SECTION II. 



DISEASES OF THE UTERUS. 



CHAPTER I. 



CATARRH OF THE UTERUS AND CATARRHAL ULCERS OP THE CERVIX 



UTERI. 



ETIOLOGY. During menstruation the hyperaemia of the uterine 

 mucous membrane is so excessive that the overfilled vessels are rup- 

 tured. Before the hyperaemia attains this grade, and when it is di- 

 minishing, the mucous secretion from the uterus is increased and 

 changed. This catarrh, which is physiological as it were, becomes 

 pathological if the hyperaemia of the uterine mucous membrane and 

 the change of the secretion last beyond the normal duration of men- 

 struation, or come at a time when no ripened ovum has been detached. 

 Remembering this, we may readily understand why catarrh of the 

 uterus is among the most frequent of diseases, being at most excelled 

 in frequency by catarrh of the stomach, an organ subjected to the 

 same conditions. 



The tendency to uterine catarrh varies greatly with the age. It is 

 rare in childhood, when periodical recurrence of physiological conges- 

 tion of the uterus does not yet exist ; during the age for child-bearing 

 it is very frequent ; in old age the predisposition is decidedly less. 



Among the exciting causes are : 



1. Congestion in the vessels of the uterus ; in diseases of the heart 

 and lungs, where the return of blood to the right heart is impeded, the 

 hinderance to the flow of blood from the veins of the uterus usually ap- 

 pears as catarrh of the mucous membrane, and is analogous to cyanosis 

 and dropsy of other parts of the body. Still more frequently the ob- 

 struction to the escape of blood is nearer the uterus. In many cases, 

 compression of the hypogastric veins by tumors, or, more often, by col- 

 lections of hardened faeces in the rectum or colon, are the causes of 



