The treatment for chronic congestion and enlargement of the uterus is essentially the same as that recommended for chronic uterine catarrh, the details of which need not be repeated here. The sitz bath, the hot douche, rest from violent exercise and from sexual excitement, and the avoidance of all the exciting causes of the affection, are the essentials of treatment. The method of treating this affection which was popular a dozen years ago, is now pronounced by the most eminent medical authorities to be in the highest degree irrational, and detrimental to the patient. The cauterizations to which thousands of women have been subjected, year after year, the only effect of which was to produce an aggravation of other ailments, are now condemned in no stinted terms by the very men who once employed these remedies.

In our experience during the last few years as Medical Superintendent of the "Medical and Surgical Sanitarium," we have met with hundreds of these cases, in which caustics had been employed at intervals for periods ranging from six months to twenty years; and we have to say that we have never met a case in which there was evidence of substantial benefit from the course of treatment employed. The effect of long-continued cauterization is to increase the very diffi culty which it is supposed to be efficient in curing. What the congested organ needs is not the application of irritating caustics, but the use of soothing remedies. The warm sitz bath attracts the blood to the surface, and thus relieves the local congestion. The hot douche acts efficiently as a remedy, by causing contraction of the dilated blood-vessels. Cold injections were formerly recommended for this purpose, but the benefit received by their employment was very slight, if any good at all was accomplished. Cold applications to the uterus cause immediate contraction of its blood-vessels, but the contraction produced is almost immediately followed by dilatation, so that the congestion may be aggravated rather than relieved. Hot applications cause first a slight increase of congestion, but this condition is subsequently followed by a contraction of the blood-vessels, which continues for a long time. This is well shown by a simple experiment. The hands dipped in cold water, or rubbed with ice, are at first blanched, but in a few seconds become red from congestion of the blood-vessels of the skin; while upon the other hand, if the hands are dipped in hot water, they become at first reddened, but after they have been immersed for a long time the skin becomes white through contraction of its small arteries. This is well shown in the white and wrinkled skin of the hands of a washerwoman, which have been immersed in warm water for several hours. In performing surgical operations upon the womb, when annoyed by troublesome bleeding, we have frequently resorted to the use of sponges dipped in hot water and applied directly to the organ, and have thus been able to witness an ocular demonstration of the utility of hot applications to this organ in the speedy checking of the bleeding, and the marked paleness of the organ after the application.

When there is considerable catarrhal discharge, some benefit may be derived from the employment of astringents. In addition to the hot water douche, alum, common salt, solutions of tannin, of golden seal, and various other astringent substances, are usefully employed for this purpose. It is a very good plan to add a teaspoonful of powdered alum, or common salt, to the last pint of water employed in the douche.