This complaint consists (as the name implies) in a change in the situation of the womb, by which it falls much lower than it ought to do. In some cases it protrudes entirely without the vagina. The slighter cases are therefore called a bearing down, and the more decided ones a descent or falling down of the womb. The complaint is met with in women of every rank and age: but more frequently in those who have had several children than in such as have not had any.

Every disease which produces general debility, or local weakness in the passage leading to the womb in particular, may lay the foundation of this complaint; hence immoderate indulgence in sexual intercourse, frequent miscarriages, improper treatment during labour, and too early or a long-continued erect posture soon after delivery, and in some cases after abortion, are the most common causes of this disease. At this time the womb weighs eight or ten times as much as when unimpregnated, and descends by its weight. In the unmarried it is apt to take place in consequence of violent exercise, such as jumping, dancing, skating, riding, lifting heavy weights, etc., while out of order.

The disease comes on usually with an uneasy sensation in the loins while standing or walking, accompanied now and then by a sensation of bearing down, as also pains in the groins extending to the labia. All the symptoms are relieved by lying down. As the malady proceeds, the appetite fails, the stomach and bowels lose their tone, there is much flatulence and considerable debility; the spirits are depressed, employment and exercise become irksome, and life at last becomes miserable. The discharge varies much at times, the menstrual flow is usually increased, and flooding sometimes takes place. Before the external protrusion of the tumour the discharge is greater than afterwards, because the surface of the vagina ceases to secrete when permanently exposed to the air. After a time, patches of healthy-looking ulceration attack the exposed surface, but seldom go deep.

By neglecting to pay proper attention to the early symptoms and threatenings of the disease, the woman becomes at length incapable of making water without first lying down or pushing up the swelling, which seems to impede the flow of urine; and if the complaint continues to increase, the womb is actually forced out of the parts, and takes on a form of a bulky substance falling down between the thighs. This severe degree of the disorder seldom occurs, however, among women in northern climates, except in those who have had many children, and are at the same time of a relaxed and feeble frame; but in warm climates it is frequently met with, and particularly in negroes and mulattoes.

In its early stages, if conception should take place, a confinement for some weeks in a recumbent position on a sofa or bed will often enable the parts to regain their tone, so as to render subsequent artificial assistance unnecessary. Where pregnancy does not take place, it will be necessary to employ the aid of art to keep the womb in its proper position. In the present day there are so many contrivances for this purpose, that the patient, or the medical attendant, will have no difficulty in selecting such an instrument as will be at the same time effectual for the purpose, and not very inconvenient to the patient. At the same time, if she ever wishes to be cured, she must carefully abstain for the future from all those causes which have caused, or may have assisted in causing the trouble. No more dancing, jumping or skating; no more tight stays; she must prevent straining at stool by keeping the bowels gently open; at the same time the constitution must be strengthened by nourishing diet, and by tonics. The patient may take any of the tonic mixtures recommended in this work, or she may take the Citrate of Iron and Quinine. If the weather will allow of it, she should take a cold bath, or sponge all over, from head to foot, every night and morning. An infusion of Green Tea, or a decoction of Oak Bark, or best of all, an infusion of two drams of Tannic or Gallic Acid in a pint of water, may be injected into the vagina with a female syringe, two or three times a day. The liquid injected must be as cool as the patient can bear it. She should rest as much as possible and not fatigue herself, or attempt to move or lift heavy weights.