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3rd. Anatomically, it is least protected from an anteversion (or flexion), for the uterine axis is obliquely forward, as regards the force of gravity, and it sustains, upon its posterior and upper wall, some of the weight of the intestines. Moreover, there are no
fundo-sacral ligaments; and the bladder, generally empty, or nearly so, is the sole antagonist of the round ligaments.
Among one hundred and fourteen women examined, by M. Panas (vide “ L'Union Medicale ”), one-third were subjects of these errors in place; and they were mainly young, unmarried or non-parturient, and therefore, less liable to accident.
Inferentially, this diversion should be attended by less physical annoyance than its opposite state. Torsion of the broad ligaments can here only reach over an arc of 35°, and is not necessarily obstructive.
4th. In her defences against retroversion, nature has spared no pains. The round ligaments above and in front, and the cervicosacral below and behind, not to speak of the obliquity of the broad ligaments and the intestinal compress in Douglas' cul-desac, all fortify the uterus most evidently, in this direction. The cervix kept within an inch and a half of the sacrum, and the round ligaments preserving a fundo-pubic distance of two inches and a half, no retroversion can occur. (Meigs, Woman and Her Diseases, p. 208.)
Inferentially, this displacement is far more serious in its results than any other. Torsion of the broad ligaments may here extend over an arc of 160°, obstructing the venous channels, giving rise to congestions, ovarian and uterine, and by impeded or distorted reflex action, originating hypertrophies, hyperæsthesias, and disurbances of the menstrual function.
Such is the success of fashion, as arrayed against nature, that “ seventy-five per centum of uterine disorders and displacements consist in retroversion of the womb,” (loc. cit.)
5th. The uterus can descend in its own axis, (i. e., "lapse”) but one inch and a half.
It can be moved forward, its obliquity being preserved (“ prolapse”) not more than two inches and a half.*
* The writer considers that any divergence of the upper uterine axis backward, so far as, or beyond a parallelism with the vertical axis of the body, derivatively speaking, a “retroversion."
6th. Inferentially, the os uteri was not intended to impinge upon the pelvic floor.
Still less should it rest upon foreign bodies of greater firmness and resistance.
7th. The vagina is intended as a reservoir.
Retroversion and prolapse rob it of its receptive and retentive powers, and diminish the probability of conception.
Anteversion has less of this tendency.
8th. The fact that the cervix uteri “falls easily” into the mouth of a speculum, is corroborative of a tendency to retroversion, the normal angle of incidence of uterus upon vagina being about 70° — an acute angle.
9th. No pessary should fix the womb immovably, or elevate the os uteri more than one inch and a half (to two inches?) above the perineal structures, or force the cervix backward more than two inches and a half from the pubis. The point C (vide diagram) may be thus held at a distance of three and a half inches.
Any abdominal compress, however constructed or applied, forces the intestines in the direction where there is least resistance ; will inevitably and in time overcome the elasticity and tone of the uterine supports, muscular or ligamentous, causing lapse and prolapse, and when a degree of retroversion exists, will certainly increase its extent, and hasten the evils which attend thereupon.
Finally, artificial supports for the uterus should always harmonize with Nature's provision for the safety of tissues, the propagation of the species, and the comfort, bodily and mental, of the patient wearer.
ARTICLE II. – On Life, from a Physical Basis; and some
Qualities or Phenomena, which are thought to be Pecu-
The qualities possessed and phenomena developed by human beings and other organized bodies, and the qualities and phenomena of inorganic matter on their surfaces, present few points of resemblance. Observers, from the remotest antiquity, have all, or mainly all, united in attributing certain phenomena to an unknown force, or something, which they designated as “ vitality,” “ vital force,” or “ vital principle,” or “ life.” Its existence was inferred from the phenomena of life, and the qualities and phenomena possessed by living beings were admitted to demonstrate its existence.
Doubters may, perhaps, have existed, from time to time, of this philosophy; but, if so, they failed to make any impress on current science or thought, until a very recent period. But they do exist now, and though their numbers may be few, they will not likely ever be any less.
In this iconoclastic movement, the Muskingum County (Ohio) Medical Society is entitled to whatever merit may hereafter attach to the initiative, or the dishonor attached to failure, in endeavoring to bring the phenomena of organic life, in health and disease, squarely within the pale of physical or exact science, and the dethronement of the imaginary idol of " vitality,” as a superterrestrial force, which has so long swayed the minds of scientific investigators of the material and forces of organic life.
But its membership is, by no means, a unity in the matter; while all admit, perhaps, that some of the phenomena of organic life may be due to the operation of the ordinary physical forces of nature, there are others who think that living beings possess some qualities, which, in themselves, are peculiar, and irreconcilable with any ideal of life from an exclusively physical basis. Thus, at a recent meeting, one of its members read an elaborate, carefully-studied, able and dignified paper, opposed to a physical basis of life, and summing up the following qualities as points for which physical science offered no explanations :*
“But, allow me to mention some qualities which are peculiar to life, viz. :
ist. Activity: contra distinguished from simple motion, and this presenting often as opposed to the physical forces.”
2nd. Individuality; which causes even like particles of matter to present different features.
3rd. Reproduction; or perpetuation of individuality. 4th. Immutability; or the maintenance of “life," notwith
* Copy furnished me by the author.
standing all the molecular changes which take place in an organic body.
5th. Sensation; or the appreciation of bodily states and wants. 6th. The quality of Perception. 7th. The quality of Instinct; and, in man, 8th. The faculty of Reason ; 9th. The faculty of Consciousness;
roth. The Will, and mental and moral phenomena in general.”
These are strong points, well and wisely chosen, and if they cannot be reduced to simple physical elements, and shown to have their manifestations due to the operations of ordinary chemical and physical law, the attempt to construct a physical basis of life has been undertaken without sufficient knowledge, and must be considered a failure. It will, therefore, be needful to analyze each of these ten qualities separately, and ascertain whether they can be reduced to simpler elements than appear on their surfaces.
ist. Activity, and“ as contradistinguished from simple motion.” Activity, if it has any meaning at all, is rather a quality of motion than anything distinct from motion. It is, in fact, motion — nothing more, nothing less — if it represents any thing else than a quality of motion; and, in organic life, is certainly due to correlations of the ordinary physical forces of light, heat, electricity, etc., etc. It seems to me quite unscientific to invent causes, when those already in actual existence are at hand to account for any or all of the qualities or phenomena of “life.” The simplest element therefore of activity is motion.
3rd. Individuality. That is, separate and distinct existence. The wheaten loaf is certainly the formless protoplasm of all animal tissues; that is, man and beast, bird and worm, fish or insect — the most diversified distinct existences — inay eat from the same wheaten loaf, and at will make their tissues; that is, their separate existences. Hence, their individuality must consist in something else than matter, for the same first matter of life enters into them all; and the simplest element, therefore, of individuality must be in form, or forms. Thus, the difference between bone and brain matter is certainly very striking, yet that difference is due to form, and not to the material of which each is composed; for, in different proportions, probably, their ultimate elements are the same. Nor is the resemblance between the human infant, deriving its whole sustenance from its mother's milk, and the mother's milk, any nearer; yet the tissues of the infant have certainly been constructed from its mother's milk; and the difference between them is principally in their forms. Again, the material of the pen which traces the manuscript from which this article is printed, existed, possibly, at one time, in combination with quartz rock in California. It was gold then, and is gold still. After passing through many metamorphoses, it has become a pen, and the feature which distinguishes it from the gold from which it was made, is its form. The simplest element, therefore, of individuality is form.
4th. Reproduction. In organic life, no one expects, because such things have never happened to any one's knowledge, that in the act of reproduction, an elephant should give birth to a chicken, for example, or to perpetuate any other than its own general forms. Hence, reproduction, stated in its simplest terms, consists in form and motion.
5th. Immutability. Maintenance of form with incessant, or, perhaps, frequent molecular changes. The simplest statement of immutability, as applied to the maintenance of life or form, is form ; and is due to the operations of what the writer has designated as the “ form force" of organic life. * But the records of morbid anatomy unhappily show that organic forms fall short of immutability; for if the forms of organic life were really and truly immutable (in the ordinary meaning of the word); that is, always maintaining “ life” or “forms," organized bodies would be immutable, and, in addition, possess another quality, to-wit: immortality. These would be, because there could be neither disease, old age, or death; for these are due, taking the testimony of pathology and morbid anatomy to (in their phraseology) changes of structure, which is, again, simply changes of form. For if the forms of organic life were always maintained intact, the vocation of the physician would as certainly cease as the vocation of Demetriust ceased with the worship of Diana. The simplest element of immutability, as here used, is form. * “Western Journal of Medicine,” September, 1869. † Acts of the Apostles, xix. 27.