“If these cords were so important as the advocates of the Alexander-Adams operation try to make us believe, in binding the uterus forward, and, as we are recently informed, have a strength equal to support four and one-half pounds weight, a great deal of uneasiness, if not actual pain, would be felt and located along the inguinal canal, following this structure to its points of insertion, in sudden dislocations of the uterus backwards. This is, however, not the case; when sudden painful symptoms arise, they are invariably referred to the sacral region. In sudden retroversions or flexions, as in the pregnant uterus, occurring accidentally or those retroverted or flexed uteri which are so often met with in a state of subinvolution after confinements, there are no symptoms pointing to a tension of these cords at all, but all symptoms point to uterine pressure on the posterior pelvic wall, which can be precisely located. And these pains disappear as soon as the offending member is put right.” There is no doubt that the uterus retains its abnormal retroflected position by the same forces that keep it in a normal or anteflected state; these are (1) intra-abdominal pressure, and (2) the force of gravitation of its own weight. In some women there are certain predispositions to the occurrence of a retroflexion. If the walls of the uterus are weak and relaxed, especially that portion where the cervix unites with the body of the womb, then the body may fall in any direction, and, as the bladder is liable to be distended, and thus raise the body of the uterus upwards, folds of intestine are likely to intervene, so that the organ is inclined backwards, and the abdominal pressure, now falling on the anterior surface of the body, presses the womb backwards and downwards into a flexion. A fall backwards or a violent push or jump may cause retroflexion any time during life. Retroflexions of this nature are not as a rule injurious, and if the circulation is not compromised, nor the uterine canal obstructed, women may go through life without feeling any the worse because their womb occupies an abnormal position. It is only when the organ is congested and swollen, so that its own tissue is painfully sensitive, and the surrounding tissues are compressed by the foreign body, that it requires measures for relief.