ntroduced into the canal of the neck of the
womb, when a thumb screw in the end of the handle is turned, by which a small
blade is thrown out from each side, and as the instrument is withdrawn from the
canal an incision is made on each side, thus enlarging the passage. The upper
figure illustrates the instrument closed, ready for introduction; the lower one,
with the blades projected for cutting.]

Many times patients cannot understand why it is that the operation of
cutting the constricted cervix causes no pain; they often being entirely
unconscious of the making of the incision. The explanation is easy. The
cervix uteri, or neck of the womb, is supplied with but few nerves of
sensation, and is almost as destitute of sensation as the finger or toe
nails, the paring of which causes not the slightest pain. On this
account we never find it necessary to administer chloroform or any other
anaesthetic when undertaking this operation. If the patient be extremely
sensitive the application to the cervix of a weak solution of cocaine is
quite sufficient to completely benumb or anesthetize the parts so as to
entirely avoid all pain from the operation.

[Illustration: Fig. 5.

STOHLMAN'S HYSTEROTOME.

This instrument has two cutting blades which shut past each other, as
seen in the lower figure, so as not to cut when introduced into the
canal of the uterine neck. After introduction, the cutting blades are
separated, as shown in the upper figure, the extent of the incision
being regulated by the thumb-screw attached to the handles, as
represented in the lower figure.]

* * * * *

MENORRHAGIA.

(PROFUSE MENSTRUATION.)

The word _Menorrhagia_, which is of Greek derivation, literally means
_monthly breaking away_, and is employed to designate profuse
menstruation. This disorder must not be confounded with those
hemorrhages which are not periodical, and which are due to other causes.
The term _menhorrhagia_ is restricted to an immoderate monthly flow. The
menstrual flow may occur too often, continue too long, or be too
profuse. It induces a feeble pulse, cold extremities, weak respiration,
general debility, and may occur in opposite states of the system,
_i.e._, in women who have a plethoric and robust habit, or in those of
flaccid muscles and bloodless features. When the menstrual discharge is
natural, it is so gradual that by mixing with the vaginal secretions it
is prevented from coag