CATARRH OF THE UTERUS. 127 



mentioned. Exploration with the finger alone can, at most, decide 

 that there is swelling of the portio vaginalis, which, as we shall here- 

 after see, accompanies most cases of uterine catarrh, and that the ovules 

 of Naboth are present. Catarrh of the uterus generally runs - a very 

 tedious course. The disease may drag on for years, and it often defies 

 all treatment. In the proper place we shall speak of chronic p'aren- 

 chymatous metritis, flexion and closure of the cervical canal, as the 

 frequent results of this disease, which, in other cases, is due to this 

 closure, and is kept up by it. 



TREATMENT. In the treatment of catarrh of the uterus it is most 

 important to fulfil the causal indications. Grateful as we should be 

 for the labors of recent gynecologists, and brilliant as the results of 

 their treatment of uterine catarrh appear when compared with the 

 results of former treatment, still some of them are not free from the 

 reproach of neglecting the causal indications while attending to the 

 indications from the disease. Where catarrh of the uterus is one of the 

 symptoms due to general venous congestion, dependent on disease of 

 the heart or lungs, very often the causal indications cannot be fulfilled, 

 and the remedies that have a beneficial effect on catarrh of the uterus 

 are not employed for the uterine disease, but for some other disturb- 

 ance. If the congestion of the uterine mucous membrane be due to 

 habitual constipation, proper treatment of this disease, as previously 

 advised, has the best results. We do not treat catarrh of the rectum, 

 which depends on congestion of the hemorrhoidal veins due to habitual 

 constipation, with local remedies till we have tried whether " sublata 

 causa cessat effectus ; " nor should we employ local treatment for 

 catarrh of the uterus till we are satisfied that removal of the existing 

 constipation is not sufficient for the cure. Then the peculiar conditions, 

 of which we shall hereafter speak, will preponderate. After active local 

 treatment, laxative mineral waters are often prescribed as after-treat- 

 ment ; and these do more good than the actual treatment, because they 

 fulfil the causal indications. A woman named G-raff^ living in Thurin- 

 gen, has an enormous practice among patients with leucorrhcea. They 

 all drink complicated infusions of manna, rhubarb, senna, and other 

 laxative remedies, and many bless the result of this treatment, to which 

 they were driven by the lack of success of all previous treatment. 

 Physicians, who do not pay sufficient attention to the causal indications 

 in treating catarrh of the uterus, deserve the blame for this. Of course, 

 any thing, that could have induced or can keep up irritation of the 

 uterus, must be carefully removed and kept away. Hence the causal 

 indications may require the removal of tumors of the uterus, or the cure 

 of other changes of structure which induce the catarrh of the uterus 

 Where the uterine catarrh depends on constitutional disease, it is not 



