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cause of the most cases.

Symptom.—This disease follows the same kind of an infection in the womb and vagina; the patient complains of pain in the region of the tube, a little to the side or sides of the womb, and the pain is made worse by motion, exercise or long standing. If it is the acute variety, the temperature rises, the pulse grows faster, and sometimes there is nausea and vomiting.

[WOMAN'S DEPARTMENT 503]

The Symptoms of the Chronic Variety are due to congestion and adhesions. There is a constant pain in the region of the tube and the patient protects herself when she walks, rides or sits down. There are difficult, painful monthly periods and too much flow. The history shows gonorrhea or septic infection, that is, disease caused by the absorption of products of putrefaction.

Treatment of the Acute Kind.—First thing is absolute rest and quiet in bed. Then prolonged hot injections in the vagina of hot water, and if you wish, one teaspoonful of listerine, etc., in each injection. Put a hot-water bag to the sore side, or fomentations of different remedies, like hops, catnip, pennyroyal, smart-weed. The applications should not be of great weight. The bowels should be kept open.

For Chronic Variety.—This frequently calls for an operation. When the symptoms are due to inflammation in the tube alone, ten per cent strength of ichthyol and glycerin tampons placed behind the lower part of the womb three times a week do much to improve the condition.

This is an unfortunate disease, and it must be closely watched for symptoms that may arise from a pus condition. There are many cases of this kind in our public hospitals, and when they are due to gonorrhea they may have been caused by the husband who had an acute or latent gonorrhea—an attack he thought cured.

DISEASES OF THE OVARY.

Inflammation of the Ovary or Ovaritis.—This is an inflammation of the ovary and it may be either acute or chronic.

In the acute form the ovary is slightly enlarged and the follicles on the circumference are distended and filled with thick fluid or pus.

In the chronic variety the ovary may be small and contain cysts; there is a destruction of the follicles and a hardened condition develops. The function of the ovary is then impaired.

Causes.—Gonorrhea, septic infection from adjacent tissues, acute fever diseases, mumps, and peritonitis. Falling (prolapse) often gives rise to chronic inflammation.

Symptoms.—Pain in the lower abdomen (pelvis), difficult and painful menstruation, too much monthly flow (menorrhagia), and painful intercourse.

Treatment.—Ichthyol (ten percent) and glycerin tampons placed behind the lower back part of the womb three times a week. The bowels should be kept open with salts. The diet should be milk or liquid. Sometimes an operation is necessary. In the department on operations this subject will be touched upon in regard to operations.

PHYSICIANS' TREATMENT.—Change of the mode of life, and proper hygienic measures will generally be all that is needed.

[504 MOTHERS' REMEDIES]

TUMORS OF THE OVARY.—Cystoma is the most common tumor of the ovary. The word "cystoma" means a cyst tumor, or cystic tumor. A cyst means a cavity containing fluid and surrounded by a covering (capsule). Ovarian cyst or tumors is often seen in print these days. Ovarian tumor takes in the cystic variety, cancer and sarcoma, two malignant tumors.

Symptoms.—These depend upon the size of the tumors. The large tumors are generally cystic. Examination of the vagina shows the pelvis filled by a tense, watery, fluctuating mass. Examining the abdomen, the abdomen is seen more or less distended by a regular swelling, and sometimes this is enormous. The abdomen is rounded and there is no bulging at the sides like there is in ascites (dropsy). The navel is not prominent. The tumor can be outlined. It cannot be in ascites.

Treatment.—In bygone years tapping was done for these tumors. If it gets large or the health fails, an operation should be performed. This is very successful in uncomplicated cases. Inside of two months the patient is about well. I know I have saved many lives of women by recommending an operation for such tumors.

For the congested ovary, treatment by tampons and medicine often helps. I have frequently given a medicine called Apis-Mel for this condition and with success. I give it in tablets of 1/100 of a grain regularly four times a day.

MENSTRUATION AND ITS DISORDERS.—Normal menstruation occurs monthly in the female. There is a flow of blood from the cavity of the womb. The time for its beginning is different in different countries, it being earlier in warm climates, ten to twelve years, and later in cold ones (fifteen to seventeen years); the average is fourteen years.

Pregnancy suspends menstruation and often nursing the child does, also. Menstruation continues longer in robust, healthy women. Change of life (Menopause) occurs usually between forty and fifty years. The healthy girl and woman comes around every twenty-eight to thirty days. This is the usual time. The flow lasts from two to eight days and the quantity is about one ounce each day. A slight feeling of weight and fullness in the lower abdomen (pelvis) should be the only symptom present in a healthy female. The blood lost should not cause any special degree of weakness.

PREMATURE MENSTRUATION. Too early menstruation.—Premature or precocious menstruation is when it occurs before puberty. This is in part hereditary, but bad associations may be a cause of this early menstruation.

Treatment.—The cause, if possible, should be removed. The nerves should be kept quiet by rest and, if needed, general tonics like iron, arsenic, and nux vomica prescribed and given.

[WOMAN'S DEPARTMENT 505]

DELAYED MENSTRUATION.—This is often caused by slow development of the generative organs. The girl may not come around until seventeenth to nineteenth year.

Causes.—It may be due to heredity. Lack of proper nourishment and proper exercise are the most important causative factors.

MOTHERS' REMEDIES.—l. Obstruction of Monthly Flow.—An herb combination for.

    Poplar Bark 2 ounces
    Ginger 1/2 ounces
    Bayberry 1 ounce
    Cinnamon 1/2 ounce
    Anise Seed 1/2 ounce
    Golden Seal 1/4 ounce

Mix well and give a teaspoonful in a cup of boiling water sweetened with sugar two or three times a day. Excellent in obstructions of the monthly periods, debility, loss of appetite, etc. This combination is fine when used as a tonic. It is stimulating and has been known to cure many severe cases.

2. To Promote the Menses, Smartweed for.—"Smartweed is good to promote the menses. Always steep in cold water; never boil. Dose.—Two teaspoonsful every hour. Be sure to take warm."

VICARIOUS MENSTRUATION (In place of).—When menstruation is absent or suppressed, bleeding sometimes occurs periodically, from the ear, nose, any existing raw surface, leg, ulcer, and from the respiratory (breathing) tract, and also from the bowels.

AMENORRHEA.—This is absence of menstruation.

Causes.—Delayed puberty, anemia (want of proper blood) chlorosis (green sickness). diabetes, malaria, tuberculosis and acute illness may cause it. Sometimes change of climate causes it and nursing baby too long.

Symptoms.—If it is associated with atresia, that is, want of the normal outlet, of course no signs of flowing can show, but colicky, cramp-like, monthly pains appear in the lower abdomen. These increase in severity as the retained blood distends the womb.

Treatment.—If there is no opening for the vagina or cervix one must be made, by operation. If it is due to anemia or chlorosis, Blaud's pills will benefit. The following is the formula:

    Dried Sulphate of Iron 2 drams
    Carbonate of Potash 2 drams
    Syrup—Sufficient quantity to make forty-eight pills.

Take one to three pills three times a day, after meals.

MENORRHAGIA.—Too much bleeding at the monthly periods. If it occurs between the monthly periods it is called Metrorrhagia, womb-bleeding at any time, especially between the periods.

Causes.—These may be constitutional or local, the latter being the most important.

Local Causes.—These are inflammation of the womb, displacements of the womb, malignant disease of the womb, fibroid tumors and disease of the ovaries.

[506 MOTHERS' REMEDIES]

Symptoms.—Sudden or gradual increase in the amount of blood lost at the monthly periods. Then secondary anemia, weakness and run-down feeling.

PHYSICIANS' TREATMENT. 1. Profuse Menstruation, an Easily Prepared Herb
Remedy for.—

    "Cranesbill Root 1 ounce
    White Poplar Bark 2 ounces
    Bistort Root 1 ounce
    Golden Seal 1 ounce
    Geranium 1/2 ounce
    Cloves 1/2 ounce
    Ginger 1/2 ounce
    Ground Sugar 1/2 pound

Mix. This compound is excellent for complaints of weak females, such as leucorrhea, bearing-down, or profuse menstruation, etc. Dose: One teaspoonful of the powder, in a half cup of boiling water three times a day. Drink the clear liquid only." Any woman suffering with, female trouble will find the above combination very beneficial.

2. In young girls and women who are not married, thirty drops of the fluid extract of Ergot three times a day. This medicine will cause the womb to contract. Hot douches can be given to married women. If the bleeding is severe it may be necessary to pack the vagina with sterile gauze. Ergotin ten to twenty drops, may be needed, given hypodermically. If it is due to constitutional causes, like anemia, a played-out feeling, paleness. weakness, etc., a tonic treatment is needed.

3. Blaud's pills will do well. This is the formula:

    Dried sulphate of iron 2 drams
    Carbonate of potash 2 drams
    Syrup enough to make a mass

Mix and make forty-eight pills. Take one to three, three times a day after meals.

4. If the appetite is poor, bitter tonics such as gentian, quassia, cinchona, or nux vomica are needed.

    Compound Tincture Cinchona 2 ounces
    Compound Tincture Gentian 2 ounces

Mix. Take one teaspoonful before meals, in a little water.

5. Tincture of nux vomica in doses of two to three drops after meals is a good stomach and bowel tonic.

6. Golden seal root made into a tea is good in some cases, especially if the tongue is much coated.

7. Oil of Erigeron or flea-bane is good for oozing bleeding. Dose: Three to five drops in a capsule every four hours.

8. Oil of cinnamon in one dose of one-half dram is good where flea-bane oil cannot be used or obtained; usual dose, one to five drops. An infusion can be made of the cinnamon bark and drank freely.

[WOMAN'S DEPARTMENT 507]

9. Cranesbill (Geranium maculata). The fluid extract is splendid when diluted three or four times with boiled water, used locally for bleeding from the womb, or as an injection for the same; or an infusion can be made of the plant and injected into the vagina. The local cause mentioned should be treated. The displacement should be corrected.

DYSMENORRHEA or Difficult Menstruation.—This term means difficult and painful monthly periods. The pain may occur before, during or after the periods.

Causes.—It may be caused by a narrow cervical canal, the canal from the inner womb to the vagina. This is often very narrow and almost closed. Again it is produced by the womb being turned back and bent on the canal, thus partially closing it. This causes the blood to be retained in the womb and then the womb contracts to expel the blood, pains being the natural result. Diseases of the womb and ovaries also cause it. Sometimes the membrane of the womb is cast off in the form of shreds or even a cast of the inner womb.

Symptoms.—The flow may be scanty, moderate or profuse, often clotted. The pain varies. It may be slight before the flow, or the first day or two, or it may be severe, agonizing and continuous for one or two days, or during the whole period and sometimes for some days after there may be pains.

MOTHERS' REMEDIES. 1. Painful Menstruation, a Good Tonic for.—"This may be relieved by sitting over

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