The sterility is apt to be permanent.
Chronic glandular endometritis can generally be cured by treatment. Mild or recent cases may get well spontane ously, but severe cases usually persist for a long time, or until the menopause.
Treatment. —For acute metritis due to suppression of the menses the flow should be re-established if possible in the early or congestive stage. As soon as possible after the suppression the patient should take a warm sitz-bath (100° F.), and go to bed. Hot drinks, hot poultices to the abdomen and groins, and hot-water bags or bottles to the feet and legs should be employed. In married women scarifica tion of the cervix may be used with bene fit. The production of slight nausea by means of tartar emetic, ipecac, or lobelia is useful as a sedative to the congested pelvic organs. If the menstrual flow is re-established by these means within a day or two, the patient may leave the bed after the flow has ceased, but should lie down two or three hours in the middle of each day, and take but little exercise for three or four weeks. At the time of the next period she should keep to the bed and repeat the hot applications, etc., if the flow does not appear on time. The bowels should be kept open by salines.
If the menses are not re-established within two or three days after their sup pression, the patient should remain in bed for a week or ten days, apply counter irritants over the iliac and suprapubic regions, and take copions hot' douches (115° to 120° F.) two or three times daily in the recumbent posture. She should secure a daily evacuation of the bowels and, if practicable, introduce small cot ton tampons, saturated with a 10-per cent. soluticn of ichthyol in boiled glycerin, high up into the vagina every other and leave them for about eighteen hours. Tonics and an easily digested diet should be prescribed.
Acute metritis following labor or abortion calls for a thorough evacuation of the uterus by the fingers or curette, anti, if septic symptoms persist, antisep tic intra-uterine douches every twelve hours (1/30°E, of corrosive mercuric chlo ride followed by sterilized water or 1-per cent. creolin) and vaginal douches of the same character every six or eight hours.
Treatment of beginning, endometritis by means of medicated steam recom mended. Resorcin at V. and varying
in temperature from 104° to 140° F. is used. 13ut slight dilatation of the cer vical canal is required, and accidents are thus avoided. The exudations become coagulated and are excreted by means of contractions, causing a mild form of colic. Sordes (Jour. de Med. de Bor deaux, Sept. 1, '05).
Excellent results obtained in seven out of eight cases of septic endometritis after labor and abortion by the injection of superheated steam into the uterine cavity. The apparatus consists of a metal can with a spirit-lamp and a ther mometer which registers up to 200° C., some rubber tubing, and a ea.theter. The application lasts about half a minute, and never over a full minute. By means of a tap, the current of steam can be in terrupted while the catheter is being adjusted before use, lest scalding or burning should occur. The temperature of the steam /mist be a little above boiling-point, about 110° C. The jet of steam is followed by no bad effects and gives little or no pain. 'Uterine contrac tions are actively stimulated and ill smelling discharges cease. Steam kills the bacteria in the endometrium, and as it coagulates albumin all blood-vessels and lymphatics are sealed up, and fresh granulations can develop under the pro tective covering. Kalin (Contralb. f. Oyniik., No. 49, '96).
Excellent results obtained from tinct ure of iodine in post-partmn endometritis. It acts best when used in the early stages and as often as once or even twice daily. As soon, however, as the signs of acute inflammation subside and the secretion diminishes, the remedy should be ap plied less frequently. Pains of varying character usually follow this mode of treatment. The method of application is as follows: The patient lies on ber ba.ck, and a speculum is introduced into the vagina. If the cervix is blocked with mucus, the os is drawn down with a volsella, the porno vaginalis is irrigated, and the parts dried with aseptic cotton wool; the canal is then swabbed with the pure tincture of iodine. In eases in which the corpus uteri is also involved the remedy is applied in the same way as to the cervix. A. Solowjev (Wratch, No. 12, '97).