefer, in even these cases, to make a counter opening in the vagina,
for this precludes the possibility of the abscess sacking or burrowing
further into the tissue. The cavity of the abscess should be thoroughly
rinsed out with a 2 per cent carbolic acid or a 1 to 2,000 corrosive
sublimate solution, and if there is a tendency in the abscess to close
before its cavity is healed out, a rubber drainage tube should be
inserted, so as to give the pus all the possible facility to escape. If
the abscess breaks into the bladder or into the rectum, then a counter
opening into the vagina will greatly insure and expedite recovery.
Sometimes the ovaries and tubes become diseased as a result of the
perimetritic inflammation; this, then, becomes a subject of special
inquiry and treatment. It should hardly be necessary to remind the
reader that sexual relations are to be suspended while there is the
least sign of the affection to be discerned. Although old adhesions and
displacements, the result of old chronic pelvic peritonitis, are often
naturally and permanently removed through a supervening pregnancy, the
intelligent use of the galvanic current will also accomplish that end.
CHAPTER XXIV.
PELVIC CELLULITIS OR PARAMETRITIS.
THE term _cellular_ was given to this tissue, because under the
microscope it shows large meshes or cell-like cavities, that are also
termed areolæ, hence, the tissue is often called areolar tissue; it is
also called connective tissue, because it combines all the different
organs and structures of the body together. It is very elastic and
contractile, and by the fluid which it contains in its areolæ, motion
of parts on each other is facilitated.