File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14581785117).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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. Its usual cause is injury to the cervix. Inpre-Listerian days it was common after incision of the cervix.It may occur from laceration of the cervix with Hegarsdilators, or with the lingers ; or from the use of tents withoutantiseptic precautions. I have known a patient complainthat excessive sexual intercourse had produced the illness ;but I know not whether to regard this as cause or coincidence.I have seen it in virgins, in whom I could not find outthe cause. 268 DISEASES OF WOMEN. Peculiarities of non-puerperal parametritis.—The diseasein these patients differs from that in puerperal women inthat it seldom tends to rise into the false pelvis; and in thatit more often leads to organisation of lymph into fibroustissue, and less often ends in suppuration. Symptoms and signs.—The disease begins as in thepuerperal form, with fever, sometimes a rigor, and pelvic pain.Diagnosis is not possible until the exudation has become firmenough to be felt. It is then made from the seat of the
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Bladder Vesico-uterineperitoneum Cervix uteri Douglass pouchRectum Fig. 91.—Horizontal section through pelvic cavity, showing cellular tissue surround-ing rectum, and peritoneum in front of it. (After Freund.) exudation. It is at first felt, as in the puerperal form, at theside of the uterus, low down, the induration beginning wherethe vagina is inserted into the cervix. When the inflamma-tion extends, it spreads down and back, instead of up into thefalse pelvis as in the puerperal form. When there is muchexudation the mass it forms feels as if it sloped off from thecervix uteri outwards and towards the pelvic outlet. (Fig. 84.)The upper third of the vagina becomes fixed by it. If thedisease is bilateral, this fixation of the vagina is striking;the upper third of the vagina feels hard, stiff, and smooth; PARAMETRITIS. 269 and it usually participates in the inflammation, so that it isinjected, and secretes pus. The exudation extends back oneach side of the rectum, so that when you ex

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