. alum,<strong>1861</strong>.] Ul 797two ounces at a time, and Bhould not be often repeated;otherwise they will give rise to a local irritation in the rectum,which will prevent their retention. One or more dropsof tinct. opii, accordingl j of the patient, will greatly;aid in the retention of the injection.A-'- the violence of the disease has been checked, a continuanceof the tonic treatment should he persevered in forsome time, not only to prevent the sequelre liable to follow,but a recurrence of the attack, which often rea<strong>pp</strong>ears afteran interval of several wn of these agents would
798 Uterine Inflammation. <strong>October</strong>,be analogous to that of two other important agents, nitrateof silver and tincture of iodine, which are called caustics bycourtesy, but are no more caustics than tincture of cantharides.I wish it to be clearly understood that I hold theseagents sufficient for the surgical treatment of uterine inflammatorydiseases in the large majority of cases, and so doesDr. II. Bennett, although it has been stated that we usestrong caustics in ordinary cases of uterine disease. In acomparatively small number of instances, the structures ofthe womb have been too deeply modified by inflammationor by hypertrophy, are in so low a state of vitality that theabove-named agents are insufficient to bring about a cureof the disease. Then I have recourse to another class ofsubstitutive agents, which arc undoubted escharotics, forthey cause a loss of substance proportionate to the amountof caustic used. Those caustics induce healthy acute inflammationin the tissues tmderlying the eschar, and, byjudicious management of this healthy inflammatory action,the cure of chronic cases is often induced.The caustics of which I shall treat are, the acid nitrateof mercury, potassa fusa cum calce, potassa caustica, andthe actual cautery. At first sight it may seem strange toclass together sulphate of zinc and potassa fusa cum calce,but one is justified in doing so, because the substitutiveaction which I ascribe to a solution of sulphate of zinc ispre-eminently shown in the results of potassa fusa cumcalce, which often so raises the vital endowments of theuterine tissues as to promote rapidly healthy nutritive actionin tissues which had been diseased for many years.Such is my mode of practice, and I am glad to find thatit accords to a certain extent with the practice of all whoseopinion carries weight, and who having in vain tried to cureuterine diseases by nitrate of silver or milder measures,have recourse to one or the other of the strongest caustics.Dr. Fleetwood Churchill depends on nitric and muriaticacids, and on the acid nitrate of mercury, which is also preferredby Dr. E. Kennedy and by Dr. West, and althoughthis distinguished pathologist considers ulceration of thecervix to be a condition of slight pathological importance,when he has to trace out a plan of treatment for his pupils,he has none other to propose than that already long agocarefully laid down by Dr. H. Bennett. The late Dr. Rig-1>\\ though adverse to the surgical treatment of uterineaffections, admitted that there were certain cases of uterine
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