WOMB, DISEASES OF THE. The organ which is devoted to the retention of the foetus during the early stages of its development [REPRODUCTION IN PLANTS AND ANIMALS, in Nev. Htsv. Div.] and which is also called the uterus, is subject to all those pathological con ditions which are found in other organs composed of similar tissues. The principal tissues to which attention need be directed are the muscular substance of the uterus and its lining mucous membrane. The latter is continous through the oa uteri with the same membrane in the vagina, and the affections of the one are often found in the other. Like the mucous membranes in other organs, those parts may be inflamed or congested, or their function may be disturbed. One of the most common and troublesome forms of disease of these membranes is that which is called leucorrhea. and which is attended with an increased secretion from the mucous membranes. This may or may not be attended with pain and other symptoms of congestion. Where the latter is present, the disease requires a different treatment to those cases where no such symptoms are present. Rest, saline purgatives, and an antiphlogistio regimen is beneficial in these cases. On the other hand, where the pain is slight, and the pain more that of nervous irritation, and there are generally symptoms of a debility and want of Vine in the system, there tonics, such as quinine and iron, especially the latter, will be found of great benefit. Rest, culd bathing, and a regimen adapted for debilitated states of the system, should be recommended. These cases are often accompanied by nervous symp toms, which more or leas approach the condition of hysteria [11 esTente], and which also require special treatment.
In cases where the congestion is more active, the secretion from the mucous membrane becomes puriforrn, and has a yellow colour. In these eases the more active measures resorted to in inflammatory affections need be had recourse to. Where such an inflamed condition of the mucous membrane is kept up, ulcers frequently occur on the surface of the membrane, more especially in the contracted portion called the oa uteri. These ulcers are frequently attended with excessive irritation of the nervous system, producing intense pain of the back, more especially in the region of the coccyx. The general system also
frequently suffers in these cases, and great feebleness and exhaustion is the result. Although such ulcers will frequently pass away by judicious general treatment, it is in such eases that local applications have been found of most especial benefit Injections of tannic acid, alum, sulphate of zinc, and nitrate of silver, are all to be commended. Occasionally, in inveterate cases, it may be necessary to apply lunar caustic, or even caustic potash, to the ulcer itself. This practice, which is very commonly pursued by French practitioners, does not commend itself so strongly in England.
The tissues of the uterus are especially liable to attacks of malig nant disease. The nature however of the ulcerations produced by the development of cancerous formation is essentially different from the ulcerations last spoken of. Nor is there any evidence to prove that simple ulceration ever terminates in the malignant form. It is also important, however painful it may be to know, that where malignant ulceration has been once set up, it can never be arrested. This ought to prevent the local applicatiou of such powerful remedies as the actual cautery and caustic potash, which can only add to the sufferings of the patient without producing any beneficial result.
The uterus is subject to the occurrence of fibrous, cellular, and other tumours, which, although they produce great inconvenience, are not necessarily fatal. When these occur on the internal surface of this organ, they are frequently more or less pedunculated, and may be removed by ligature or the cemsseur.
The uterus not being attached directly to the solid framework of the body, is liable from the stretching to which its parts are subject during pregnancy to considerable displacements. It may ha tilted over backwards, which is called retroversion ; or it may be introverted, or it may sink lower than natural into the outlet of the pelvis, con stituting what is called prolapsus uteri. For these mechanical defects various appliances have been made with more or less success.