that needs
attention, and is left in ignorance of it, her physical health may be
slowly and seriously undermined and the cause of it may not be understood
or even guessed at. A woman who becomes nervous and irritable, loses vim
and vitality, has headaches, backaches and anemia, and no symptoms, or few,
that point to disease of the womb, will suffer a long time before she seeks
relief of the right kind, and will be astonished and outraged when she is
told that it all results from a bad tear of her womb that she knew nothing
about.

2nd. A physician should in justice to himself insist on this late
examination, because if a woman is told, at some subsequent time, by
another physician that she is badly torn, and she was not told of it by the
physician who confined her, she is very apt to form an unjust opinion of
his work and to entertain an unfriendly feeling toward him as a man.

Some physicians also, to their discredit, are not slow in permitting an
unjust opinion of a colleague to be spread around, by preserving a silence,
when an explanation would result in an entirely different opinion by the
patient. They permit it to be inferred that the physician was responsible
for the tear, when such is not the case. No physician on earth can prevent
a tear of the mouth of the womb and this should be explained to the
patient. Where the physician is at fault is in the failure to examine his
patients when it is possible to tell that a tear of any consequence exists.
If such an examination is made, he is in a position to state that a tear
exists of sufficient extent to justify careful attention. Immediate
operation is seldom necessary, and if the patient is comparatively young,
it may not be wise to operate, because if pregnancy takes place within a
reasonable time the womb will again tear. She should be told, however, that
should she not become pregnant during the next three years she should be
examined from time to time, and if the condition of her womb, or her health
suggest it, she should have the tear attended to. If after this explanation
she neglects herself she must blame herself, she will at least have no[119]
cause to harbor any resentment against her physician who has done all any
physician is called upon to do under the circumstances. Another important
reason for finding out the character of the laceration is because these
lacerations of the mouth of the womb frequently cause sterility.

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