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This clinic was started nine years ago. For the past three years it
has been arranged that each patient receives a combined medical and
gynaecological examination at her first attendance. The following is a
brief analysis of 200 consecutive patients seen under this system.
1. Sub-involution. (53 Cases, of whom 37 had been confined in hospital,
16 at home.)
Under this heading are included only those patients who still complained
of haemorrhage, and in whom the uterus was found definitely
enlarged on examination. In several instances it corresponded with the
size of the pregnant uterus at 3 or 4 months and was easily palpable above
the pubes. In one case fibroids were present; all others returned to
normal size with treatment by ergot. The average interval between
delivery and first attendance at the clinic was 4.8 weeks.
2. Cervicitis. (25 Cases, of whom 15 had been confined in hospital, 10
at home.)
Cases characterised by purulent discharge, sometimes blood-stained,
usually accompanied by erosion and sometimes by laceration of the cervix.
(The last feature was noted to be severe in three instances.)
3. Perineal Laceration. (4 Cases, of whom 3 had been confined in hospital,
1 at home.)
Four complete tears. Attempts at repair had been made in all;
complete failure of union in 3; recto-vaginal fistula persisted in 1.
4. Dental Sepsis. (39 Cases, of whom 27 had been confined in hospital,
12 at home.)
Only women are included whose dental sepsis was severe, and who
were in urgent need of extractions, on account of widespread caries,
multiple abscesses, or pyorrhoea, (e.g., "12 teeth extracted," "8 teeth
and 5 roots extracted," "7 teeth and 9 roots extracted"—dental
surgeon's subsequent notes).