CONTRACTIONS AND CLOSURES OF THE UTERUS. 137 



the body, particularly into the intestine and vagina. As a diagnos- 

 tic hint, we will here mention that pain in a limb, really caused by 

 pressure of an exudation upon a nerve, has now and then been mis- 

 taken for a pure sciatica. 



Schultze also describes a latent parametritis posteriori, of insidi- 

 ous, tedious course, usually due to mechanical causes, and said to 

 produce a shortening of Douglas's folds, and to be a most important 

 factor in the production of anteflexion and anteversion.] 



The perforation of subperitoneal abscesses or of intraperitoneal 

 exudations into the intestines or bladder is marked by the sudden 

 decrease in size of the tumor, and by the evacuation of purulent 

 masses with the stools or urine ; perforation into the abdomen causes 

 severe general peritonitis, which quickly proves fatal. Even in 

 favorable cases the patients generally recover slowly. In many of 

 the patients under my observation the neuralgic pains lasted for 

 months. 



TREATMENT. [Treatment of an acute recent perimetritis de- 

 mands absolute confinement to the bed, leeching to the groins, the 

 application of ice-bags to the abdomen, mercurial inunction, confine- 

 ment of the bowels by opium in short, the treatment of a peritoni- 

 tis. A recent parametritis calls equally for complete repose, but 

 in other respects the treatment may be less active. The bowels 

 should be gently moved, while cleansing and disinfecting injections 

 should be frequently repeated, to clear away all putrid secretions, 

 which are the common exciting cause of this form of inflammation.] 



Local abstraction of blood and the application of cataplasms to 

 the lower part of the abdomen act well in the treatment of recent 

 cases of perimetritis and parametritis. We should continue the use 

 of the latter as long as there is any swelling left, even if there be 

 no pain. In protracted cases I have found great benefit from the 

 use of warm salt baths, with an addition of mother-liquid, and the 

 internal administration of iodide of iron. At the same time, we 

 must keep up the nutrition and strength by proper diet, and treat 

 any existing fever by antipyretics. 



CHAPTER IV. 



CONTRACTIONS AND CLOSURES OF THE UTERUS H^EMOMETRA, 

 HYDROMETRA. 



IN young persons who develop late, moderate degrees of contrac- 

 tion of the os uteri are quite frequent. They hinder conception, 



