130 DISEASES OF THE UTERUS. 



rather than used on a brush. I should employ these solutions much 

 oftener, if it were not so difficult to protect the fingers and clothes 

 from being soiled. The application should be repeated once a week 

 or oftener, till the discharge diminishes and the portio vaginalis 

 has regained its normal appearance. The result of this treatment 

 is so striking, that touching the os uteri and its cervical canal, in 

 chronic catarrh of the organ, must be classed among the most grati- 

 fying operations in medicine. The pain induced by the cauteriza- 

 tion is usually very insignificant, but in some cases it is quite se- 

 vere. If the nitrate of silver be passed far into the cervical canal, 

 some women will have painful contractions of the uterus, that may 

 continue for hours. Besides nitrate of silver, the remedies most 

 frequently used for catarrhal erosions and follicular ulcers of the 

 os uteri are pyroligneous acid, liquor hydrargyri nitrici, and cuprum 

 aluminatum (lapis divinus). Pyroligneous acid is particularly bene- 

 ficial where the ulcers have a great tendency to bleed ; the liquor 

 hydrargyri nitrici, and still more the lapis divinus, are to be tried 

 when the nitrate of silver has failed. In such cases the actual cau- 

 tery is a very effective remedy, and the opposition to its use is 

 ascribable to its psychical effect rather than to the pain or danger 

 accompanying it. Pyroligneous acid poured through the speculum 

 is an invaluable remedy for the granulating ulcers of the os uteri 

 that bleed readily. In most cases it arrests the haemorrhage more 

 certainly than sesquichloride of iron or alum ; the latter is applied 

 to the os uteri in substance more readily than in solution. We 

 should only use injections into the cavity of the uterus in cases of 

 absolute necessity, i. e., only when the above treatment fails, and 

 we are forced to believe that the cavity of the uterus chiefly is dis- 

 eased. In such cases we should use the ordinary solutions of nitrate 

 of silver (3 ss. to water j). The effect of these injections is 

 much more severe than that of touching the os uteri with nitrate 

 of silver ; they not unfrequently induce severe inflammatory symp- 

 toms ; where the cervical canal is contracted, they should never be 

 employed. 



[Injections into the cavity of the uterus are never to be prac- 

 tised except in cases of the utmost urgency, when other treatment 

 fails, and when the chief seat of disease is known to be within it. 

 For this purpose nitrate of silver (0'5 to 30'0) may be employed, 

 or, when there is a tendency to bleed in consequence of prolifera- 

 tion of the mucous membrane, the liq. ferri chloridi, tincture of 

 iodine, alum, tannin, or carbolic acid. It is well known that the 

 liquid injected may possibly pass through the tubes into the peri- 

 tonaeum ; but aside from this danger, the operation not only excites 



