osity, perhaps,
on this subject, unless, perchance, there is no evidence of their own
reproductive powers. If, however, these appear to be deficient, then few
topics are more deeply interesting or investigated with greater personal
solicitude. Such persons will seldom submit their condition to the
family physician, for it is a delicate subject, involving personal
considerations, and, therefor, they prefer to consult with one who
cannot connect their unfortunate situation with any of the incidents
which enter into the history of their lives. This is very natural, and
sometimes is the only way to keep private matters profoundly secret.
Being widely known as specialists, devoting our undivided attention to
chronic affections, and having unusual facilities for the investigation
and management of such cases, we have been applied to in innumerable
instances, to ascertain the causes of barrenness and effect its removal.

It is admitted that the question of a woman's sterility is practically
decided in the first three years of married life, for statistics show
that less than ten out of a hundred women who do not indicate their
fertility in the first three years of wedlock ever bear children. We
have treated many who gave no evidence of fertility for a much longer
period of married life, and who afterwards gave birth to children. We
are unable to state the proper ratio of the number of the married who
are childless; much less have we the right to assume that all who
decline the responsibilities of motherhood are necessarily barren.

CAUSES. The causes of barrenness may be obliteration of the canal of the
neck of the womb, sealing up of its mouth, or inflammation resulting in
adhesion of the walls of the vagina, thus obstructing the passage to the
uterus. In the latter case, the vagina forms a short, closed sac. In
some instances, the vaginal passage cannot be entered in consequence of
an imperforate hymen. Again, the cause of barrenness may either be a
diseased condition of the ovaries, preventing them from maturing healthy
germs, or chronic inflammation of the mucous membrane of the neck of the
uterus, which does not render conception impossible, but improbable. It
is one of the most common causes of unfruitfulness, because the female
seldom, if ever, recovers from it spontaneously. It has been known to
exist for twenty or thirty years.

Chronic inflammation of the vagina also gives rise to acrid secretions,
which destroy the