Causes.—­The majority of cases are caused by labor, and is due to a cervix that is not perfectly dilated.  Very hurried, quick labors cause it sometimes, but the greatest injuries are due to the various operations for delivering the child through a cervix that is not fully dilated.

Symptoms.  Immediate and remote.—­On the immediate, when the tear is severe, there is bleeding; later, sub-involution, that is, the womb does not return to its normal size and weight.

Remote symptoms.—­Leucorrhea, thick and mucus in character; profuse menstruation and inability to become pregnant.  When the tear has extended through the internal opening the woman win not be able to carry the child to full term, even if she becomes pregnant.

[498 Mothers’ remedies]

Treatment.—­Tampons of ichthyol (ten per cent), mixed with glycerin, introduced twice a week against the cervix and permitted to remain forty-eight hours will often afford relief.

The tear should be repaired after child-birth, if possible.  If not then, and if it does not heal, it should be repaired later when the tear extends through the internal (opening) or in case of extensive raw surface on the cervix.

Inflammation of the cervix.—­This is an inflammation of the mucous membrane lining the canal of the cervix (cervical canal), known as Endocervicitis; it may be acute or chronic.  The acute form is seen most often as a part of a general infection involving both womb and cervix, and will be described later.  The chronic form is a very common condition and it is difficult to treat.

Cause.—­Injury and tear of the cervix.

Symptoms.—­Leucorrhea, profuse and frequent menstruation, pain in the back and loins.  On examination a string of thick mucus is seen at the external opening (os) of the cervix; and of women who have borne children there are usually signs of tear and rawness of the cervix present; (Endometritis usually produces a thin watery discharge, while gonorrhea produces a thick, pus-like discharge).

Treatment.—­Hot vaginal douches, containing one dram of sulphate of zinc to one pint of water, used every night for ten minutes.  Hot water with witch-hazel, about four drams to the pint, is also good.  Tincture of iodine applied locally twice each month.  White oakbark tea used as an injection once a day for this trouble; also good for vaginitis.

Inflammation of the lining of the womb.  Endometritis.—­Endometritis is an inflammation of the lining membrane of the womb, with a tendency to extend to the lining membrane of the fallopian tubes and to the peritoneum.  These are the acute and chronic varieties.

Causes.—­It may occur during an acute skin disease eruption, like that of scarlet fever, and occasionally upon exposure to cold during menstruation.  The most frequent exciting causes are the microorganisms, like the gonorrhea poison, etc.