Mother's Remedies Part 132

The Pelvis. It is so called from its resemblance to a basin, is stronger and, more ma.s.sively constructed than either the skull or chest cavity; it is a bony ring, interposed between the lower end of the spine, which it supports, and the lower extremities, upon which it rests. It is composed of four bones, the two innominated, (nameless), which bound it on either side and in front, and the Sacrum and Coccyx, which complete it behind.

Further description will be given in the department of Obstetrics. The cavity of the pelvis contains the bladder, the r.e.c.t.u.m, and some of the generative organs peculiar to each s.e.x and some windings of the small intestine; they are partially covered by the peritoneum (lining membrane of the abdominal cavity).

Anatomy of the Female Genital Organs.--The external genital organs, to which the term v.u.l.v.a is usually given, consist of the mons veneris, l.a.b.i.a majora, l.a.b.i.a minora, c.l.i.toris, vestibule, meatus urinarius, hymen, fossa navicularis, fourchette and perineum.

Mons Veneris.--This is a rounded eminence surmounting the pubic bones, and is composed of fatty tissue, covered by skin and hair.

The l.a.b.i.a Majora.--There are two more or less prominent longitudinal folds of cutaneous (pertaining to the skin) tissue, covered by hair and mucous membrane, which is continuous with the mucous membrane of the genital organs and urinary tract. They join at each extremity, forming the anterior and posterior commissures (uniting together). Between the posterior commissure (union) and the margin of the bowel is a s.p.a.ce of about an inch in extent, the Perineum. It is important to remember this part, for it is often torn in labor, to a greater or less extent.

The l.a.b.i.a are the a.n.a.logue of the s.c.r.o.t.u.m in the male.

The l.a.b.i.a Minora.--These are two smaller folds situated within the l.a.b.i.a majora, extending from the c.l.i.toris, downward and outward for about one and one-half inches on each side of the v.a.g.i.n.al opening. At their convergence at the c.l.i.toris each lip (labium) divides into two folds and these surround the glans (c.l.i.toris) forming its covering (prepuce) above and the bridle (frenum) below. These lips (l.a.b.i.a) are composed of mucous membrane covered by a thin epithelial layer. They contain a network of vessels and numerous large mucous crypts (small sacs or follicles) which secrete a quant.i.ty of (fatty) matter.

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The c.l.i.toris.--This is an erectile structure, the a.n.a.logue anatomically of the cavernous body of the p.e.n.i.s, and is an elongated organ partially covered by the anterior extremities of the l.a.b.i.a minora and connected on each side with the rami (slender process of the bone) of the pubic bones and the ischia (two bones) by a band. The c.l.i.toris is surmounted by a small tubercle (a small nodule) of spongy erectile tissue, the "glans c.l.i.toris," Two cavernous bodies of erectile tissue enclosed in dense fibrous tissue compose the body of the organ.

The Vestibule.--This is the smooth surface of triangular form situated between the c.l.i.toris and the entrance to the v.a.g.i.n.a. The l.a.b.i.a minora bound it on either side. It contains the opening of the urethra.

The Hymen is a thin fold of mucous membrane of half moon in shape (semi-lunar) and is spread across the lower opening of the v.a.g.i.n.a.

The Glands of Bartholin are small oblong bodies, two in number, situated on each side of the commencement of the v.a.g.i.n.a above the deep fascia band like tissue. Each gland has a single duct and by this duct opens the inner surface of the adjacent l.a.b.i.a minoris just external to the hymen. They are made up of mucous glands and a colorless tenacious fluid is secreted by them, which lubricates the v.a.g.i.n.a. These glands sometimes become diseased.

Hence the description.

The v.a.g.i.n.a.--This is a membranous ca.n.a.l and extends from the v.u.l.v.a to the uterus (womb) and connects the external and internal organs of generation.

It is four to six inches in length, the anterior wall being from one to two inches shorter than the posterior. It lies in the cavity of the pelvis in front of the r.e.c.t.u.m, behind the bladder and follows first the line of axis of the cavity of the pelvis, and afterwards the axis of the outlet.

The v.a.g.i.n.a consists of an internal mucous lining (membrane) continuous above with the mucous membrane lining the womb and below with the covering of the l.a.b.i.a majora. The next covering (inward) is a muscular coat consisting of two layers--an external longitudinal and an internal circular. There is a layer of erectile tissue between the muscular coat and mucous lining. The lower end of the v.a.g.i.n.a is surrounded by a band of striped muscular fibers comprising the sphincter muscle of the v.a.g.i.n.a (sphincter v.a.g.i.n.a).

The internal organs of generation, more commonly called the pelvic organs.

These comprise the womb, fallopian tubes and ovaries.

[492 MOTHERS' REMEDIES]

The womb is the organ of pregnancy, and receives the fruitful egg (ovum), supports it during its development and expels it at the time of labor (parturition). In form it is pear-shaped, weighs from 12 drams to 3 ounces and is situated in the pelvic cavity, between the bladder and the r.e.c.t.u.m, with its base upwards and its apex, smaller end downward. Its upper broad extremity is called the fundus--base of the organ, and the lower, constricted, narrowed portion is called the Cervix (neck or constricted portion). The body of the womb gradually becomes narrower from the fundus to the Cervix.

Its anterior surface is covered on its upper three-quarters by the peritoneum, while the lower fourth is connected with the bladder. The peritoneum covers the whole of the posterior surface. The womb is held up (suspended) in the pelvis by ligaments; two anterior, womb and bladder (utero-vesical), two posterior, womb-sacral (utero-sacral), two lateral broad ligaments, and two round ligaments. The womb sacral (utero-sacral) which holds the womb well up in the hollow of the sacrum and the round ligaments which keep the womb well forward enter most actively into the support of the womb. The round ligaments are strong muscular fibrous cords and serve to hold the womb forward. When pregnancy exists they increase in size with the womb, and keep the fundus forward in its excursion upwards into the abdominal cavity, and after confinement, become smaller with the womb, guiding the womb back again to its regular position. The broad ligaments are little more than reflection of the peritoneum serving to support the vessels that nourish, as they go to and from the womb.

The womb has three coats, enclosing a central cavity. This cavity of the womb is small by comparison with the size of the organ and it communicates with the Fallopian tubes by two minute openings at each side of the body, and with the v.a.g.i.n.a below, through the mouth or opening of the womb.

The external coat of the womb is called servos, derived from the peritoneum; the middle or muscular coat, which forms the chief substance of the womb, consists of bundles of unstripped muscular fibers intermixed, with loose connective tissue, blood vessels, lymphatics and nerves; the internal or mucous coat is continuous through the fringed extremity of the fallopian tubes, with the peritoneum, and through the mouth of the womb (os uteri) with the mucous membrane of the v.a.g.i.n.a. This mucous membrane is lined in the body of the womb by epithelium arrayed in columns (Columnar Epithelium) which loses its ciliated (eye-lash) movement character during pregnancy. In the lower half of the Cervix, the epithelium (this kind of cell lines all ca.n.a.ls having communication with the external air) is of the stratified (arranged in layers) variety. The appendages of the womb are the fallopian tubes, the ovaries and their ligaments and the round ligaments. The fallopian tubes convey the ova (eggs) from the ovaries to the cavity of the womb. They are two in number, one on each side, situated in the free border of the broad ligaments and extend from each horn, an excrescence of the womb that looks like a horn, of the womb outward to the sides of the pelvis; each is about five inches in length, and has a small ca.n.a.l beginning at the womb in a very small opening called the internal mouth (ostium internum). This ca.n.a.l gradually widens to its ending, the abdominal mouth (ostium abdominal) by which it communicates with the peritoneal cavity, the timbrae. A series of fringe-like processes surround this mouth or opening and this farther end is known as the fimbriated extremity. The tube has three coats, serous or external or peritoneal; the middle or muscular, continuous with that of the womb, and an internal or mucous coat continuous also with the lining of the womb and peritoneum (covered with ciliated Columnar Epithelium).

[WOMAN'S DEPARTMENT 493]

The Ovaries.--They are a.n.a.logues, anatomically, of the testes in the male.

They are two egg-shaped bodies situated one on each side of the womb on the posterior aspect of the broad ligament, below and behind the fallopian tubes; each is connected by its anterior margin to the broad ligament; internally to the womb by the ovarian ligament, externally to the fringe-like extremity of the fallopian tubes by a short cord-like ligament. They are white in color; about one and one-half inches long, three-quarters of an inch wide and one-third of an inch thick and weigh about two drams each.

The ovarian ligament extends from the inner side of the ovary to the superior angle of the (Uterus) womb. The round ligaments, two in number, are about five inches long and are situated between the layers of the broad ligament, one on each side of the womb in front and below the fallopian tube. They pa.s.s forward and outward from the womb through the internal abdominal ring, along the groin ca.n.a.l and out at the external abdominal ring.

I have given a lengthy description of these organs; I think it will repay a careful reading. To understand a disease one should understand the organs that are subject to the disease.

CAUSES OF DISEASES OF WOMEN.

Dr. Child says among primitive people, woman is notoriously free from many of the diseases to which her sister in our present-day civilization is especially p.r.o.ne. As we ascend the scale of civilization, departing from a natural and adopting an artificial mode of life we find nature enacts due penalties for the transgression of her laws. The female among savage tribes has every advantage and opportunity to develop physical perfection, and her endurance suffers little, if any, by comparison with the male. How different is our modern system when the young girls are sent early to school and subjected daily to long hours of study, often in badly ventilated cla.s.s-rooms, for nine months in the year, and this at the time of p.u.b.erty, one of the most important periods of their life when they need plenty of out-door exercise. Surely, as Goodell says, "If woman is to be thus stunted and deformed to meet the ambitious intellectual demands of the day, if her health must be sacrificed upon the altar of her education, the time may come when to renew the worn out stock of the Republic it will be necessary for our young men to make matrimonial excursions into lands where educational theories are unknown."

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Menstruation.--Many of the disorders of menstruation are due to carelessness and neglect of this function. There should be rest of both body and mind at this time, and especially at p.u.b.erty. Rest is seldom allowed, but the daily routine is gone through, regardless of what may happen.

Dress.--The way the abdomen is now constricted, and this is now a prominent feature of women's mode of dress, is without doubt an important predisposing cause in female diseases. This contraction of the normal size of the cavity of the abdomen, with the subsequent compression and displacement of its organs, must of necessity produce dynamic (powerful) changes in the pelvis that cannot be otherwise than injurious to the pelvic organs. Tight lacing or any lacing, aside from the remote effects so unnatural a practice must produce, causes marked atrophy (dwindling) of the abdominal muscles. These are often so weakened that during labor they cannot properly a.s.sist the uterus (womb) in effecting delivery, and as a result instrumental interference, with its attendant dangers becomes necessary.

Prevention of Conception.--This is a very common practice among civilized women, and it has a most destructive effect upon the pelvic organs, as well as upon the general system.

Criminal abortion.--The chief danger from the criminal interruption of pregnancy is sepsis (absorption of poisons) into the system. This may be acute in character and have a fatal termination, or chronic in nature, leading to permanent injury of the womb and fallopian tubes, sterility and chronic invalidism.

Child birth.--Pelvic diseases frequently come from injuries received during labor.

Venereal diseases.--Dr. Child says, "Syphilis exerts its usual baneful influence, but gonorrhoea is responsible for more pathological (diseased) lesions (conditions) in the female pelvis than any other one factor. Its attack, if not resulting in ultimate loss of life, always leaves the tissue in an impaired condition, from which resolution (returning to natural condition) is rare. It is doubtful if a woman once infected with gonorrhoea ever recovers from its ravages. As a cause of sterility its power is beyond estimation."

INFLAMMATION OF THE v.u.l.v.a.--(Vulvitis).--An acute or chronic inflammation of the v.u.l.v.a (external genitals) either from a specific, like gonorrhoea, or non-specific cause.

Causes.--Veit says, "Seventy-five per cent of the cases are caused by gonorrhoea."

Other Causes.--Acc.u.mulation and decomposition of discharges from the womb and v.a.g.i.n.a, inflammation of the inner lining of the womb and of the v.a.g.i.n.a. Foul, putrid discharges from neglected supports (pessaries) and tampons in the v.a.g.i.n.a; sloughings from cancer may act as exciting causes.

Contact with ammoniacal and sugar urines has a similar effect.

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In Infants.--It is usually due to want of cleanliness in failing to remove decomposing urine and feces. Mothers often allow soiled, foul smelling diapers to remain for a long time on the baby.

Symptoms and Condition of the Parts.--In the acute stage the mucous membrane around the opening of the v.a.g.i.n.a is red, swollen, painful and bathed in pus. The glands in the groin and glands of Bartholin are usually enlarged and tender. The glands of Bartholin and those around the urethra may become infected and fill with pus. The fatty glands of the l.a.b.i.a majora are also sometimes affected and then appears the disease called Follicular Vulvitis (in the chronic stage secretion is abundant). The parts feel hot and there is more or less burning and itching. Walking makes the trouble worse, due to rubbing of the parts. Pa.s.sing of urine increases the distress.

When the disease is caused by gonorrhoea it is more extensive and involves the v.a.g.i.n.a, urethra, the glands around the urethra and glands of Bartholin. This gland infection frequently results in an abscess.

Treatment.--In the acute form the patient should go to bed and remain there for some time. The parts should be kept constantly moist with a wet antiseptic dressing, listerine, hot water, etc., applied to the v.u.l.v.a and kept there.

1. If there is much pain the following solution may be used:

Acetate of lead 1 dram Laudanum 1/2 ounce

Water enough for six ounces.

Mix and apply constantly with sterile cloths.

2. For chronic form Dr. Child says, "The v.u.l.v.a should be shaved, thoroughly cleansed and a mild ointment applied daily thereafter," such as: