The question is simply this: If the knee-chest treatment, and the remedies that have been suggested, do not give permanent relief, then there must be some such defect in the pelvic floor as I have heretofore described. If the vagina is too wide, it should and can be narrowed to its normal dimensions, by removing the excessive tissue; if the vagina is torn into the perineum, this too must be united. Should the cervix of the uterus be abnormally elongated, so that it makes it physically impossible to return it to its natural position, it should be shortened or amputated, and if all these three complications coexist, then an operation combining and remedying all these defects, should be performed at one sitting. This method alone will restore the patient to health and usefulness. CHAPTER XX. VERSIONS AND FLEXIONS OF THE UTERUS. VERSION, in the nomenclature of diseases of the womb, means that the entire organ without any deflection in its normal axis turns, inclines or leans either forwards, backwards or sidewards. The prefix _ante_ is used in the sense of forwards and in composition with _version_ we have the word _anteversion_, which in conjunction with the term uterus, signifies that the organ is inclined forwards. The prefix _retro_, signifies backwards, and in composition with the word _version_ and in connection with the word uterus, it implies that the womb is turned backwards. The word _flexion_ differs from _version_, inasmuch as it signifies a bending or bowing, which breaks the normal axis of the womb. The neck or cervix of the uterus may retain its normal position, while its _body_ is abnormally deflected or bent in any direction. The prefixes _ante_ and _retro_ are also used in composition with the word _flexion_ as they are with _version_. These distinctions should be remembered. ANTEVERSION OF THE UTERUS. In anteversion the uterus has so far changed its normal shape that the cervix of the organ is stretched out or extended in a line with the axis of the body. This occurs when the uterus is unusually swollen from inflammatory enlargement. The normal location of the body does not materially change in these cases. It is a little more depressed on the fundus of the bladder and the cervix is correspondingly elevated, so that the latter stands considerably higher than in health. If the bladder is empty, and the patient bears down or does anything that increases the intra-abdominal pressure, the body of the womb is forced down, upon the anterior vaginal wall, which prolapses into the vagina, while the cervix is raised, so as to point upwards and backwards. When the bladder is full, the body of the uterus is naturally raised, and the cervix correspondingly depressed. And this is attributable to a rigidity or stiffness about the organ, that is characteristic of a chronic inflammatory enlargement of the uterus. Sometimes the organ is permanently fixed by inflammatory adhesions, that lessen or prohibit these movements.