Acute Variety.—­The whole mucous lining is inflamed.  In severe cases the whole mucous lining is destroyed and the deeper muscular tissues of the womb are invaded.

Gonorrheal Variety.  Symptoms.—­There is general pain in the lower bowel region, in spells at first, later constant, with rapid rise of temperature and pulse.  A purulent (pus) discharge appears early from the cervix, usually about the second day, and difficult and burning passing of urine are early symptoms.  There is inflammation of the vagina accompanying it in about fifteen per cent of the cases, while inflammation of the fallopian tubes, pus in the tubes, and local peritonitis are common results.

[ Woman’s department 499]

Mother’s remedy.  Inflammation of the Womb. 1.  A Good Tonic for.—­“For inflammation of the uterus or ovaries try a hot sitz bath every day for a week, and then every other day.  In case of hemorrhage this bath is invaluable, and will relieve when all other means have failed.  It can be taken during the hemorrhage, or at frequent intervals between times.  Remember, one should always lie down after a sitz bath.  If desired you may give aconitum tincture.  Dose:—­Two drops in a half glass of water, tablespoonful doses every ten to thirty minutes according to the severity of the case.”  If a woman has taken a severe cold, then the aconite should be given, but under no other condition.

Physicians’ treatment.—­Dr. Child advises that the cervix be dilated, and the interior of the womb, cervical canal and vagina swabbed out with a ten per cent silver nitrate solution.  Subsequently vaginal douches (1 to 5000) corrosive sublimate solution followed by a salt solution, one dram of salt to a pint of water, should be given for at least one week.  Keep the bowels open.

Septic puerperal endometritis.—­This is an inflammation of the inner lining of the womb that occurs after child-birth during the first few weeks, and is due to a poison.

Symptoms.—­The attack usually begins with a chill, preceded by a regular increase of the temperature and pulse.  The face looks flushed at first, but it soon becomes pale and the patient has an anxious look, as the disease goes on.  There is very little pain, if any.  The discharge that always follows labor is diminished or stops and has no odor, if there is any discharge.

The death rate is from five to twenty-five per cent.

Treatment.—­Never scrape out (curette) the womb for this disease.  The womb should be washed out with a hot salt solution, one teaspoonful of salt to one pint of water, and then packed with ten per cent iodoform gauze.  This solution should also be injected hot into the rectum and frequently.  The bowels should move freely, and if necessary injections may be given for that purpose.

The strength must be kept up by a liquid diet.  Milk, brandy and strychnine, if necessary; 1/100 of a grain of strychnine can be given every four hours.  Milk should be given every half hour, about two ounces at one time:  or more if it agrees well.