Flexion of the womb is understood to be a condition in which the uterus is flexed or bent upon itself at a sharp angle, just as a rubber hose that is bent sharply on itself becomes compressed at the kink so as to shut off the flow, in this manner the flow of blood from the cavity of the womb is partly shut off, and the obstruction is the cause of the painful menstruation.

In some women who have flexion or a bent womb there is no obstruction, because the probe passes the canal freely; in these cases dysmenorrhœa must be traced to some other cause. If it is clearly established that flexion is the cause of the obstruction, the most successful treatment is the electrical current. I have often had cases where little mucous growths no larger than a small marble, grew in the canal and obstructed the free escape of blood; after these were removed, the dysmenorrhœa ceased at once.

Other obstructions may be due to a stricture of the vagina or some deformity of the hymen; a very slight surgical operation will permanently relieve both of these hindrances.

There is a much larger proportion of cases that suffer from painful menstruation in whom the uterine organs are perfectly healthy, but who are systematically injured by dishonest or hungry specialists, by being subjected to local treatments. I have had cases of this nature fall into my hands very often. They had made the rounds of the specialists and had been made the innocent prey of avaricious professional competition, so that it is of the greatest importance to distinguish this class of cases from those in which the pelvic organs are the seat of the difficulty.

Nervous and congestive dysmenorrhœas are particularly adapted for the hygiene of home treatment. Nervous or neuralgic dysmenorrhœa is very often overlooked, and treated as a local lesion of the womb.

The psychical exaggeration which many women experience at the approach of the menses is abnormally heightened in dysmenorrhœa. The pains in the back, in the hips, and in the lower part of the abdomen disturb the normal operations of the mind. The irritation of the nerves of the womb is often reflected to distant organs, and pain is felt in remote regions. Some women suffer only just a day or two preceding the flow, while others suffer severely during the entire period, so that they are forced to keep to their bed the greater part of the time.

Professor William Goodell, one of the most profound and original female specialists in America, has this to say in a recent publication: “I have learned to unlearn the idea— and that was the hardest task of all—that uterine symptoms are not always present in cases of uterine disease; or that, when present, they necessarily come from uterine disease. The nerves are mighty mimers, the greatest of mimics, and they cheat us by their realistic personations of organic disease and especially of uterine disease. Hence it is that even seemingly urgent uterine symptoms may be merely nerve counterfeits of uterine disease. I have, therefore, long since given up the belief, which, with many, amounts to a creed, that the womb is at the bottom of every female ailment.

“Nerve strain, or nerve exhaustion, comes largely from the frets, the griefs, the worries, the carks and cares of life. Yet although the imagination undoubtedly affects it, it is not a mere whim or imaginary disease, as all healthy women and physicians think; but it is the veriest of realities. When some flippant talker or some slipshod thinker scoffs at nervousness as a sham disorder, I say to him: ‘Can the bribe of a principality keep you from blushing when you are ashamed, or from blanching when you are afraid?’ Under the flitting sense of shame or of fear these vasomotor disturbances are momentarily beyond your control; and so they are in the nervous woman, whose vital organs are, as it were—not transiently but—perpetually blushing and blanching under deficient brain-control over the lower nerve centers.

“Strangely enough, the most common symptoms of nerve disorder in women are the very ones which tradition and dogmatic empiricism attribute to womb disease.

“They are, in the order of their frequency, great weariness and more or less of wakefulness and inability to walk any distance, a bearing-down feeling, headache, nape-ache and backache, scant, or painful, or delayed, or suppressed menstruation, cold feet, and irritable bladder, general spinal and pelvic soreness, and pain in one ovary, usually the left, or in both ovaries. The sense of exhaustion is a remarkable one; the woman is always tired, she passes the day tired, and she goes to bed tired, and she wakes up tired, often, indeed, more tired than when she fell asleep. She sighs a great deal, she has low spirits, and her arms and legs become numb so frequently that she fears palsy or paralysis.