Concerning the commoner displacements and malpositions of the uterus which are a source of perplexity, annoyance and discouragement to every physician, the following summary might be made:
Displacements occurring immediately after confinement should be discovered, diagnosed and treated at once, at which time they are readily curable.
Displacements recent in character which have occurred from any cause, if treated with confidence, are permanently curable in the large majority of cases. In all cases the cause should be removed. Chronic displacements, those that have stood for perhaps a year or more, may be relieved, but complete permanent cures are very rare, as tissue metamorphosis occurs by this time, and if there is any degree of inflammation, adhesions are likely to form.
A long train of symptoms resulting from the changed position, reflex nervous irritation, constipation, etc., follow these displacements. Acute manifestations of these symptoms may be relieved by proper treatment and the displacement remain and become chronic. After special causes of irritation and local engorgement, these symptoms may return to again be removed by proper treatment, the real condition still remaining.
Pessaries were at one time very popular. They have proved to be of questionable efficacy, and in no case should they be allowed to remain in more than a few days. They exercise their best influence in contributing to the relief of chronic conditions while other treatment is being instituted, their influence to be dispensed with as soon as the influence from the other treatment is apparent.
The use of tampons properly medicated is adjustable to a wider range of conditions with better results than any other course of treatment. Cures in a number- of cases have been accomplished by their careful use.
Dr. Woodward's method of intrauterine medication contributes very satisfactorily to the correction of misplacements, and to the cure of chronic conditions which have been induced by the misplacements.
The use of electricity, especially the faradic current, will be found of great service in reducing enlargements, especially those from chronic nephritis, or from sub-involution of recent origin. The use of glycerin tampons for enlargements in conjunction with electricity is important.
Whatever method is adopted it must be persisted in for months, and the general tone of the patient must be improved by every available indicated measure.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.