UTERINE CATARRH. 123 



catarrh of the uterus ; we have before said, that some patients suffer- 

 ing from uterine catarrh, dissatisfied with the treatment of their phy- 

 sicians or even of celebrated gynecologists, fall into the hands of 

 charlatans, or use Morrison's pills, and for a certain time are benefited 

 by the continued use of these laxatives that are vaunted as panaceas. 



2. Many cases of uterine catarrh are caused by direct irritation of 

 the uterus, and, from what was said above, it is evident that any nox- 

 ious influence acting on the uterus, when in a state of congestion, 

 will prove more injurious than at other times ; hence that imprudence 

 during menstruation most readily induces uterine catarrh. The uterus 

 is directly irritated by too frequent or too energetic coitus, by mastur- 

 bation, or by wearing pessaries, etc. The uterine catarrh accompany" 

 ing other diseases of the uterus, such as parenchymatous inflammation, 

 neoplasia, etc., and which is usually called symptomatic catarrh, also 

 depends on the direct irritation. 



3. Like other catarrhal affections, this also may depend on consti- 

 tutional disease. Acute .catarrh of the uterus occurs in typhus, cholera, 

 variola, and other infectious diseases ; chronic catarrh usually accompa- 

 nies chlorosis, scrofula, and tuberculosis. As we have often said, the 

 connection between the local disturbance and these general diseases is 

 not understood. 



4. When we read of the epidemic appearance of uterine catarrh, 

 it simply means that, without any known cause, the disease occurs 

 more frequently at one time than at another. 



ANATOMICAL APPEABANCES. Acute catarrh of the uterus is rarely 

 seen post mortem. The changes of the mucous membrane of the uterus 

 in acute catarrh do not differ from those of other mucous membranes 

 in the same disease. There are hyperaemia, swelling, succulence, and 

 relaxation of the tissue ; the secretion of mucus is diminished at first, 

 but subsequently increased ; in the first stages this mucus is clear and 

 deficient in solid constituents ; subsequently it becomes yellowish, and 

 contains quantities of young cells. 



In chronic catarrh the mucous membrane is more swollen and hy- 

 pertrophied ; it is brownish red or slate gray ; the secretion from the 

 cavity of the uterus appears more or less purulent, and is often mixed 

 with blood. The secretion from the cervix uteri, on the other hand, is 

 usually tough, coherent, and forms gelatinous plugs. Where the pro- 

 cess has lasted a long while, the structure of the mucous membrane is 

 changed. The ciliated epithelium is replaced by cells without cilia. 

 Part of the glands is destroyed; while others swell up like cysts. In 

 many cases the surface of the uterine cavity, particularly of the poste- 

 rior wall, is covered with granulations that bleed readily, or with poly- 

 poid growths. The swollen and granulated mucous membrane often 



