128 DISEASES OF THE UTERUS. 



always possible to remove the cause ; but frequently the original dis- 

 ease is so important, or other dangerous results of it are so prominent, 

 that we cannot attend to the uterine catarrh. This is particularly true 

 of tuberculosis. 



Finally, it is not always possible to say whether anaemia and chlo- 

 rosis are the results or cause of this disease. If we think that the 

 sequence in which the symptoms occur and other causes justify us in 

 the latter supposition, we may often obtain the best results from the 

 use of iron, quinine, a moderate amount of wine, and nutritious diet. 

 Moreover, the good result of cold-water treatment, sea-bathing, and 

 different mineral waters in uterine catarrh, is due to the fact that they 

 have fulfilled the causal indication. Any practitioner will bear witness 

 that the constitution suffers in many cases without our being able to 

 discover the cause ; and that anomalies of the constitution, which show 

 themselves by a change in the secretion and function of different or- 

 gans, cannot always be cured by preparations of iron and nourishing 

 diet, even if there are evident coexistent signs of anaemia and hydrae- 

 inia. Under such circumstances, all we can do is, to change and im- 

 prove the constitution by placing the patient under the most different 

 circumstances, changing the entire mode of life, and particularly by 

 modifying as much as possible the exchange of tissue by baths and 

 douches, by giving quantities of water with or without the addition 

 of salts, and by other means. Among the anomalies of secretion that 

 occur in the different organs of such patients, catarrh of the uterus is 

 very frequent ; and it often disappears very quickly when we succeed 

 in improving the constitution, while it does not yield to exclusively 

 local treatment. I have seen the most surprising results from such 

 treatment in the Greifswalder clinic, where the arrangements to some 

 extent replaced the treatment by mineral waters and baths, and where 

 Professor Liebermeister, at that tune assistant physician of the medi- 

 cal clinic, kept account of the effect of the changed diet, increased ex- 

 ercise, and copious supply of salty liquids, of the baths and douches, by 

 weighing the body and examining the urine. 



The indications from the disease may be far more readily fulfilled 

 in catarrh of the uterus than in catarrh of other organs that are less 

 accessible. The uncertainty of internal remedies for catarrh has been 

 repeatedly mentioned They may be dispensed with in the treatment 

 of uterine catarrh, and muriate of ammonia (which many physicians 

 consider just as efficacious foi bronchial catarrh as for gastric and hi 

 testinal catarrh) is not used in uterine catarrh because we have bettei 

 and more certain remedies for it. I should be entirely misunderstood, 

 if it were supposed that I considered the local treatment of uterine 

 catarrh as superfluous, or underrated its results ; in what was said 



