A Medical View of Pelvic Peritonitis.

ELLA RICHARDSON COUTURE, B. S., M. D., AUBURN, CAL.

The gynecologist is seldom called upon until the case has become chronic. The patient has exhausted the skill of herself and all of her friends and all the proprietary remedies she ever heard of. She comes to the office hopeless and discouraged and always assures you she does not expect to be cured, but nevertheless proceeds with her "tale of woe." We will pass over that long familiar story so full of pain and woe to the patient and perplexity for the physician, giving you a few of the remedies and the conditions for which we have used them. We assure you some of the results have been surprising. After a careful examination, noting the extent and results of the recurring inflammations, the general physical condition, the temperament and characteristics peculiar to the patient herself, we seek the remedy or combination of remedies suitable for her rather than her disease—for example:

Belladonna—For the quick, active brunette, jolly when well, a growler when ill, bright, shiny eyes, dilated pupil, quick, excitable pulse, throbbing carotids, pains come and go quickly, just darts, burning soreness, worse at night, delirious, may be better up to 11 a. m., then worse. Menstruation too profuse, bright red, comes in gushes that feel hot to the patient.

Pulsatilla—Light, fair, frivolous, flighty, easily swayed, bitter sour taste; flat, coated tongue, borrowing trouble, hysterical. Menstruation one day one way, one day another. Pains shift suddenly in character and locations. Thick, yellow, bland leucorrhea, chilly but better out doors in the open air.

Mitchella Repens—A splendid tonic where there is that anxious longing they know not for what.

Bryonia—Large, fat, fair, quick actioned women, thirsty for large quantities of water at a time. Pains sharp, cutting, stabbing in character. Does not want to be moved, must lie perfectly still. Constipated, with broad tongue, white or yellow coat.

Cantharis—Urine hot, comes in drops with great anguish. Bright specks before the eyes.

Mercurius Corrosivus 6x—After the inflammation of the acute attack is over to help absorption and it is wonderful what it will do. Low fever, chilly up and down back, creeps, sallow, dirty complexion. Perspiration, cold, clammy, sticky, which gives no relief.

Rhus Tox—Long pointed tongue, tip red. Restless, must be on the continual move. Pressing, cutting pains in the abdomen, worse at night especially toward evening.

Palladium—Sharp cutting pain in uterus as if a knife thrust through, aversion to any motion. Very proud and egotistical, fond of admiration. We once cured a case with the 6x that had a tumor, large as a small egg in left ovarian region, was hard, we were more than surprised to see it absorbed in two months' time as well as was the consultant who had expected to operate.

Platina—The haughty, scornful woman, better than any one else, sensitive to the least touch and terribly afraid to die, much trembling of limbs.

Echinacea—Twenty to thirty drop doses repeated every hour to three or four times daily is the king pin, and in septic form can not be equaled.

For the local treatment of these cases we use several tampons of wool that have been previously medicated with boro-glyceride, saturated solution; or ichthyol 10 to 20 per cent solution with glycerine. We place the tampons anteriorly, posteriorly and latterly also under the cervix, lifting the uterus, ovaries and adnexa, taking the weight off the ligaments, the medicament absorbing the adhesions. We direct in 48 hours the removal of the tampons, the taking of a vaginal douche consisting of three quarts of hot water, just as hot as can be borne, putting a tablespoon of boro-glyceride with last pint of hot water same to be retained as long as possible. The douche must be given with patient on her back, hips elevated and bed pan to receive tile overflow. The patient is directed to return twice a week for local treatment.

We insist upon our patient breathing properly, long and deep, of pure fresh air— for breath is life. We look after elimination, making sure the skin, liver and kidneys are doing their work.

Ellingwood's Therapeutist, Vol. 3, 1909, was edited by Finley Ellingwood M.D.