Excerpt from Laceration of the Cervix Uteri as a Frequent and Unrecognized Cause of Disease

After the reception of this injury, and consequently a bad getting-up from her confinement, the female will at length consult her physician in consequence of her inability to stand with comfort, complaining of a continual backache, with pains down her limbs, a profuse cervical leucorrhoea, and, as a rule, hemorrhagic and frequent menstruation. The probabilities are that she will be faithfully treated for both ulceration and pro lapsus, in mistaking the effect for the cause. The ulceration, which will seem to be the most prominent feature in the case, will likely baffle all attempts to heal it, or if any improvement should take place ln her condition, after a suflicient rest in the lecumbent position, a 1elapse will follow again and again after attempting to exercise. We find frequently laceration of the perineum in these cases, and as the vagina was unable to re gain its natural size after delivery, from the then existing pro lapse of the uterus, the canal becomes still more dilated, as the organ, from a want of proper support, continues to advance as a wedge towards the vaginal outlet. The necessity for correct ing the position of the uterus is apparent, yet to give adequate support to the organ any instrument used must necessarily be so large as to allow the vaginal walls to prolapse, so as to ob struct the circulation, and by thus increasing the weight of the uterus add to the difficulty. Such a case will pass from one physician to another, until eventually the leucorrhoea will cease, and the profuse menstruation diminish as the surfaces become cicatricial in character from the frequent use of the nitrate of silver or from the application of caustics. But she becomes gradually a confirmed invalid, the hypertrophy remains, and with the impairment of her general health the nervous ele ment becomes most prominent.

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