THE USE OF THE CURETTE IN THE TREATMENT OF ENDOMETRITIS
C. L. BONNIFIELD
1897
Journal of the American Medical Association (JAMA)
and through this accelerates the access of alkalin blood to the inflamed districts. Our views of disease at present are in a stage of transition, the inherited slab bones are found to not fit anymore and if several diseases are discovered to present one identical pathologic phenomenon, they are thrown together heterogeneously as they might be. Loewitt observed what he calls leukopenia in rabbits with rapid sinking of temperature as soon as they were exposed to shock; another repeats the same
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... eriment on turkeys, with the same results, finds leukopenia in neurasthenia (a totally arbitrary classification of morbid symptoms, which accompany many entirely different diseases) and says that leukopenia is the cause of neurasthenia, because we notice the same morbid fears there. Since excessive formation of uric acid has been discovered in many other diseases besides gout, Haig and others subject almost every chronic ailment to the uric diathesis, it has seemed to me therefore necessary to show that uric acid has no toxin effect and that its presence has directly nothing to do with the apparent disease. We have to go back to the generation of uric acid, to the poisonous noxes, which create uric acid, and there we find that gout is a disease per se, it has nothing to do with rheumatism or other diseases, we are able to distinguish it clearly from that whole mass of confused conception and substitute for its treatment a really physiologic basis. 544 N. Wells Street. Endometritis, for the purpose of discussing the use of the curette in its treatment, is best divided into three varieties\p=m-\catarrhal, septic and gonorrheal. Catarrhal endometritis is the form of pelvic disease most frequently induced by improper habits of life, consequently the one most amenable to constitutional or medical treatment. A large percentage of cases occur in unmarried women. In the society girl it is produced by the nightly exposure of the arms and a large portion of the chest, whereby the blood is driven into the interior of the body, congesting the uterus along with other organs; the tight corset, displacing the abdominal organs and interfering with the action of the heart and lungs; the numerous meals at irregular hours of stimulating and indigestible food, the position assumed in dancing and the exposure and lack of rest during menstruation. In her less fortunate sisters, the school teacher and the shop girl, the constant standing serves as an efficient exciting cause. Another cause, I deem of importance, is unsatisfied sexual desire. Genito-urinary surgeons tell us this is an important factor in the production of hypertrophy of the prostate, which is a condition in the male somewhat analogous to fibroid tumors of the uterus in the female. We all recognize the fact that this latter affection is a penalty frequently paid for celibacy. If it produce this graver result of persistent uterine hyperemia it is fair to suppose that it will also produce catarrhal endometritis.
doi:10.1001/jama.1897.02440050026001g
fatcat:xloitk7v7bhathauqnceith254