Friday, June 14, 2013

Cauterization of Cervix

Roger Mitnick  /  at  1:56 PM  /  No comments

CAUTERIZATION OF CERVIX


Ulceration existing on the cervix uteri, or within the
cervical cavity, has a remarkable tendency to perpetuate itself indefi-
nitely, notwithstanding the subdual of all acute subacute inflammatory
action. This tendency is, no doubt, increased by the periodical san-
guineous congestions to which menstruation physiologically exposes the
inflamed tissues. Should it not yield, and it seldom does, to antiphlo-
gistic means directed as above, the most efficacious treatment, indeed
the only one that can be depended upon, is by direct stimulation of the
diseased and ulcereted surface, to modify its vitality in such a manner
as to induce a healthy action, and finally cicatrization. This end is ob-
tained by the use of caustics of varied strength, according to the nature
and extent of the dis3ase, its chronicity, and the effects obtained.

In the application of these two principles resides the entire theory
of the treatment of ulcerative inflammation, not only in the neck of the
uterus, but in any other part of the economy. We must first subdue
subacute inflammatory action by emollients, depletion, and astringents ;
and then modify by direct stimulation the diseased surface, so as to
substitute healthy reparative inflammation for morbid ulcerative inflam-
mation.

Although as I have stated these principles apply to ulcerative inflam-
mation in any region of the body, it is more especially in the treatment
of ulceration existing on the mucous surfaces at the various openings
of the body, that they are exemplified. Thus it is that we find cau-
terization to be the principal rescource in all ulcerations of the nares,
mouth, fauces, and anus, as well as in those of the external genital
organs, both of the male and the female. In all these situations,
cauterization presents an additional advantage to those which it offers
on a free ulcerated surface. The eschar which forms on the ulcerated
surface protects it efficiently from the contact of the various fluids
excreted through, and secreted by, the organ, the mucous membrane
of which is attacked, and thus allows the process of reparation to take
place undisturbed.

The progress of inflammation and ulceration is, generally speaking,
at once arrested by cauterization. The congestion and redness of the
cervix diminish visibly, the granulations become smaller and healthier,
the escape of blood is stopped, and the purulent secretion assumes the
character of laudable pus, if it has not presented it before. When
cauterization is suspended, the ulceration generally remains stationary
for a time ; but if left entirely to itself it is nearly certain to relapse,
after a variable period, however advanced the healing process may have
previously been.

'
SYMPTOMS OF CAUTERIZATION

The first symptom of cauterization always takes place at the circum- 
ference. The margin of the ulcerated surface loses its well-defined
character, and mingles imperceptibly with the red, inflamed, but not
ulcerated, mucous membrane. As the latter returns to its natural
pale colour, a film of white cicatricial tissue appears around the ulcera- 
tion, and gradually progresses towards the centre. Towards the end 
of the treatment, points of cicatrization will occasionally appear in the
centre of the ulceration, and by their gradual extension abridge the
process. When the ulceration is cicatrized, it presents a pale rosy,
or ash-coloured hue, which is pretty nearly the natural colour of
the healthv cervix, and soon becomes so much like the surrounding
tissues, that it is often next to impossible to say where the ulceration
existed.

The fibrous frame of the mucous membrane covering the cervix is so
slight, that the healing of an ulceration, however deep, is never follow-
ed by the formation of hard fibrous cicatrices, as in the healing of ulcer-
ations of the skin when they involve its fibrous structure. The mucous
membrane of the cervix, indeed, seems, as it were, to be renewed.
Even when a deep slough has been formed by the action of a powerful
caustic, such as potassa fusa, or the actual cautery, in the course of a
few months, or even weeks, all trace of the cicatrix disappears, and the
cervix again becomes soft and supple.

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