My Experience with Intrauterine Medication.
J. M. COLEMAN, M. D., PEKIN, ILL.
Intrauterine medication, as the name applies, is that manner of treatment in which remedial agents are applied directly within the cavity of the uterus. Such treatment is indicated in all the diseased conditions of this organ and will always give good results when properly employed, it is easily and painlessly given, without danger to the patient and does not keep her in bed for several days as is sometimes the case on other treatments. It has proven serviceable to me in many ways, financially and otherwise.
I have been able to cure patients who were drifting from one physician to another seeking relief. Also my own patients who, if not relieved of their ills, would have left me and would not recommended me to others.
I first secured all the information possible from others, also Dr. Woodward's book devoted to the subject and increased my outfit with necessary paraphernalia and carefully began the work. I was City Physician for the poor of Pekin at this time and had a number of chronics, who had been making the rounds, seeking relief and being without money, were usually given very little treatment and their conditions were becoming worse instead of better.
By this treatment I cleared the docket and at the same time gained sufficient practical experience to successfully treat many patients who willingly contribute to my bank account.
There are the usual troubles incident to women, forms of uterine disorders, metritis, enlargements, dislocations of different kinds, catarrhal, gonorrheal, syphilitic cases in which the disease has extended into and through the cervix, where nothing short of direct application of curative remedies will be of any use. Headaches and sciatica reflex from these diseases are relieved and cured when other means fail.
Mrs. R., age 30 years; married for several years, no children, history, violent headaches for years, occurring monthly or more often, at which time she was prostrated for one or two days, with no relief except hypodermics of morphia, which relieved the pain but produced extreme nausea, which she said was nearly as bad as the headache. Menstruated every two or three weeks, uterus enlarged, boggy and partly dilated. I easily and painlessly dilated enough to introduce a recurrent flow catheter and washed out the uterus, using ten per cent peroxide solution, alternating with glycothymoline twenty per cent till return flow was clear. I applied a tampon of wool saturated with glycerin against the os.
The treatment was given every third day, as often as not interfered with by the menstrual flow, later once a week and as the conditions improved the patient did not think it necessary to come so often. At this time after more than a year there has been no return of the headaches, menstruation nearly normal, and whole general health so much better, that she thinks it unnecessary for further treatment.
One more case: Mrs. B., age 26 years, married, three children, general breaking down of health, gonorrheal infection was suspected, but denied by woman's husband. Patient not able to do her little housework, uterus enlarged, congested, ulcerated cervix, which bled easily. Sciatica in both lower limbs which she said would surely kill her.
I washed out the uterus every second day at first, then less often. The pains and other symptoms were better at once. Improvement continued till now, after more than a year from first treatment, she is doing family washings to help support herself and children.
There are many other cases in which I have successfully used this means of treatment, in fact am just getting a good start, each day offers new fields and new ideas. In several cases of miscarriage of from three to eight weeks, whether accidental or otherwise, intrauterine medication has proven a staunch friend in emergency.
These patients do not like to call their family physician, thinking to get all right without his help, but when consulted at the last moment, we find rather serious conditions to contend with, decaying, retained membrane or shreds, patient weak from hemorrhage, temperature high and increasing, the conditions so alarming at times that the case looks extremely doubtful. Empty the uterus with curette or forceps, if any large pieces remain, then a thorough washing out will soon produce the desired results.
The choice of the solution or the per cent of solution used may be varied to suit the different conditions existing, also as physicians have their preferences for certain remedies, but the main point to be reached, help for the patient, whatever remedies may be employed. Do not forget internal medication, whatever may be indicated; nursing, proper feeding, everything that is necessary to be done to help the patient, enabling us to earn the gratitude as well as the necessary article for our work.
COMMENT: This method has been introduced within the past five years by Dr. Charles Woodward of Chicago. His little work on the subject gives full details. He has had 30 years successful experience with the method and can give some astonishing experiences. He cured for me a case pronounced to be purulent salpingitis, in which a severe operation seemed to be the only hope.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.