MIDWIFERY. 
insj at the cessation of the menses : here it 
often precedes disease of tiie uteres, and 
should be treated as if we were in expec- 
tation of schirrus ; recommending a Careful 
abstinence from wine and spirits ; animal 
food to be quite cut off, if the constitution 
will bear it ; together with whicli, no exer- 
cise of any consequence should be allowed. 
An occasional purge should also be given ; 
tlie injection and bath being used regu- 
larly. 
Procidentia uteri, or the falling down of 
the uterus. The uterus is connected late- 
rally to the pelvis, by the broad ligaments ; 
and anteriorly by the round ligaments. 
When these parts have lost their tone, they 
allow the uterus to fall through the vagina, 
so that the menstrual discharge has been 
frequently seen coming from the lowest 
part of the tumour, the os uteri. The most 
frequent causes are, rising too soon after 
delivery or after abortion. Next to fluor 
albus, it is the most common female com- 
plaint that is met with. There is a drag- 
ging/eel in the back, and uneasiness abmit 
the hips, arising from the dragging at the 
broad ligaments : there is also a pain in the 
groin, and the tedium these sensations pro- 
duce are exceedingly uncomfortable, thougit 
not amounting to pain. The procideiit uie- 
"rus will at last interfere with the stools and 
urine, and be pushed down at those times, 
when the woman tells us she feels some- 
thing like an egg ; this gradually increases 
till at last it falls altogether out of the body, 
producing pain, and perhaps ulceration of 
the os uteri', from the contact of the clothes ; 
and the bladder, from its connectitm with 
the nterns, being dragged down, makes an 
angle with itself, which stops the passage 
throngh the urethra. Now while there ate 
these powers acting in bringing it dowti, 
there are no muscles to bring it back; 
and Whfere gravitation leaves it, there dis- 
ease finds it. The only sure relief for pro- 
cidentia uteri is from the use of pessaries ; 
the best are of an oval form, flatted on 
botli sides; the outer edge must be left 
broad and rounded off, as it is in close con- 
tact vfith the soft parts round it ; but to- 
\fards the hole in the middle it may be 
made thinner, and this will diminish the 
bulk and weight : these are to be kept of 
different sizes. The best are of wood; 
the coik pessaries cannot be kept cleau. 
They were formerly made round ; but this 
is more coiivcwieiit, and obstructs the pas- 
sage ot the urine and feeces; they also used 
to be made with very large holes, this was 
dangerous; the os uteri has become sfran* 
gulated by getting into it ; when this has 
happened, a pair of pliars may be so in- 
troduced, as to break down the ring, so as 
to enable us to get it out. In introducing 
this instrument, it is anointed as we please, 
and so passed edgewise ; it is to be laid 
across the pelvis in such a manner that the 
largest diameter is'fi’om one ischinm to that 
on the opposite side. This disease is cur- 
able in early life by a horizontal posture, 
and the use of astringent solutions. 
Dropenj of the Ovarium is by no means an 
uncommon disease ; its first symptom is a 
sense of pressure on the bladder or rectum ; 
it may further affect the nerves amd absor- 
bents, producing dependent symptoms. 
But it is so long before it produces any 
real illness, that the water has sometimes 
been drawn off for some months before 
any other complaints have been felt. Front 
one tumour, forty-nine pints have heed 
drawn off; and in a few days afterwards, 
from another tumour in the same patient, 
nine pints more. There is a case menti- 
oned by Bonetus, where one hundred and 
twelve pints were drawn off. The fluid in 
these cases is not serous, but gelatinous and 
glary ; and there has been fat and hair 
found in these tumours, and even teeth ; 
this will happen where there has been no 
impregnation. It is a disease which may 
be borne a long fin>e : in one patient, who 
had it from the year 1770 till 1798, it was 
tapped as often as eighty-four times. In 
the memoirs of tile Royal Academy, a 
woman is mentioned who had it from the 
age of thirty to that of eighty. It always 
begins on one side, and gradually spread* 
over the other. As to treatment, none in 
the way of medicine has been known to 
have the least effect upon it. Tapping will 
not always be quite successful; therefoie, 
the patient should be warned of the proba- 
bility of there being more cysts than one. 
Another complaint to which females are 
subject, has been called Dropsy of the Ute- 
rus-, but, for many reasons,nosuch disease can 
exist, and the expression therefore is incor- 
rect. The cases mentioned of this disease 
have most probably been hydatids in the 
uterus. It is, however, a slight complaint 
which cures itself. Dr. Clarke mentions a 
case, where a lady with a tumour of this 
kind went into a pastry-cook’s shop, and 
sat down in the parlour ; the wet, which she 
felt, increased, till the whole shop was de- 
luged, and very unpleasant conjectures 
were the consequence. In anolhei' case, 
