The other class acquire the affection in adult life, after a once healthy or natural menstruation has been established. Of this class there are two species, which must be separately analyzed, so as to avoid a confusion of ideas, that often makes this subject, _which is the most simple_, one of the most intricate, in the text books in gynecological practice. One variety of the acquired affection can be described, in common with the congenital form, to which I first referred: because the anteflexions in both cases are due to precisely the same pathological conditions, namely, a loss of muscular tone in the uterine walls, so that the organ becomes flabby and weak, like a green wilted stalk, allowing the body of the uterus to topple forwards. The relaxation of the uterine walls is usually more pronounced at that portion which is distinguished as the _isthmus_ of the uterus, and corresponds to that part of the organ where the cervix goes over into the body, forming a sort of natural hinge joint between body and neck. If the bladder is empty, the body of the womb will naturally drop, not necessarily forwards, for it may fall backwards, but in the majority of cases it drops forwards, because the womb is already inclined forwards in its natural position, so all that is necessary to induce an excessive anteflexion, is for the body of the uterus to sink lower than it is natural for it to be. A kink or sharp bend will cause in any canal an occlusion. Take a small rubber tube, for instance, and bend it sharply at right angles; the result will be at the corner of the deflection, that the tube will be flattened, and its walls will come together. In the case of the uterine canal, where there is an abnormal flexion, there is precisely the same condition, and as a result an obstruction not only to the menstrual fluid, but to the mucous secretions, which are pent up in the uterine cavity. The retained fluids decompose and irritate the mucous lining; and this entails a complication of inflammatory diseases, which can never be cured, unless the flexion is remedied. The other variety of the acquired flexion is due to a pelvic cellulitis. This is an inflammatory process, entirely outside of the uterus. The womb is surrounded by a great deal of loose cellular tissue, that fills out the interspaces between the different ligaments and pelvic organs. This tissue often becomes the seat of an inflammation. The exudation from the inflammation may be of such a nature that it forms strands of _fibrous tissue_, running from the isthmus of the uterus backwards to the sacrum. These strands contract or shrink in the course of time, and this draws the isthmus of the uterus backwards, and fixes or attaches it to the posterior pelvic wall. By this contraction of the fibrous tissue the cervix is constricted and the body falls unnaturally forwards.