Bromine-vapor most satisfactory agent in the treatment of endometritis. It is introduced into the uterine cavity through a catheter at tached to an atomizer, diffuses rapidly, and exnts a remarkable curative action in cases of acute endometritis and sal pingitis. Nitot (La Gynecologic, Oct., '97).
A steam-jet at a temperature of 100° C. in endometritis and in various septic and chronic inflammatory conditions ad vocated after use in thirty-one eases. Used carelessly, there is some danger of obliterating the lumen, but with ordi nary precautions it is perfcetly safe. Johnson (Boston Med. and Surg. Jour., Mar. 16, 1900).
When the attack follows an operation, an ice-bag should be kept on the lower abdomen for twenty-four or thirty-six hours, the infected surfaces be thor oughly disinfected by a strong antiseptic, and one of the above-mentioned antisep tic douches be used either to the end.ome trium or vagina as required.
As the inflammation subsides, hot douches, laxatives, tonics, rest in bed, etc., are indicated.
In chronic uterine inflammation all causes of the diseases and all conditions that perpetuate it should receive atten tion.
Septic forms require active antiseptic treatment. In those forms of chronic endometritis in which hremorrhage is a prominent symptom, especially where an exaet diagnosis is required, the curette is advisable. Where leucorrhcea is the ellief characteristic, or where the curette has failed, a powerful caustic is re quired; and, of those which have proved effectual, eldoride of zinc is perhaps the most eertain. But we may hope in the near future to see it replaeed by some better method, possibly hy formalin and atinoeausis. Symly (Glasgow Med. Jour.. May. 1902), Displacements should as far as possible be corrected, stenosis relieved, and pelvic inflammatory conditions and tumors be treated or removed.
Most marvelous results achieved in luemorrhage depending upon chronic en dometritis with chronic peritonitis, by the hypodermic use of a solution con taining 11/2 drachms each of crystallized phosphate and sulphate of soda dissolved in 4 ounces of distilled water. From 1 to I 'A drachms of this solution is to be injected into the buttock or thigh twice a week. The solution must be made fresh and filtered each time. Cheron (Jour. Amer. Med. Assoc., Apr. 28, '88).
Application of an etltereal solution of iodoform to the cervical canal recom mended in obstinate eases. Dol6ris (Bull. Gen. de Titer., No. 11, '97).
The patient should remain in bed dur ing a portion or all of the menstrual period, and take more than ordinary- care of herself after abortions or confinements.
When menstruation is imminent or present, treatment should be withheld. An exeeption to this rule would obtain should the flow be very profuse or pro tracted. In the presence of an acute inflammatory process intra-uterine treat ment should be withheld. In malignant disease of the cervix, the possibility of a severe Immorrhage attending local treatment of whatever character must be anticipated and provided for. In all eases the rislc of inflammatory reaction in pelvic structures remote from the cer vix must be taken into consideration. Currier (Trans. Med. Soc. State of N. Y., Feb., '90).
Stress laid on the complications which endometritis may set up in a patient who becomes pregnant. The acute form is generally secondary. Chronic endo metritis attacks the deeidua vera. The eause of endometritis is usually gonor rhcea. Syphilitic endometritis is prob able. Endornetritis cannot be treated as long as the pregnancy lasts. Only when syphilis is suspected can benefit be de rived from drugs. After delivery or abortion the endometrilis can be treated by the free use of the curette. The in creased vascularity, of the decidua vera explains the frequeney of hremorrhages during pregnancy. The deeidna reflexa is rarely attacked; hence the placenta is usually found healthy, and the child may be delivered alive. Tarnier (Jour. des Sages-femmes, Jan. 1, '94).
Chronic glandular endometritis, alone or in connection with chronic septic or interstitial endometritis, and all menor rhagic cases uncomplicated by pelvic peritonitis should be curetted.
Dilatation, curetting, irrigation, and draining recommended as the best and most rapid method of obtaining a. cure. Waldo (N. Y. :lied. Jour., Feb. 13. '92) ; Baldy (Med. and Stirg. Rep., Afar. 12, '92); Noble (Annals of Gyntecology and Rediatry, June, '92); Garrigues (Times and Register, Apr. 30, '92); Gossmann (Mlincliener med. Woch., May 31, '92); Thielhaber (Miinchener med. Woch., June 28, '92); Goffe (Virginia Med. Alonthly, Sept., '92).