OBSTETRICS 235 



ered with a grayish-colored mucous exudate. Con- 

 siderable tenderness may also be present and the 

 examination resented by the patient, especially if 

 the mucous membrane is extensively lacerated. 



Treatment. — This consists of irrigations of anti- 

 septics and astringents, such as solutions of chinosol 

 1-1000, one-per-cent potassium permanganate, one- 

 per-cent sulphate of zinc, one-per-cent creolin, or 

 the iodin saline solution mentioned elsewhere (nor- 

 mal saline solution, one pint; tincture of iodin, one 

 dram). 



Prolapse of the Vagina and Uterus 



Of the two, prolapse of the vagina is most com- 

 mon. In neglected cases grave alterations, chiefly 

 of a hypertrophic character, may take place in the 

 vaginal mucous membrane, even gangrene some- 

 times resulting. 



Symptoms. — The vagina protrudes through the top 

 of the vulva and appears as a pear-shaped mass of 

 inflamed tissue. In recent cases it appears moist 

 and covered with mucous; later it becomes drier 

 and of a dark red or brown color. 



In prolapse of the uterus, one horn only comes 

 down and protrudes from the vulva as a mass of 

 inflamed, mucous-covered tissue having salient 

 borders. 



Treatment. — Clean thoroughly with antiseptic so- 

 lutions, and if much congestion is present constrict 

 the blood vessels with local application of adrenalin 

 solution, pushing back the prolapsed organ and tak- 

 ing care to restore the parts to their normal posi- 

 tion. Otherwise straining will invariably take place. 

 To overcome this, a dose of one-fourth to one grain 

 of morphin sulphate or one to three tablets (No. 1) 

 of H-M-C should be given, and repeated as neces- 

 sary. 



