Physicians’ treatment.—­Exercise, fresh air, with freedom from worry, anxiety and care.  Many women at this time of life need much encouragement, and cheerful company is a good tonic.  Prominent annoying symptoms should be met with the proper medicine.  Irregular bleeding of the womb at this time or after should lead to an examination as to its origin.

[514 Mothers’ remedies]

Cystocele—­Cystocele is simply a tumor formed by the bladder pressing into the walls of the vagina.  The bladder descends into the pelvis on account of relaxation or destruction of its normal support.  The anterior wall of the vagina yields.

Causes.—­Tear of the perineum allows the bottom of the pelvis to relax.  Undue relaxation of the ligaments of the bladder and of the floor of the pelvis, with over distention of the bladder, are responsible for the majority of the cases.

Symptoms.—­Weight and dragging feeling.  A tumor can be felt in the vagina.  It decreases when the bladder is emptied.

Treatment.—­Supports are suitable in some cases (Skene’s pessary).  An operation is necessary in many cases.

Rectocele.—­The muscle that holds up the lower end of the rectum is relaxed or torn and this deprives the lower end of the rectum of its support so that during expulsion of the feces forward distention of the anterior wall of the rectum into the vagina results.  The posterior wall of the vagina is carried before the advancing anterior rectal wall, and appears at the entrance of the vagina as a bulging tumor which is increased in size with every effort of the rectum to cast out the feces.

Causes.—­Hard child-birth (labor) and the long time the head of the child was resting on the perineum.  This resulted in an overstretching or tear of the muscle that holds up the lower end of the bowel and the parts were necessarily weakened.

Symptoms.—­It is hard to entirely empty the rectum because of the presence of the tumor.  This is soft, rounded, increasing and decreasing in size and disappears upon pressure.

Treatment.—­Keep, if possible, the tumor from getting larger, regulate the bowels.

An operation may be necessary to restore the parts to their normal condition.  A physician must be consulted.

[Obstetrics or midwifery 515]

OBSTETRICS OR MIDWIFERY

Small bodies are contained in the ovaries.  These are called eggs or ova.  The human egg is about 1/125 of an inch in diameter.  This egg enlarges and one or more escape from the ovaries, usually about the time of the monthly sickness, and are caught by the ends of the Fallopian tube, enter its canal and are carried into the womb.  After they have arrived in the womb they are, as a rule, cast off with the secretion and leave the body.  If in the course of its travel from the ovaries, through the tube to