CAUSES OF DISEASE AMONG WOMEN. -- The great prevalence of diseases peculiar to the sex among American women, is a matter of remark by medical authors. The women of European countries are far less subject to these maladies than are American women, but yet they are more or less prevalent among all civilized people. Among the principal causes to which this state of things is attributable, the following may be enumerated: --

   1. Carelessness at Menstruation. -- Neglect to care properly for themselves at the menstrual period, either through carelessness or ignorance of the consequences, is probably one of the most common causes of uterine or ovarian disorders. Neglects of this kind are most likely to occur, and are most harmful, during the first two or three years after the beginning of the menstrual period.

   2. Sexual sins, in the form of self-abuse in the unmarried and excesses in the married, and prolonged excitement from erotic thoughts in both classes, are unmistakably a frequent cause of ovarian and uterine diseases.

   3. Neglect of the Bowels. -- Constipation is a prevalent disorder among women. It is sometimes the result of improper diet and sedentary habits, but is quite as frequently the effect of neglecting to evacuate the bowels at a regular hour each day, which is essential to proper

   4. Excessive Use of Drugs. -- This must also be set down as a frequent cause of disease in women, though not always of local disorders. After-dinner pills, liver regulators, laxatives, etc., frequently operate in an injurious manner upon the pelvic viscera.

   5. Errors in Dress. -- Tight-lacing, the wearing of heavy skirts about the waist, neglect to properly clothe the limbs, the wearing of high-heeled shoes, -- these and other errors in dress common among American women, are responsible for a large share of the weak backs and other evidences of local disease of which women complain.

   The importance of woman's dress has excited so much interest of late that it might not be out of place to give to its consideration at this point, a larger amount of space than under ordinary circumstances would be admissible. Not long since, a writer in the North American Review took up the cudgel in defense of what are considered by the majority of intelligent physicians as the most objectional features of fashionable dress. As the profession and reputation of the writer referred to are such that much harm may be done by the sophistical arguments which he presents upon the subject, it may be profitable to devote a little time to their consideration, though their real weight is so slight that if they had

   "Without going into the consideration of the dress of women in various parts of the world, it will be sufficient if I confine what I have to say on the subject to their apparel as worn at the present day. But it is an important fact that in the earlier periods of the history of the human race, there were no essential points of difference in the dress of the two sexes, except perhaps, in the way of wearing the hair. Roman men and women, for instance, wore pretty nearly the same kind of external garments. A plate in Planché's `History of Costume' represents a group of Anglo-Saxon men and women of the tenth century, and it is difficult, if not impossible, to tell which of the figures represent men and which women. The traditional fig-leaf was the same for both sexes, and from it were evolved skirts that varied but little in shape and general appearance, whether they concealed the nakedness of a man or that of a woman. The differences that now exist have mainly been caused by the revolt of man from the inconvenience of long skirts, and the assumption by him of a separate covering for each leg. What he has gained in the facility with which he can run, leap, climb trees, straddle a horse, row a boat, and do the many other things that his occupations require of him, he has certainly lost in grace and elegance. Trousers are of oriental origin, and in the form of breeches were worn by the ancient Gauls and Britons. They went out of fashion, however, soon after the occupation by the Romans, and the gown took their place, or rather re-acquired its place, for both sexes.

   "So far as I know, the wearing of trousers by women is a mere matter of convenience and æsthetics that they are perfectly competent to settle for themselves, and that they certainly will decide without interference from the other sex. It is not a question into which sanitation enters. There are no statistics to show that the partial exposure of the lower extremities to the atmosphere, which more or less attends upon the absence of trousers, leads to greater ill-health or mortality than when they are more securely covered with trousers. Rheumatism, sciatica, hip-joint disease, white-swelling, neuralgia, etc., are more common in men than they are in women. It is true that women sometimes wear drawers in winter, but they are in general a poor protection in themselves compared with the close-fitting woolen drawers of men, and the superimposed trousers of even more compact material. As a matter of fact, however, women endure cold weather as well as do men, not because they are more warmly clad, but because, owing to the flowing character of their garments, and the fact that they are not in close contact with the lower part of the body, a stratum of air exists between them and the skin, and this, being a good non-conductor of heat, prevents the rapid cooling of the surface that would otherwise take place. It acts just as does the two or three inches thickness of air when double windows are put into a house."

   A Muddled Professor. -- What a pity that the discovery that loose skirts are warmer for the legs than closely fitting garments, should have been made at so late a day as this! What an amount of earnest talk has been wasted! How the advocates of dress reform have

   Personally, we have never had any experience in petticoats; but when we have seen a woman battling her way along the street against a December wind, with

   "But as the occupations of women are gradually becoming identical with those of men, it appears to be desirable, on the score of convenience, that they should wear trousers, even at the sacrifice of warmth and beauty. A woman commanding a steamboat would certainly be more efficient in trousers than in long skirts. A saleswoman in a shop would do her work with more comfort to herself, and more to the satisfaction of her employer, if she were disencumbered of the gown and petticoats that prevent her from climbing step-ladders to get down goods, or jumping over the counter, like her male rival. Even as a physician, or as a nurse in a hospital, she would more effectually perform her work if she wore trousers, and thus had more freedom in the motions of her lower limbs. A woman surgeon, for instance, called upon to reduce a dislocation of the shoulder-joint, would find skirts very greatly incommodious when she came to put her heel into the axilla of the patient

   "If I had the determination of the question, I should prescribe trousers for all women that do manual labor, except such as is of a purely ornamental character, -- embroidery, crocheting, etc., -- and such as is strictly confined to the use of the hands, without the legs' being necessarily brought into use, -- sewing, knitting, writing, painting, etc. The sewing-machine should never be worked by a woman in skirts. The gown and petticoats I would reserve exclusively for women embraced in the above-named exceptions, and for those whose office in society is to be ornamental and useful in the various social relations of life. Certainly a great deal of the æsthetics of a drawing-room, a ball-room, or a dinner-table would be lost if the women who attend them wore trousers instead of the silk, satin, and velvet gowns that now add so much to their loveliness. I can quite conceive that a man thoroughly imbued with the prejudices received from a biased education, indisposed to accept new ideas, and deeply endowed with a love for the beautiful, might be reluctant to pay his addresses with a view to matrimony to a woman wearing trousers. Still, under the influence of familiarity with the idea of a change in the nether garments of the sex, and especially should they be generally adopted by pretty women, it might reasonably be expected that a change of opinion and emotion would ensue, and that perhaps in time he

   Our author is afraid that the ball-room and the dinner-table will lose some of their "æsthetics" if women should put on trousers; but he at once admits that the "æsthetics" of the dress question is wholly a matter of habit, and may be completely reversed if sufficient time is allowed.

   "There is another point that requires consideration, and that is the practice of wearing the gown cut low in the neck, so as to expose the breast, and without covering for the arms. It is doubtful if this leads to any ill consequences. It has been continued for many generations without apparent injury. It might be supposed, at first thought, that bronchitis, pleurisy, pneumonia, and many kinds of rheumatism and neuralgia would be the result of the custom; but such is really not the case, all these affections being much more frequently met with in men who cover the chest and arms with several thicknesses of woolen material in addition to a shirt of linen or cotton."

   Our learned author evidently delights in paradoxies. He gravely says, "There is another point that requires consideration," referring to the practice of exposing the arms and chest, formerly more fashionable than at the present time. One certainly would expect to hear at least some word of condemnation of this fashion, the unhealthfulness of which has been too frequently demonstrated by those addicted to it, to require the dictum of a learned doctor either for or against it. Indeed, the Professor himself seems to recognize the apparent weak-

   "It has been strenuously urged by many so-called sanitary reformers, that women should support their skirts by straps passing over the shoulders, and some few have been induced to adopt the method. It is to be hoped that it will not spread. A woman's hips are proportionally wider than those of a man, and there is no better way of keeping up the many petticoats that it is sometimes necessary to wear, than by fastening them with strings or bands around the waist, over the corset. Shoulder-straps hinder the movements of the chest, and tend to make those who wear them round-shouldered. Besides, they could not well be worn with a low-necked dress. Even if trousers should come into general use for women, it would be better that they should be kept up by the support of the hips than by suspenders pass-

   This paragraph certainly reads like the ingenious advertisement of a fashionable modiste, prepared after the style of the latest pattern of quack medicine advertisements. The Doctor speaks as one in authority when he says, "There is no better way," etc. Did he ever try the experiment? We know of some hundreds of intelligent women who have tried the experiment of changing the weight of the clothing from the waist to the shoulders, and we do not know of a single instance in which the experimenter has been willing to return to the old style of dressing after shoulder straps had been adopted. Suppose the Doctor should try the experiment himself once. Let him supply himself with a fashionable corset, now button his pantaloons tightly around his waist, and fill his pockets with buck shot or twenty-dollar gold pieces, and start off for a ten-mile tramp. If he do n't complain of a dragging pain in the lower bowels and an insupportable backache before he gets around home, it will be because he hails the first cab, and takes the journey on wheels.

   "Shoulder straps hinder the movements of the chest, and tend to make the wearer round-shouldered." Undoubtedly this is true if "many petticoats" are suspended from them; but what intelligent woman who has undertaken to reform her dress does not know that "many petticoats" are never, instead of "sometimes,

   But did it ever occur to our learned authority that corsets may "hinder the movements of the chest, and tend to make those who wear them" narrow-waisted? It is true, women have wider hips than men, but this anatomical peculiarity is given to women for quite another purpose than to hang either trousers or petticoats on. The Italian farmer works the cow as well as the ox before the cart or plow. What would even Dr. Hammond say if he should find one of these old-fashioned agriculturists adjusting a yoke around the middle of his female bovine, because her hips happened to be a little wider than those of her broad-shouldered brother?

   "A good deal more might be said in regard to hats, shoes, and stockings. But as I remarked in the beginning, women will settle all the questions of dress for themselves. There is no evidence to show that in this respect men have ever interfered with them; and if they should presume to make the attempt, it is not at all likely that their advice would be heeded."

   We are able at last to find one sentiment with which we can quite agree. Women are settling this question of dress for themselves, and are perfectly competent to do so, and it is certainly to be hoped that they will not allow fashion-blinded men, even though they may be backed by the prestige of a world-wide reputation in some specialty, to interfere with their attempts to rescue

   Diseases of Women. -- The disorders described in this section are some of the most common to which women are subject, and are all sufficiently serious to demand special attention when recognized. We have not space here to give accurate directions for the required treatment, but think it proper to describe the several maladies named, so as to render the reader intelligent respecting their nature, and thus induce her to take prompt steps to procure proper treatment when they are recognized. In other works published by the author, simple measures of treatment, such as can be used safely and successfully at home, are carefully and fully described.

   General Suggestions. -- We may add, however, the following general suggestions respecting the treatment of those disorders, which are applicable to nearly all forms of diseases peculiar to women: --

   Nearly all forms of uterine disease are accompanied by more or less congestion of the womb and ovaries. There is pain in the region of the ovaries, across the lower part of the bowels, in the back, or in other parts adjacent to the sexual organs. Leucorrhoea is also present in a great majority of cases. For the relief of these various symptoms, there is no one measure so generally applicable and capable of accomplishing so much as the hot vaginal douche. This consists of the injection of hot water into the vagina. The water should be as hot as can be borne without discomfort, and should be taken in considerable quantities. Not less than one gallon, and generally two or three gallons, should be

   When the leucorrhoeal discharge is very abundant, and is not relieved by the persistent use of hot water, alum or tannin may be added to the last portion of water used, one or two drams to the quart.

   Women suffering from uterine diseases should usually rest at the menstrual period. It is not always necessary that the patient should remain in bed, though this is sometimes required; but a large share of the ordinary duties should be suspended for a day or two preceding the period, until a day or two after. By this means the aggravation of troubles which usually occur at each menstrual period, may after a time be decreased, until nature has time to restore the morbid conditions to proper action.

   Leucorrhoea, or Whites. -- This most common of all maladies peculiar to the sex, is not always an independent function, but sometimes a symptom of other disease. It is always indicative of some disease, and should receive prompt attention. A slight whitish discharge may take place just before or just after the menstrual period, which is entirely natural; but when it continues during the interval between the periods, it is evidence of disease, either of the vaginal mucous membrane or of the womb, or both. Viscid mucous discharges are generally from the womb. Curdy discharges are occasioned by catarrh of the vagina. Offensive watery discharges indicate tumors of the womb, which are sometimes malignant. Bloody discharges are the result of tumors of various kinds, and cancers and lacerations of the womb.

   Vaginitis. -- This is an inflammation of the vagina which corresponds to gonorrhoea in the male. There is much swelling, heat, and tenderness, and smarting or burning sensation, accompanied by more or less discharge, usually of a greenish character. The principal causes are discharge from the womb, use of caustics, the wearing of uterine supporters, self-abuse, and other sexual excesses.

   Vaginismus. -- This condition is one in which great irritability exists about the mouth of the vagina, causing violent contraction, accompanied by cutting pain. It is often the cause of much suffering as well as inconvenience. The principal causes are inflammation of the vagina, rawness of the mucous membrane, vascular growths of the urethra, fissure of the anus, hysteria, itching of the genitals. This complaint often occasions great distress, and is characterized by intense itching, burning, or tingling of the external organs of generation. The itching sometimes extends into the vagina to some extent. The most common cause of the disease is an ichorous discharge from the womb or the vagina, which frequently occurs in old age. This disorder is sometimes present in cases of diabetes. The effect is occasionally wholly nervous in character.

   Uterine Catarrh. -- This is a catarrhal inflammation of the mucous membrane lining the uterus. The most common causes are taking cold at the menstrual period, and self-abuse or sexual excesses. Women who do not nurse their children after childbirth, are very apt to suffer with this disease. The general symptoms are a

   Inflammation of the Womb. -- The symptoms are pain in the lower part of the back, and just above the pubic bone, tenderness on pressure at the last-named point, weight or dragging feeling in the bowels, desire to relieve the bladder too frequently, leucorrhoea, headache, general nervous debility. The most common causes are sexual excesses, employment of means to prevent conception, improper dress, abortions and miscarriages, getting up too soon after confinement, injuries in the neck of the womb, or perineum, occurring at childbirth. To these must also be added the wearing of uterine supporters, which frequently, by not fitting properly, produce serious inflammation of the womb.

   Ulceration of the Womb. -- The condition usually known as ulceration of the womb, is not what is commonly termed ulceration elsewhere, but would be more properly termed abrasion, or erosion. The neck of the womb, when seen through a speculum, is usually red, enlarged, and raw. This condition generally exists in connection with congestion or chronic inflammation of the womb. One of its most frequent causes is laceration of the neck of the womb at childbirth. These cases are frequently treated for years without other than temporary relief, through failure of the medical attendant to recognize the fact that a tear has occurred. In these cases the repair of the injury after proper preparatory treat-

   Amenorrhoea, or Suppressed Menstruation. -- This term is applied to a condition in which the menstrual flow is absent. There are two varieties of the disease, one in which the flow has never made its appearance, though the proper time has arrived, and the other in which the flow has been suppressed after having been once established. There are numerous causes of this disorder. It is usually the result of impaired nutrition. Every case of amenorrhoea is not pathological, however. Sometimes, as in fevers and other wasting diseases, the function is suspended as a means of economizing the vital forces of the body. In these cases, no attempt should be made to restore the function by drugs or other means. Great harm is often done by the use of amenagogues. A temporary suppression of the menstrual flow sometimes results from the disuse of flesh food on the part of persons who have been accustomed to using it freely; but we never have seen any harm arise from the suppression of the menstrual flow in these cases. Persons suffering with amenorrhoea sometimes have a vicarious hemorrhage when the menstrual flow first makes its reappearance. The hemorrhage may occur from the nose, stomach, or bowels, and has often been known to occur through the skin in the form of bloody sweat.

   Scanty Menstruation. -- The principal causes of scanty or deficient menstruation are inflammation of the ovaries; ovarian tumors, consumption, or other wasting diseases; anteflexion of the womb; mental depression, or general debility.

   Menorrhagia. -- This condition is that in which there is a too profuse discharge of blood. The system is weakened by the loss, and so much so, in many cases, that the individual does not recover her accustomed strength before the occurrence of the next period, when she becomes weakened still more. By a continuance of this periodical loss, the person may be reduced to a state of almost utter helplessness. A deathly pallor of the countenance, extreme emaciation, loss of strength, and general debility mark the effects of the constant drain upon the system. Thousands of young women continue to suffer in this way year after year, until their constitutions are almost hopelessly wrecked, being deterred by false notions of modesty or delicacy from consulting a proper medical adviser and finding relief.

   The observance of a few simple precautions, and the application of proper remedies, will very promptly check the unnatural loss in most of these cases. In the first place, absolute rest, chiefly in a supine position, must be observed, not only during the menstrual period, but for a few days previous to its commencement. If this does not restrain the flow, cool and even cold compresses may be applied to the lower part of the abdomen and to the small of the back. In severe cases no harm will come from the use of an ice-compress, made by inclosing pounded ice between the folds of a towel. Great care must be taken to make the hands, arms, feet, and limbs thoroughly warm by the application of warm bottles and woolen blankets. These measures will scarcely fail to accomplish the desired end, if employed efficiently and judiciously. It may be well to add, just here, that the popular fear of using cold in such cases is ground-

   Much good will result from these simple measures at the time of the period; but a radical cure can only be effected by removing the cause of the difficulty. The patient's general health must be improved, and local congestion must be removed. This will be accomplished by attention to general hygiene, gentle exercise out-of-doors between the periods, abundance of good food, tonic baths and other necessary treatment if there is derangement of the digestive organs, and daily hip baths with a local douche. The hip bath should be taken in water of a temperature of 92^o at the beginning, after five minutes lowering it five degrees. After five minutes more, it may be lowered a few degrees more. By taking a warm foot bath at 95^o or 100^o at the same time, quite a cool bath may be endured without chilling. The bath should be continued fifteen to thirty minutes, according to the strength of the patient. A shorter bath than this will do little good, as the sedative effect will not be obtained.

   The douche may be taken at the same time with the bath, or before, as is most convenient. The fountain or siphon syringe should be employed, and the water used should range from 105^o to 120^o, as best suits the sensations of the patient.

   By these simple remedies alone we have successfully treated scores of cases of this sort. In some cases, other remedies may be required, and in nearly all, accessory

   Hemorrhage from the Womb. -- A profuse flow of blood from the womb, occurring at any other time than the menstrual period, is a hemorrhage, and not menstruation. The flow of blood is sometimes so profuse as to endanger life. It may usually be stopped by pressing into the vagina a sponge or mass of cotton soaked in vinegar. Meanwhile the patient should lie in bed with the feet elevated.

   Dysmenorrhoea. -- This condition is that in which there is more or less pain and difficulty in connection with the menstrual process. The causes are various, as disease of the ovaries, congestion of the uterus, malformation, and displacement or distortion of the organ. Some of these conditions require the attention of a skilled physician to remedy; but all may be palliated more or less by simple measures of treatment which may be used at home. A warm sitz or hip bath just at the beginning of the period will often give almost magical relief. The application of fomentations over the lower part of the abdomen, and the corresponding portion of the spine, or of hot bags, bottles, etc., in the same localities, is a measure of great utility. The patient should be covered warm in bed, should keep quiet, and great care should be used to keep the extremities well warmed. The use of electricity is a very valuable aid in numerous cases, but this requires the services of a physician, who should always be employed in severe cases when within reach.

   In many cases of this form of disease, the suffering is so great that the constant dread of its periodical repe-

   Ovarian Irritation. -- The symptoms of this malady are tenderness in the groin, pain in walking or standing, and more or less continuous dull pain, which is greatly aggravated at the menstrual period, the latter being generally induced by a chill, which is quickly followed by a fever, resembling that present in inflammation of the ovaries. The most common causes of ovarian irritation are self-abuse, sexual excesses, improper dress, taking cold at the menstrual period, disappointment in love, abortion, constipation of the bowels, inflammation and displacement of the uterus, the opium habit, the use of "preventives." Cases of this sort require skillful medical care and management.

   Inflammation of the Ovaries. -- The principal symptoms are sudden pain in one or both groins, sometimes extending down the legs, frequently pain in the breast of the affected side, increase of pain during menstruation, with tenderness on pressure, pain in moving the bowels, general distress, nausea, more or less fever. The most common causes are taking cold during menstruation, mechanical injury, anteflexion, or gonorrhoea.

   Cellulitis. -- This is an inflammation of the cellular tissue about the womb. The symptoms are chills, accompanied by fever and pain across the pelvis, sometimes nausea and vomiting, tenderness on pressure above the pubic bone, painful urination and defecation, profuse menstruation. Abscesses sometimes form, which may open externally, through the bowels, vagina, or bladder. Contractions of the uterus about the womb,

   Prolapsus, or Falling of the Womb. -- Of all forms of displacement of the womb, this is perhaps the most common. A woman suffering from prolapsus, complains of tenderness just above the pubes; irritation of the bladder and rectum; sense of fullness in the vagina; dragging pain in the back, extending around the body, which, with the other symptoms, is aggravated by walking or long standing upon the feet; profuse or painful menstruation; leucorrhoea. Sometimes local symptoms are entirely absent, all the unpleasant sensations being experienced elsewhere. Patients complain of a dull ache at the top of the head, nervousness and depression of spirits, constipation of the bowels, general debility. In very bad cases, the organ sometimes becomes so prolapsed that it protrudes from the body, a condition subjecting the patient to great suffering and inconvenience. In these instances, however, the patient may be relieved by a proper surgical operation, by means of which the organ is supported in a natural position.

   In most of these cases, as well as in other forms of displacement, the patient has usually worn pessaries of some sort for years, with the effect of ultimately increasing the gravity of the condition, and greatly adding to the difficulty of effecting a cure. The most common causes of falling of the womb are the wearing of heavy skirts suspended from the waist, dancing, taking cold at the menstrual period, self-abuse, lifting heavy weights,

   Other Forms of Displacement. -- Anteversion, anteflexion, retroversion, retroflexion, and the various other forms of displacement, are due to very much the same causes as those which give rise to prolapsus, and the symptoms are also very much the same. Backward displacements give rise to greater and more constant pain in the back; while forward displacements produce greater pain in the lower part of the body in front, disturbed action of the bladder, and hence too frequent and painful urination, etc. Remarks made regarding the treatment of prolapsus, apply with equal force to these other forms of displacement.

   Prolapsus of the Ovaries. -- The symptoms of this unfortunate and very serious condition are pain of a sickening character during movement of the bowels and in walking, and after standing on the feet for some time, starting in the groin and extending along the front of the thigh on the affected side; painful connection. On making an examination with the finger, the ovary can usually be felt as a round swelling on one side of the womb. Sometimes, in extreme cases, the ovary may be found behind the womb. The most common causes are chronic congestion of the womb, prolap-

   Rectocele. -- This is a condition in which the posterior wall of the vagina is greatly relaxed and pulls forward, dragging with it, also, the anterior portion of the rectal wall. This forms a pouch in which the fæces sometimes accumulate, and into which they are pressed when attempting to move the bowels, making it necessary to press the parts back in order to secure a movement. The most frequent cause is a tear of the perineum at childbirth. Cases of this sort require a surgical operation. We have found it necessary to perform this operation in many cases, and have uniformly met with most happy results.

   Cystocele, or Prolapsus of the Bladder. -- This is a condition somewhat similar to the preceding, only involving the front wall of the vagina, the back wall being dragged down to the vaginal wall, which forms a pouch bulging out at the vaginal entrance. The patient experiences difficulty in evacuating the bladder. In a case recently under the care of the author, the amount of prolapsus was so great that the urethra was doubled upon itself, so that the bladder could not be evacuated without pressing backward on the prolapsed portion with the hand. In consequence of the retention of urine, the bladder being seldom emptied, disease of the bladder is likely to be set up, with its many attending inconveniences and often great suffering.

   The most common cause of this condition is prolapsus

   Sterility. -- In six cases out of seven in which married people are unable to beget children, the fault is with the wife. The most common causes in women are contraction of the canal of the womb, displacements, catarrh of the womb, leucorrhoea, and profuse menstruation. Of the remote causes, sexual excesses, especially self-abuse, are the most potent. In occasional cases the womb or ovaries may be absent. Sometimes both of these organs are wanting. When this condition exists, a wise and experienced physician should be consulted, as in many cases the cause is of such a nature that it can be removed by proper treatment.

   Nymphomania. -- This is a mental and nervous affection in which the patient is affected with uncontrollable sexual desires, which frequently lead to the grossest breaches of modesty. This humiliating disorder is most frequently the result of self-abuse, and allowing the mind to dwell without restriction upon lascivious thoughts. It is sometimes the result of ovarian irritation, and is occasionally observed in various diseases of the brain.

   Hysterical Breast. -- The breast is painful to the touch, and sometimes much swollen. The most frequent causes are disease of the womb and ovaries, self-abuse, and disorders of digestion. In one of the worst cases we ever met, in which the breasts were exceedingly sensitive and much swollen, the patient was greatly addicted to masturbation. The difficulty disappeared almost immediately when the habit was discontinued.

   Painful Sitting. -- The patient complains of pain when sitting down or when rising from a sitting posture, at the extreme lower end of the spine. The affection is most frequently found in diseased conditions of the ovaries, though it is sometimes the result of injuries received in childhood, or a fall in which the force of the blow was received upon the lower portion of the spine. The affection is curable, though in some cases a surgical operation is required.

   Dyspareunia, or Painful Connection. -- This disorder may arise from a great variety of causes. This is undoubtedly more frequent than is known to physicians, as women often suffer in this manner for years without making it known even to their husbands. The suffering may be the result of fissure of the vagina or rectum, irritation of the bladder and urethra, vascular growths at the mouth of the urethra, or sensitive points about the mouth of the vagina. In some cases it seems to be a purely nervous affection. Nearly all cases are curable by the adoption of appropriate means.

   Urethral Tumors. -- The symptoms are smarting, burning, or cutting pain, during or after passing the urine. Sometimes the pain is constant. It is generally

   Bladder Disorders. -- Various disorders of the bladder are accompanied by frequent or painful passage of urine. Retention of urine, and dull, aching pain after urination, are among the most common discomforts to which women are subject through local diseases. These are, in many cases, not due to disease of the bladder itself, but to some irritation of the womb or reflex irritation arising from disease of the ovaries.

   Constipation. -- Perhaps the majority of women are more or less afflicted with constipation. This may be due to sedentary habits, as well as to the use of concentrated food and irregularity in attention to the calls of nature. Most persons suffering in this way become more or less habituated to the use of laxatives of various sorts, the tendency of which is to aggravate the disorder, if long continued.

   Constipation is one of the most prolific causes of misplacements, and of congestions and inflammations of the womb and ovaries, and frequently gives rise to very serious local troubles. When present, this condition

   Chlorosis, or Green Sickness. -- The chief characteristics of this disorder are the discoloration of the skin and absence of the menses. The condition occurs most frequently about the time of puberty, or just afterward. It is not due, as many suppose, to the suppression of the menses, but to a morbid condition of the system, which is itself the cause of deficient activity of the sexual organs. This disorder is not infrequently the result of self-abuse. The cause must be sought for and removed. When this is accomplished, nature will usually effect a cure within a short time.

   Lacerations at Childbirth. -- The most common of all injuries received at childbirth are tears or lacerations of the neck of the womb, or the perineum. Thousands of women are suffering with the results of injuries of this sort, without being aware of their condition. Tears of the womb are often mistakenly treated as "ulcerations." The only way in which a radical cure can be effected is by a proper surgical operation, which in the hands of a skillful surgeon is attended by little pain, and is radically curative in its effects. In the treatment of some hundreds of cases of this sort by operation, we have never lost a patient, and the results have been in the highest degree satisfactory. The author does not indorse the views of some surgeons who hold that every laceration, however slight, requires an operation; but believes where a tear exists of sufficient extent to give rise to constant irritation, the latter cannot be permanently removed by

   Vesico-and Recto-Vaginal Fistulæ. -- In cases of difficult and prolonged childbirth, the septum between the rectum and vagina is sometimes injured to such an extent that a rupture occurs, and an opening is formed between the bladder and the rectum into the canal. This opening may be made to close up, in many instances, by frequent and prolonged vaginal injections with hot water; but this measure is generally insufficient, and a permanent opening is formed, causing much inconvenience and suffering, sometimes producing a most loathsome, repulsive condition. The only cure for these cases is through a surgical operation, which can be performed without risk to life, and with little or no suffering on the part of the patient, by a surgeon who is skilled and experienced in this class of cases. There is no operation a surgeon is called upon to perform in which the results are more satisfactory than this. The gratitude of the patient for being rescued from the wretched condition in which she has been an object of mortification and disgust to herself, and almost completely ostracized from society, is unbounded.

   Tumors of the Womb. -- The worst morbid growths to which the womb is subjected are polypus and fibroid tumors. Polypii seldom attain a large size. They are usually attached to some portion of the canal of the womb, sometimes by long, slender pedicles. In a case

   The proper treatment of these growths is removal. It is usually necessary to treat the point from which the tumor is taken by means of the galvanic cautery, chromic acid, or some other escharotic.

   Fibroid tumors frequently cause profuse hemorrhage from the womb. The menses gradually grow more frequent and profuse, until after a time the hemorrhage becomes nearly continuous. This class of tumors can usually be removed only by means of a surgical operation. Occasionally, however, when they develop on the inner surface of the womb, they are cast off by the efforts of nature, strangulation and sloughing taking place. The surgeon is sometimes able to remove fibroid tumors in this situation by the aid of special instruments devised for the purpose. Fibroids which occur before the change of life, usually shrink away and disappear after the period is passed. The proper management of these cases consists in the adoption of such measures as will prevent great loss of blood at the menstrual period, and keep under control the inflammatory processes which are likely to be set up.

   Cancer of the Womb. -- This malady is in ninety-nine cases out of a hundred the result of a neglected tear of the neck of the womb. It is important that this fact be generally known, and it should impel persons suffering with a tear of this sort received at childbirth, to apply to a competent surgeon for the necessary operation. Cancer is most successfully treated by prevention. It is undoubtedly true, however, that in many cases the

   Deficient Development of the Womb and Ovaries. -- This condition is indicated by the failure of the menstrual period to make its appearance at the proper age, sometimes a masculine appearance of the patient, and frequently a slight growth of hair upon the upper lip. Cases of this sort require very skillful management, and should not be neglected. No good can be derived from the use of medicines of any sort, but such methods of treatment should be adopted as will improve the general nutrition, upon which the disorder depends.

   Ovarian Tumor. -- This condition, sometimes known as ovarian dropsy, was formerly regarded as an utterly hopeless malady; but it can be cured in a great majority of cases by removal of the diseased ovary, with the morbid growth which has developed. This operation, known as ovariotomy, is one of the greatest triumphs of modern surgery. The cysts usually present in these cases sometimes attain enormous size. In one case operated upon by the author, the tumor weighed upwards of fifty pounds, while the total weight of the person after the operation was less than one hundred pounds. When the morbid growth becomes as large as it was in

   Stricture of the Neck of the Womb. -- Constriction of some portion of the neck of the womb is a not infrequent condition. The constriction is usually located at the inner end of the canal, though it may occur at any point. The usual symptom is pain at the menstrual period, and catarrh is sometimes present in the latter condition, when produced by other causes. This malady may be remedied by the proper surgical operation.

   Floating Tumor. -- A movable tumor, usually a little larger than the egg of a goose, sometimes exists in women who have borne children in rapid succession, especially women of small size who have borne very large children. It is usually found upon the right side, and by lying upon the back it may disappear, or be pressed up under the ribs, but falls down again as soon as the vertical position is assumed. The movable body consists of a kidney which, with its attachments, has become loosened from its usual position at the back of

   Relaxed Abdomen. -- The relaxed condition of the abdominal wall frequently present in women who have borne a number of children, and in which the abdominal walls have been greatly distended during pregnancy, is often not only a source of great inconvenience, but a cause of serious disease. The abdominal walls normally support themselves in position; but when thus distended, they allow the stomach and intestines to fall into the lower portion of the abdominal cavity, thus bringing pressure upon the pelvic organs, which in turn become displaced, and otherwise diseased. Tight-lacing or the wearing of heavy skirts suspended from the waist, and the wearing of corsets, are very common predisposing causes of this condition.

   Imperforate Hymen. -- Through over-development, the hymen is sometimes imperforate, thus retaining the menstrual flow, and producing the appearance of delayed menstruation, when the function is really properly performed, the menstrual flow accumulating within the cavity of the womb or vagina. These cases of course require the services of a surgeon. A condition much more frequent than the foregoing is one in which the hymen, while not imperforate, is developed to such an extent that the vaginal orifice is nearly closed, and the membrane sufficiently firm and unyielding to present an obstacle to coitus, requiring the services of a surgeon, though occasioning no difficulty before marriage.

   Tumor of the Breast. -- The most common tumors of the breast are fibrous, encysted growths. These growths are usually attended by more or less pain, but are not dangerous to life, and rarely if ever develop into cancer. Sometimes, however, they occasion so much distress that a surgical operation is necessary. This should always be performed when there is the slightest ground for believing that it may be malignant in character. To Dr. T. Thomas, of New York, is due the credit of devising a method of operation by which these growths may be removed without disfigurement, even the slightest scar produced being completely hidden.

   Cancer of the Breast. -- This formidable disease seems to be rapidly increasing in frequency, notwithstanding the great number of sure cures which have been so largely advertised during the last century. The symptoms of cancer of the breast are hard and painful swelling in the breasts, causing, when somewhat advanced, retraction of the nipple. These growths are much more painful than those described under the head of "Tumor of the Breast." The proper treatment consists of thorough removal of the affected parts by operation. This method is wholly superior to any of the forms of plasters and caustics which are usually employed by the so-called cancer doctors.

   The efficacy of the methods employed by cancer doctors is greatly overestimated by the public, the majority of the cases operated upon by them being growths of a simple character, which never would have done any harm if left alone, and would not have returned, whatever method had been employed in their removal.

   Hysteria. -- From the most remote ages of medical

   The foundation of this disease is almost always laid in some indiscretion by means of which disease of the uterus is induced. Not infrequently it is the result of self-abuse. The disease should not be regarded as a