In treating this form of dysmenorrhœa, opiates must be used, as in the former variety, to afford some alleviation. Give also saline purgatives, febrifuge medicines, such as aconite, veratrium, and gelsemium; also cooling drinks. During the interval the patient should live plainly, avoid stimulants, and take moderate outdoor exercise. The suppositories (F. 163) may be used steadily. If the disease be associated with a rheumatic diathesis, the appropriate remedy for that should be used. It is in such cases especially that chalybeate mineral water, warm sea water, baths, colchicum, iodide of potassium, with friction and electricity applied directly to the hypogastric region, succeed in restoring health. (F. 103, 165). MECHANICAL DYSMENORRHŒA is that form in which there is some mechanical obstruction to the escape of the menstrual discharge. The causes of the obstruction are various. There may be either a stricture of the internal orifice of the uterus, or a narrowing of the whole canal of the cervix, or the external os uteri may be small and contracted, or some tumor may interfere with the patency of the cervical canal, and there may be retroflexion or antiflexion of the uterus. In these cases there is more or less violent expulsive pain coming on in paroxysms, and there is usually a scanty flow. Often the discharge escapes in gushes, each gush being preceded by a bearing down effort, and accompanied by an expulsive pain. There are attacks of nausea, restlessness and retching, with flatulence; there is always severe headache and congestion, with tenderness of the ovaries; and if there is endometritis, there are some other inflammatory symptoms. Modern gynecology has various remedies for this class of cases, of which it is not necessary to speak here. MENORRHAGIA. The term menorrhagia should be applied only to cases of menstrual flow, although it is often employed to signify any considerable sanguineous discharge from the uterus, other than normal monthly escape. But I will say something here of cases where there is a more abundant or a more prolonged flow than is natural to the subject of it, and of cases where there is a recurrence of the discharge at short intervals, so as to seem almost continuous. In that variety in which the discharge is normal in quality but the quantity is increased, there is undue uterine congestion, set up by constitutional causes, or it is induced by slight disease of the uterus or ovaries. When menorrhagia takes place in plethoric habits, it is manifestly remedial, and ought not to be restrained hastily. We may endeavor to reduce the plethora, and a cooling diet, the recumbent position, and saline cathartics may be enjoined. (F. 61).