airs,fusa,L861.]T99ulceration requiring ior potassa fusacum calcr. Jh\ U. Beunett prefers potae a fusa cum calce.This is not energetic enough for Professor Simpson, whoa; while the French strongly advocatea remedy older than Ili<strong>pp</strong>ocrates, the actual cautery.These comments upon the treatment of uterine inflammationwill show that i am an eclectic, and that I use allthe valuable agents which I have enumerated in certaines which I shall specify. Again reminding the readerthat I am not writing a treatise, I shall proceed to commenton the use of our principal substitutive agents.Tincture of I •'I'm'.— It is the ordinary tincture of thePharmacopoeia which I mean, not the caustic tincture. Ishall he brief on this agent, having already mentioned it asa revulsive, and having compared it with others then underdiscussion. Tincture of iodine seems to act as an astringentwhen slightly a<strong>pp</strong>lied to the hypertrophied or inflamedsurface of the neck of the womb, but as a vesciantif several a<strong>pp</strong>lications are made at one and the same time,and as a resolutive it re-a<strong>pp</strong>lied every third or fourth day.It is much less useful than nitrate of silver as a topical a<strong>pp</strong>lication,but it suits better some idiosyncracies, and is wellborne in diphtheritica! inflammation, when nitrate of silvershould not be used. The fact that a solution of iodine canbe injected into closed cavities and fistulous passages withoutseverely inflaming them, marks it out as the best liquidto be injected into the bod}' of the womb, in the very rarees requiring such treatment ; for it has less frequently11 rise to the alarming symptoms of peritonitis, whichhave very often followed the intra-urine injection of a solutionof nitrate of silver. I use one drachm of the tinctureto an ounce of distilled water, and inject it by means of aninstrument similar to that devised by Mr. Coxeter for injectingfluids into the larynx.NUtraiiof SUvi r.— --The a<strong>pp</strong>lication of nitrate of silver is ameans, under certain circumstances, of subduing externalinflammation. Might it not, on this principle, be of servicein the treatment of the internal phlegmasia '.'" Suchthe question asked by Mr. Uigginbottom in the prefaceof his admirable little work on u The Lunar Caustic," publishedin 1826. Jlis iquestion answered in theaffirmative by a great many practitioners, who have a<strong>pp</strong>liednitrate of silver for the cure of inflammatory affections of•the mucous membrane of themouth, throat,
800 Uterine Inflammation. [<strong>October</strong>,urethra, the intestines and the rectum. As regards themucous membrane of the genital organs, Dr. Sewel, in1830, strongly advocated its use ; and I have no hesitationin saying that this great agent is quite as useful in curingthe varied inflammatory conditions of the genital organs asin curing those of the skin. It is often necessary to prefacethe use of nitrate of silver by linseed tea, po<strong>pp</strong>y-head, orother cooling injections, in the same way that Mr. Iligginbottomrepeatedly inculcates the utility of cold poulticesprevious to a<strong>pp</strong>lying nitrate of silver to the inflamed skin.If, after antiphlogistic treatment, the solid nitrate of silverincreases too much habitual pains, or causes the ulceratedsurface to bleed for two or three days afterwards, it is wellto try a solution of from forty to sixty grains of nitrate ofsilver to an ounce of distilled water. In many cases thesolution is sufficient to effect, a cure ; it gives less pain, butit may be necessary to repeat it every third or fourth day.Sometimes I nse a solution of nitrate of silver containingone ounce of the salt to two or three ounces of distilledwater, as an a<strong>pp</strong>lication to ulcerated surfaces. Chronicuterine catarrh, or inflammation of the mucous membranelining the neck of the womb, which has been truly calledan open gland pouring out mucous from ten thousand follicles,seems to me the most frequent of all uterine diseases.Without having the slightest abrasion, the mucous membranelining the neck of the womb and its vaginal surfacemay be of a dusky, livid hue, tender on being touched, andsecreting pus. This condition may last for years, but itgenerally leads to more or less extensive denudation ofthe villi of the uterine mucous membrane, and gives an excoriateda<strong>pp</strong>earance to the neck of the womb. Such cawithor without excoriation, can be cured by the nitrate ofsilver in solution, and every fourth or fifth day, with theoccasional use of the solid nitrate. If the mucous membranelining the cervix be principally affected, it is often soobstinate as to render the painting of it with the solution oflittle use. The solid nitrate must be freely employed, andwhen the cervical canal is usually dilated, I sometimesleave about one-eighth of an inch in the canal ; by which itwill be clear that, so far as my experience goes, should thestick accidentally break in the cervical canal, it need giveno alarm. What cannot be removed will cause more pain,some loss of blood, and perhaps even a return of menstruation: hut the patient may be repaid for greater suffering by
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