14:4: DISEASES OF THE UTERUS. 



whether used locally or internally, promise no benefit. The advice 

 that patients with anteflexion should hold their urine as long as 

 possible, so that the distended bladder may raise up the fundus, and 

 that patients with retroversion should retain the faeces for the same 

 reason, is given from theoretical grounds, and has not proved correct. 

 ( Virchow says that anteflexion results from great distention of the 

 bladder while the uterus is fixed.) Most gynecologists advise wear- 

 ing a firm girdle around the pelvis and lower part of the abdomen, 

 and many patients praise the results of this treatment. It is diffi- 

 cult to understand that, even in retroflexion, pressure on the lower 

 part of the abdomen should relieve the patient. Perhaps their 

 greater ease may be due to the compression of the uterus and its 

 consequent bloodless state. 



Little as we can do to remove the flexions, we may do much to 

 relieve the sufferings of the patient if we treat the catarrh and pa- 

 renchymatous inflammation of the uterus, which first call attention 

 to the flexion, according to the rules laid down in previous chap- 

 ters. Occasional abstractions , of blood from the portio vaginalis 

 are peculiarly beneficial, and are almost always effective in cases 

 of flexion. 



[To allay the distressing menstrual colic caused by retention of 

 clots at the constricted point of flexure, most gynecologists resort to 

 mechanical dilatation of the cervical canal. According to the expe- 

 rience of Sims and others, bloodless dilatation by means of bougies 

 is less beneficial than, and fully as dangerous as, incision of the neck 

 by the metrotome.] 



CHAPTER VI. 



CHANGES OF POSITION OF THE UTERUS. 



THE uterus, which is very movable, may be dislocated in any 

 direction. The most important deviations in position are antever- 

 sion, retroversion, descent, and prolapse. 



Anteversion most frequently occurs in women with strongly 

 curved pelvis. The natural inclination forward of the uterus may 

 be increased by the pressure from above of fluids in the peritoneal 

 sac or of tumors, and anteversion may thus be caused. More fre- 

 quently the uterus sinks forward from its own weight ; hence al- 

 most always moderate degrees of anteversion accompany infarc- 

 tions and new formations in the fundus uteri. Anteversion rarely 

 becomes excessive, since each distention of the bladder restores the 

 uterus to place, if some peculiar circumstance does not interfere with 



