disorders the functions of the general system, instantaneously reflects
upon the ovaries and uterine nerves, and the menstrual function Is
correspondingly disturbed, and, instead of being painless, the flow
becomes spasmodic, with paroxysms of distress. In the second class,
which includes those persons who are plethoric, the ovarian and uterine
nerves seem to be the origin and centre of irritation, which is
sometimes so severe as to cause indescribable pain. We have known women
who affirmed that the severity of labor pains was not so great as that
from this cause. In one instance, the subject suffered thus for eleven
years, and then became a mother, and has ever asserted that her periodic
suffering was far more intense than the pain experienced during her
confinement. These neuralgic pains fly along the tracks of nerves to
different organs, and capriciously dart from point to point with
marvelous celerity, producing nausea, headache, and sometimes delirium.

IN THE CONGESTIVE VARIETY of dysmenorrhea, the menstrual period may be
ushered in without pain; after a few hours, the pulse becomes stronger
and more rapid, the skin grows hot and dry, the menses stop, there is
uneasiness, restlessness, and severe pelvic pains. Evidently, the mucous
membranes of the Fallopian tubes and uterus have become congested, and
the pain results from the arrest of the functional process, the
exudation of blood.

THE CAUSES are plethora, exposure to cold, excitement of the emotions or
passions, and a morbid condition of the blood. Sometimes congestion
arises in consequence of a displacement of the uterus.

IN THE INFLAMMATORY VARIETY, the mucous membrane of the uterus is the
seat of irritation. The blood flows into the capillary vessels in
greater abundance than is natural, and those vessels become over-dilated
and enfeebled and so altered in their sensibility as to produce local
excitement and pain. It may be associated with inflammation of the
ovaries, peritoneum, or bladder. Upon the return of the menses, there is
a dull, heavy, fixed pain in the pelvis, which continues until the
period is completed. There is generally tenderness of the uterus, and
also leucorrhea during the intervals between each monthly flow.

IN THE MEMBRANOUS VARIETY of dysmenorrhea, the entire mucous membrane
which lines the cavity of the uterus, in consequence of some morbid
process, is gradually detached and expelled at the menstrual period.

SYMPTOMS. There ar