It is very rare that it is due to a depreciation of vital forces from improper food, over-exertion, a prolonged nervous depression or a constitutional tendency to tubercle, scrofula or some other hereditary diathesis, although these undoubtedly predispose the patient to the disease. Abortions stand at the head of all the causes that excite this affection. When the uterus is pregnant and its natural growth is abruptly checked by the destruction of the embryo, then the organ becomes at once the seat of a congestion and great vascular activity, for the purpose of repairing the injury that the premature expulsion of the embryo or fetus inflicted. If this congestion is delayed from improper care or treatment which fails to recognize the important fact that an abortion or interruption of pregnancy is a much greater shock to the system than a delivery at full term, it must result in arrested _involution_ or permanent inflammatory enlargement. This most persons fail to appreciate, and, as a result, they do not take the same precautions that they would after the delivery of a living or fully-developed child. I am well aware that criminal abortionists are in the habit of deceiving their patrons by assuring them that there is no danger or bad results to be feared from their criminal operations. This is a vicious falsehood, and, coupled with the statement that there is as yet no living being in the womb, the crime of manslaughter is added to that of malpractice. In every case of abortion, whether accidental or criminal, the same care and attention must be given to the woman as during any natural lying-in period. There is a class of chronic inflammations that I have noticed in women who have always suffered from painful menstruations or from excessive or prolonged hemorrhage at the regular monthly period. This is complicated with some ovarian disease, which yields, however, to appropriate treatment. There is quite a series of symptoms that denote the existence of chronic metritis; these are not all present in each particular case but quite enough of them to diagnose the disease. Some of these symptoms are in the nature of complications, which in themselves may be mistaken for an individual disease, but upon a careful inquiry they can be traced directly to a chronic metritis, which if removed disposes of all the lesser ailments. The following are the most noted signs of this affection: painful copulation, and pain on defecation; a dull, heavy, dragging pain through the pelvis, much increased by walking; during menstruation the mammæ are sensitive or painful; several days before the approach of the menses there is a dull pain, which lasts during the menstrual flow; around the nipples, there is pigmentation or darkening; sometimes nausea and vomiting, and dyspepsia, headache, and languor; pressure on the rectum with tenesmus and hemorrhoids; leucorrhœa from catarrh of the womb; pressure on the bladder with tenesmus or straining.