most useful. The great advantage derived, and the absolute immunity which ensued when once the sore was healed, almost induced me to suspect that the mercurial treatment continued to exercise a protective influence. This is not so: just as long as the cervical mucous membrane remains sound, constitutional disease in the male induces no such injurious local effects as ensue when a raw surface is exposed to the contaminating influence. The observances necessary for guarding against any breach of continuity in this mucous membrane have been already described. True ulceration of the cervix uteri, where there is active destruction of tissue, most commonly accompanies some primary syphilitic disease of the external organs, but there may be found a red and angry sore, the margin being irregular and, as it were, eaten out, where there is no evidence of venereal taint. Such cases are very rare, and I believe always denote that there has been previous granular erosion. This irritable sore of the cervix may, under certain unhealthy conditions, take on a diseased action, in some degree resembling that occurring in superficial indolent sores, and denominated the sloughing ulcer or phagedæna. Application of acid nitrate of mercury to the part, and a pad of oiled wool to prevent mechanical irritation, the thorough evacuation of the bowels, and administration of large doses of opium, will suffice to arrest the progress of the disease and to alleviate the severe suffering. I have seen only three cases of this form of disease; but in each of these was a wellmarked strumous taint. Whether this was causative or coin cident I do not know. The most marked and frequent cases of true ulceration of the cervix are those in which its character indicates that disease of malignant type has invaded the uterine structure. As the extension of the disease is assuredly fatal, and the evidence as to the value of prompt and decided local treatment in cases of epithelioma and lupus is certainly favourable, it is important to lose no time in adopting the treatment already described, when once the diagnosis has been satisfactorily made out. Iodized cotton, 243 Iron, use of, 116, 156, 201 JOINT-PAINS in amenorrhoea, 133 Prolapsus, uterine, 48; active, 49; Puberty, 107 REST, 93 Retroflexion, 73; cases, 79; causes, LATERAL displacement of uterus, 88 MEDICATED Suppositories, 10, 261 Miscarriage, anteversion causing, 21 NECKAM, Alexander, on menstrua- Neuralgic dysmenorrhoea, 164 OCCLUSION, uterine, 122, 112, 183 Order of function, 99; place, 24; Ovarian amenorrhoea, 118; dysme- PARTHENOGENESIS, 238 Pessaries, air, 14, 82; boxwood and Pliny on menstruation, 18 SOUND, uterine, 12; in diagnosis, Speculum, use of, 258; history of, Sterility, 205; systemic, 206; ova- Structure, disorders of, 210 Strychnia in amenorrhoea, 116 Suppression of menstruation, 125; Syphilitic sore of cervix, 264 TUBERCLE, 234 ULCERATION of uterus, 221, 255, Urethra, vascular growths in, 240 of), 41; anteversion of, 66; cancer retroversion of, 73; rodent ulcer VAGINA, as supporting uterus, 32; Vascular tumours, in urethra, 240; THE END. |