V.
PERIMETRITIS AND PARAMETRITIS.
Lately I told you that procidentia of the womb is purely mechanical, as much so as a dislocation of the shoulder or a hernia. Now, the subject upon which I am to lecture is inflammation in the neighbourhood of the womb, and I begin by telling you, what I shall almost immediately afterwards partially contradict, that this disease is purely vital. Although it would be well worth our while, yet it is not at present a proper subject, to enter upon the great question implied in vitalistic doctrine, which has been very extensively discussed in this hospital, a discussion in which very great men have taken part,—for instance, Abernethy, Lawrence, and still more recently, Sir James Paget. I shall only say that I call this inflammatory disease vital, not because I believe in vitalistic doctrines. The whole tendency of my scientific thoughts is against vitalistic doctrines. I believe the time will come when nearly all the diseases of women will be explained by a transcendental physics, including chemistry. But that time is very far distant, and I dismiss this subject, merely remarking that the disease which we are about to discuss is vital in. contradistinction to procidentia, which is rudely mechanical.
Time will allow me to dip only superficially into our subject. In medicine and surgery inflammation is the most important of all the morbid processes. So it is in gynaecology. I shall now take two inflammations—one, parametritis;
