Flexions of the Uterus 
And Their Treatment with a Painless Self- 
Supporting1 Intra-Uterine 
Stem 
WITH REPORT OF CASES 
BY 
Frank C. Ferguson, M. I). 
INDIANAPOLIS 
Formerly Professor of Obstetrics in the Central College of Physicians 
and Surgeons 
Read before the Marion County Medical Society April 24, 
1894, and before the Indiana State Medical 
Society May 17, 1894 
INDIANAPOLIS 
SENTINEL PRINTING CO., PRINTERS 
1894 Flexions of the Uterus. 
No disease of a chronic character 
involving the reproductive organs 
of woman, is capable of causing more 
enduring pain and discomfort, of pro- 
ducing more obstinate retlex disturb- 
ances, mental and moral obliquities 
and more persistent chronic invalid- 
ism than flexions of the uterus. The 
distressing backaches, tormenting 
headaches, annoying uterine dis- 
charges, gastric disturbances, dysmen- 
orrhea, pelvic and ovarian pain, hys- 
terical and sometimes epileptic seiz- 
ures, and a multitude of other minor 
symptoms conspire to 1 make the 
patient’s life one linked misery long 
drawn out. 
Notwithstanding the marvelous ad- 
vances made in late years in the treat- 
ment of diseases peculiar to women, 
the treatment of flexions of the uterus 
and the multiform symptoms to which 
they give rise, has not kept pace with 
the advances in other departments ot 
gynecology, so that the average doctor 
can not treat these distressing cases 
3 to-day with any better success than his 
predecessor of twenty-five years ago. 
The treatment of flexions has 
always been one of the most difficult 
problems confronting the physician. 
The relation of the uterus to the sur- 
rounding organs and tissues, its peri- 
odical function and the atrophy of 
its walls produced by the distortion, 
all conspire to perpetuate the difficulty 
in spite of the various methods here- 
tofore proposed and practiced for their 
alleviation* and cure. 
The treatment of flexions recom- 
mended by authorities is as varied as 
their ideas of the pathological signifi- 
cance of these distortions. Those 
who regard them as mere sequences 
of metritis, para-or peri-metritis, 
devote their main treatment to 
combating the inflammation and ad- 
hesions arising therefrom, giving very 
little attention to the distortion of the 
organ. Chi the other hand those who 
look upon the flexion as the fons et origo 
of the symptons, give too little atten- 
tion to the accompanying inflamma- 
tion, believing that if the flexion be 
corrected all other symptoms will van- 
ish. Thus on the one hand the phy- 
4 sieian forgets that a Hexed uterus, no 
matter how produced, causes a pro- 
found disturbance in the pelvic circu- 
lation by pressure upon arteries, veins, 
nerves, lymphatics and surrounding 
organs, and from the very nature of 
the case must perpetuate the inflam- 
mation and and the symptoms that 
flow from it. 
On the other hand it is forgotten 
that much can be done to hasten the 
cure even after the distorted uterus is 
straightened and anchored in its nor- 
mal position. 
The best treatment, therefore, ot 
these distressing cases, is that which 
considers both the flexion and the in- 
flammation as factors in the produc- 
tion of the symptoms, gives to each 
the importance which it merits and 
strives to correct the distortion as well 
as to cure the inflammation. Divul- 
sion of the cervix, curettage, and the 
application ot stimulating solutions, 
such as carbolic acid and iodine, the 
use of boroglyceride tampons, due at- 
tention to the bowels and the proper 
regulation of the patient’s habits, will 
do very much to relieve the symptoms 
and improve the general health. Xev- 
5 ertheless if the flexion be not cor- 
rected and the uterus be not restored 
to its normal position, the symptoms 
soon return and another curettement 
becomes necessary; and so the case 
drags its slow length along, sometimes 
better, sometimes worse, but never 
cured. In the light of my experience 
during the last two years in the treat- 
ment of these obstinate cases, I do not 
hesitate to say that if I were com- 
pelled to confine my treatment to one 
or the other of the above methods, I 
would unhesitatingly choose the latter 
and, with a Sims’ speculum, a uterine 
dilator, a Thomas’s Smith pessary and 
a properly constructed uterine stem, I 
should accomplish a great deal more 
for my patients than he who confines 
himself to the treatment of the co- 
existing inflammation. 
Leavifig out of consideration for the 
present the various surgical operations 
that have been invented by Dudley, 
Schiiking and others for the cure of 
flexions, I think I am warranted, from 
long personal experience, in the state- 
ment that a bent uterus cannot be 
treated more successfully without the 
use of a splint or stay worn within 
6 the uterine cavity than a fractured or 
distorted limb without immovable 
dressings. But the greatest obstacle 
that always confronts the physician in 
his efforts to permanently straighten 
the ffexed uterus is, that there has 
never been invented a uterine splint, 
except the intra-uterine stem which I 
have recently perfected, and which I 
shall show you presently, that is worth 
the material out of which it is made. 
The various stem pessaries that have 
been invented for the purpose of be- 
ing worn as intra-uterine splints may 
be divided into two classes: 
1. Those which are intended to he 
used alone. 
2. Those which require a vaginal 
support, 
As commonly constructed, these in- 
struments are cylindrical in shape and 
of the same diameter throughout their 
whole length, and possess the follow- 
ing defects, which are fatal to their 
successful use: 
1. They make injurious and pain- 
ful pressure at the internal os, the site 
of the flexion. * 
2. They do not make adequate 
provision for drainage. Therefore 
7 the uterine secretions are liable to be 
dammed up in the cavity of the uterus, 
whence they may find their way into 
the tubes and pelvic peritoneum, pro- 
ducing salpingitis, pelvic peritonitis, 
etc. 
3. They do not conform in shape 
to the uterine cavity. 
4. They are not self-supporting, i. 
e., they have to be retained within the 
uterus by vaginal supports. 
5. They do not permit the normal 
movements of the uterus during in- 
spiration and expiration. 
For these and other reasons they 
are exceedingly dangerous and useless 
instruments, and their use has been 
abandoned by the best gynecologists. 
The makers of these instruments of 
torture sometimes give them the an- 
terior curve found in the normal 
uterus, as in the Wiley hard-rubber 
drainage tube. Others have made 
feeble attempts to construct self-re- 
taining stems, as in Dr. Chamber’s 
modification of the late Dr. Henry G. 
Wright’s stem, Clement Godson’s stem 
by a spring within the tube 
which projects at appertures near the 
extremity and within the uterus, and 
8 Mr. Lawson Tait’s abomination, with 
slight projections of rubber to act as a 
retaining agent. But whatever the 
form or modification, all possess the 
common defects of not conforming in 
shape to the cavity of the uterus, 
making injurious pressure upon the 
point of fiexion, producing pain and 
discomfort, and obstructing drainage. 
Basing my opinion upon the anat- 
omy of the uterus and its relations to 
surrounding organs, I think I am war- 
ranted in the statement that an instru- 
ment designed to be worn in the ute- 
rine cavity should possess the follow- 
ing characteristics: 
1. It must be free from all sharp 
angles, corners or projections. 
2. In shape it should correspond to 
the general contour of the uterine 
cavity. 
3. It should provide for efficient 
drainage. 
4. It should be self-retaining. 
5. It should permit the normal 
movements of the uterus. 
6. It should not easily corrode. 
7. It should be as light as possible, 
consistent with sufficient strength to 
maintain the uterus in its normal shape. 
9 8. It should he capable of being 
worn during menstruation. 
Previous to the time of the illustri- 
ous Dr. Hodge, of Philadelphia, a vast 
amount of ingenuity, misapplied, was 
spent in the construction of vaginal 
pessaries. But that justly celebrated 
man conceived the idea that these in- 
struments should he made to conform 
in shape to the pelvic curves. 11 is in- 
vention has stood the test of time and 
experience, because it is based on the 
common sense principle that a vaginal 
pessary to be worn with comfort and 
without pain should not press unduly 
upon any part. But gynecologists have 
failed to make practical application of 
this principle in the construction of 
intra-uterine stems. If badly fitting 
shoes makes sore feet, and a badly fit- 
ting vaginal pessary produces excoria- 
tions and ulcerations of the vagina, we 
would naturally expect the same thing 
or much worse from an intra-uteri ne 
stem made without regard to the size 
and shape of the uterine cavity, and 
possessing all the other bad qualities 
specified above. 
Disappointed and disgusted at my 
repeated failures in the treatment of 
10 flexions, some two years ago I con- 
ceived the idea of making if possible 
an intra-uterine stem free from danger 
and at the same time possessing all the 
good qualities enumerated above. The 
result of my work is shown in the ac- 
companying cut. The instrument is 
made of aluminum. It is therefore ex- 
ceedingly light, but at the same time 
possesses sufficient strength. The up- 
per extremity is triangular in shape, 
and rests within the triangular cavity 
of the body of the uterus. 
PATENT 
APPLIED FOR. 
MANUFACTURED AND SOLD BY 
W.H.ARM STRONG & CO. 
INDIANAPOLIS. IND. 
The lower part is spindle-shaped 
and rests within the spindle-shaped 
11 cavity of the cervix. These arc con- 
nected by a small stem, having cir- 
cumferential channels to facilitate 
drainage, which rests within the nar- 
row internal os. ’The uterus rests 
upon the two arms which rise upon 
either side of the cervix and are sur- 
mounted by nuts fastened on by a 
screw thread to prevent injury to the 
cervix or vaginal mucus membrane. 
The internal and the external os pre- 
vent the escape of the instrument, 
while the arms prevent it from ascend- 
ing too high into the uterus. 
The introduction of the stem is not 
difficult. The instruments needed for 
its introduction are a Sims’s speculum, 
uterine dilators, a double tenaculum, 
a sharp curette and an applicator, all 
made aseptic by previous boiling. The 
vagina should be irrigated with some 
good antiseptic. Place the patient in 
Sims’s position, retract the perineum 
with Sims’s speculum, catcli the pos- 
terior lip of the cervix with the te- 
naculum if it be a retroflexion, the 
anterior lip if it he an antiflexion, and 
draw it down within easy reach. Then 
gently insert the dilators and dilate 
the cervix to the extent of from one- 
12 half to three-quarters of an inch. If 
the case be complicated with endo- 
metritis, as nearly all of them are, the 
uterus should be thoroughly curetted. 
After bleeding has ceased, which will 
be considerable in some cases, mop the 
cavity dry with absorbent cotton, and 
apply to the whole cavity equal parts 
of tincture of iodine and carbolic acid. 
The instrument, which should be about 
one-quarter of an inch shorter than 
the uterine cavity, previously meas- 
ured, is then introduced, and the 
operation is complete. The patient 
should remain in the recumbent posi- 
tion for two or three hours, at the ex- 
piration of which time the internal 
and the external os will have con- 
tracted sufficiently to prevent the 
escape of the instrument. As a rule, 
an anesthetic is unnecessary; but if 
the patient be very nervous or hys- 
terical, or the parts extremely tender, 
it is proper to give an anesthetic. The 
stem should be worn indefinitely, 
months if necessary. It does not in- 
terfere with menstruation nor prevent 
sexual intercourse, and in suitable cases 
gives no pain or discomfort. If the 
case is a retroflexion, the uterus must 
13 lie brought forward to the position of 
ante version, and a Thomas’s Smith pes- 
sary suitably adjusted. This should 
be removed, cleansed and re-adjusted 
at least once each month. After three 
or four months it may be removed 
permanently. 
The patient is instructed to return 
at stated intervals for examination, and 
to use once each day a vaginal injec- 
tion of hot water medicated with some 
astringent or antiseptic, if there are 
indications for their use. No other 
local treatment is required. If the 
case is a retroflexion the stem should 
be curved forward sufficiently to some- 
what exaggerate the normal anti-cur- 
vature of the uterus. The exaggera- 
tion of this curve, in cases of retroflex- 
ion, is a point of great importance, 
inasmuch as the uterus will require 
much less support from behind to 
maintain it in the position of antiver- 
sion, and is much less likely to fall 
backward again when the vaginal sup- 
port is removed. The lower part of 
the instrument, where the arms pro- 
ject, should be bent forward somewhat 
in order to prevent too much friction 
against the posterior lip of the cervix. 
14 When properly adjusted the lower spi- 
ral should set squarely within the cen- 
ter of the external os, the arms pro- 
jecting upward along the side of the 
cervix. Many of these cases will give 
a history of years of suffering. They 
are broken down in general health; 
they are weak, nervous,, irritable, hys- 
terical and sometimes almost on the 
verge of insanity. Such cases need, in 
addition to curettement and the stem, 
a general supervision of their habits. 
They need tonics, electricity, massage,, 
cheerful company, outdoor exercise, 
good food and refreshing sleep. 
There can he no question that in 
some cases the uterus will be found 
more or less immobile from adhesions; 
but judging from my experience, they 
are not so frequent as claimed by many 
authorities. Within the last three 
years I have had under my treatment 
more than thirty cases, and out of the 
whole number I found but one case of 
well marked adhesions, and this was 
complicated with cancer of the rectum. 
Two of these had been diagnosed as 
adherent by other gynecologists, who 
proposed the operation of hysteropexy 
for their relief. In both cases I sue- 
15 ceeded, without difficulty, in raising 
the uterus out of its abnormal position. 
Both have been cured. One year ago 
I delivered one of twins, and she is 
now pregnant again. The other is 
passing through the menopause, and 
her opportunities for exercising the 
maternal function are at an end. It 
should not lie forgotten that a uterus 
which for years has been crowded 
down in the hollow of the sacrum, 
may be so tirmly fixed that seemingly 
it is adherent when no adhesions ex- 
ist. If in any case adhesions are found 
to exist, they must be got rid of before 
we can hope to restore the uterus to 
its normal position. But the consid- 
eration and treatment of adhesions 
and other pelvic complications is not 
called for in this paper, and I shall 
therefore pass them without further 
notice. 
Laceration of the cervix is another 
complication sometimes accompanying 
flexion of the uterus; and if from its 
extent and condition we are satisfied 
that it stands in a causative relation to 
the flexion or the associated symp- 
toms, trachelorrhapy should be per- 
formed before the stem is introduced. 
16 If the cervix is greatly hypertro- 
phied or very much elongated, or the 
perineum lacerated, the proper plastic 
operations should be done before in- 
troducing the stem. 
Anteflexion, as a rule, is congenital 
in its character. But to this there are 
a few exceptions. When congenital 
the flexion is usually associated with 
a more or less infantile condition of 
the uterus. These cases usually men- 
struate scantily and suffer great men- 
strual pain. In such cases the intro- 
duction of the stem is all that is nec- 
essary. It relieves at once the painful 
menstruation, increases the flow and 
stimulates the development of the 
uterus to its normal size. Acquired 
anteflexion is usually associated with 
endometritis. These cases need the 
curette, followed by the introduction 
of the stem. 'No vaginal support is 
necessary. Now one word as to the 
use of vaginal pessaries as the only 
support to maintain a flexed uterus in 
its normal situation. I am very much 
surprised to find in some of our latest 
text-books cuts of ring pessaries, 
horse-shoe pessaries, and other pessa- 
ries having the shape of nothing in 
17 the heavens or the earth, designed and 
recommended for the purpose, of 
straightening the flexed uterus and 
maintaining it in its normal position. 
I wish to say that no vaginal pessary, 
of whatever shape or size, is capable 
of maintaining a sharply flexed uterus 
in its normal shape and position, un- 
less the distortion lie first, corrected by a 
surgical operation or by a stem worn 
within the uterine cavity. The retro- 
Hcxed uterus will invariably straddle 
the bar of the instrument, which, 
pressing upon the point of flexion, will 
in time complicate the case by produc- 
ing inflammation and ulceration at this 
point, and possibly setting up a pelvic 
inflammation. But if the retroflexed 
uterus be permanently straightened by 
other means, a properly adjusted re- 
troversion pessary worn for a few 
months is of the greatest service. In 
other words, a retroflexed uterus must 
he converted into a retroverted one be- 
fore it can he held In its normal posi- 
tion by retroversion pessary. 
In conclusion I beg leave to report 
the following eases: Mrs. I)., aged 
32, mother of three children, the 
youngest aged four years, consulted 
18 me in January, 1800. Since the birth 
of her last child she had suffered from 
menorrhagia, mettrorrhagia, dysmen- 
orrlia, constant backache, violent head- 
aches and leucorrhea. She was an- 
emic, greatly emaciated and hysterical. 
Indigestion, insomnia and loss of all 
interest in her affairs completed the 
picture of chronic invalidism. The 
ilterus was prolapsed, sharply retro- 
flexed, the os gaping widely and dis- 
charging a tenacious mucous tinged 
with blood. The sound entered three 
and a quarter inches. Since the birth 
of her last child she had had three 
miscarriages at the second or third 
month of gestation. During the fol- 
lowing fifteen months the uterus was 
divulsed and curetted several times, 
followed by boroglyceride tampons, 
hot douches and such other local and 
general treatment as was indicated. 
Although the physician who preceded 
me in the case had diagnosed adhe- 
sions and proposed a laparotomy, 1 
succeeded without much difficulty in 
restoring the uterus to its normal po- 
sition, but found it impossible to main- 
tain it there by a retroversion pessary 
on account of its persistent straddling 
19 of the bar of the instrument. Tn the 
course of three or four months the pa- 
tient made much improvement, but 
invariably grew worse when the treat- 
ment was suspended. 
In March, 1891, I again euretted 
the uterus, introduced my stem and 
adjusted a retroversion pessary. From 
this time her improvement was rapid 
and permanent. The retroversion pes- 
sary was permanently removed three 
months afterward. In six months the 
stem was removed, the patient having 
completely regained her health. Tn 
November, 1892, I delivered her of 
twins at full term, and 1 was recently 
engaged to attend her in another labor 
which is expected to take place some 
time in July. 
Case II. Mrs. S., aged 40, mother 
of several children, consulted me in 
January, 1891. This was the most 
distressing case of pruritis valvac that 
lias ever come under my notice. It 
made its appearance soon after the 
birth of her last child six years previ- 
ously, and had continued with occa- 
sional remissions in its severity up to 
the time that I was asked to take 
charge of the case. The skin cover- 
20 ing the lower part of the abdomen, the 
vulva and the inside of the thighs was 
in a chronic state of inflammation, and 
a plentiful crop of small boils were 
scattered over the surface. The con- 
stant itching and burning, always ag- 
gravated at night, rendered sleep well 
nigh impossible. Constant pain and 
loss of rest had made her a physical 
wreck. Examination revealed a 
sharply retroflexed uterus, apparently 
bound down by adhesions, the os gap- 
ing widely, from which issued a yel- 
lowish, acrid discharge. I dilated and 
curetted the uterus, and once each 
week treated the endometrium with 
equal parts of carbolic acid, iodine and 
glycerine. Boroglyceride tampons, 
hot douches with gentle efforts to re- 
store the uterus to its normal position 
completed the local treatment. Under 
this treatment the patient improved 
somewhat, but not until I succeeded 
in restoring the uterus to its normal 
position and holding it there with the 
aid of my intra-uterine stem did her 
improvement become permanent. She 
then, without further treatment ex- 
cept daily hot douches, rapidly re- 
gained her health. She has been per- 
21 fectly well for over two years, still 
wears the stem and will not permit its 
removal. As it gives her no discom- 
fort whatever I am content to let it 
remain. 
Case III and IV. Miss T. and Miss 
W. These cases were so alike in 
symptoms that I reported them to- 
gether. Both were natives of Illinois 
and unmarried. One aged 22, the 
other 24. Both had suffered intensely 
during their menstrual periods since 
the first menstruation at the age of 
15. One had anteflexion, the other 
retroflexion. Both had epileptic seiz- 
ures with each menstruation. One 
was admitted into my Sanitarium in 
September last, the other in Decem- 
ber. I divulsed the cervix in each 
case and introduced my stem. Neither 
one has since had a painful menstrua- 
tion, and the epileptic seizures have 
vanished. 
Case V. Miss D., aged 25, living 
in an adjoining county, consulted me 
in August, 1893. She had suffered 
from the most intense dysmenorrhea 
since her first menstruation at the age 
of 15, frequently having to take her 
bed at the onset of menstruation and 
22 remain there during the How. She 
had been under the care of various 
physicians, but had failed to get re- 
lief. Her general health was fairly 
good, but she was often annoyed by 
leucorrhea, backache, excruciating 
headaches, vesical irritation and ova- 
rian pain. Examination revealed a 
sharply antetlexed uterus, and a thick 
tenacious discharge from the cervix. 
On August 30th I divulsed and curet- 
ted the uterus and introduced my stem. 
Menstruation came on in a few days 
without pain or other inconvenience. 
She has continued to menstruate pain- 
lessly, and all other distressing symp- 
toms have vanished. She has been 
wearing the stem nearly nine months 
with perfect comfort. I examined her 
May 10th, 1894. The stem gives her 
no pain whatever, and the uterus was 
in its normal position. 
Case YI. Mrs. S., aged 23, married 
three years. Had suffered from in- 
tense dysmenorrhea since her first men- 
struation at the age of fourteen. I saw 
her in consultation with Hr. Martha J. 
Smith, Sept. 18, 1893. In addition to 
the dysmenorrhea she was subject to 
violent headaches, pain in the right 
23 ovarian region, leucorrhea, menorrha- 
gia, vesical irritation, backache, con- 
stipation and dyspepsia, besides many 
other ailments of a minor nature. She 
had never been pregnant. Digital 
examination revealed an anteflexed 
uterus. The sound entered two inches 
and a half, giving her considerable 
pain. I divulsed, curetted, and applied 
equal parts tincture of iodine and car- 
bolic acid to the endometrium and in- 
troduced the stem. The next menstru- 
ation was painless. On October 13th, 
she came to my office complaining of 
paroxysms of pain located in the sub- 
umbilical region. The pain was ex- 
cruciating, making its appearance each 
evening and lasting for three or four 
hours, when it would cease, only to 
appear again the following evening. 
Presure upon the abdomen revealed a 
considerable degree of tenderness. 
Digital examination of the uterus and 
upward pressure upon the stem re- 
vealed no tenderness whatever. She 
was ordered a brisk cathartic and told 
to report in two or three days. How- 
ever, the pain reappeared the next day, 
and kept recurring for several days in 
spite of treatment. Finally I removed 
24 the stem, thinking that it might be the 
cause of the pain. But the following 
day the pain recurred as usual. On the 
day following I discovered an impac- 
tion of the colon. This was relieved 
by a thorough irrigation with hot wa- 
ter. The evacuations were enormous, 
and the pain did not recur. On No- 
vember 18tli, the patient having had 
another painful menstruation, I again 
introduced the stem. She has not had 
a painful menstruation since, and all 
other symptoms have disappeared. 
She has worn the stem six months, 
and feels so perfectly comfortable that 
she does not care to have it removed. 
I examined her on May 10th, and found 
the uterus in its normal position and 
the stem giving her not the least an- 
noyance. 
Case VII. Mrs. N., aged 32, mar- 
ried and the mother of two children, 
the younger born eight years ago, con- 
sulted me in September, 1892. She 
had not been well since the birth of 
her last child. She was emaciated, 
nervous and hysterical. Suffered from 
violent headaches and backaches, a con- 
stant dragging sensation in the pelvic 
region, dysmenorrhea, constipation, 
25 gastric disturbance, difficult locomo- 
tion and insomnia. In short, she was 
a confirmed invalid. Had been for 
eight years under the treatment of the 
best physicians in this and other cities. 
Examination revealed a subinvoluted 
andretrohexed uterus apparently hound 
down by adhesions. At the second 
visit, however, I succeeded in lifting 
the uterus from its abnormal position, 
curetted and introduced the stem. The 
uterus was brought forward to the po- 
sition of anteversion and a retroversion 
pessary adjusted. I should say that 
every physician who preceded me in 
the case had attempted to hold the 
uterus in its normal position by a re- 
troversion pessary, but they invariably 
gave her so much pain that she could 
not tolerate them. The reason is plain; 
the uterus straddled the bar of the in- 
strument, making painful and injuri- 
ous pressure upon the point of flexion. 
However, after straightening the organ 
with the stem, she wore the retrover- 
sion pessary with perfect comfort; 
menstruation was painless and her im- 
provement was rapid. Six months 
afterward I removed the retroversion 
pessary permanently. The uterus now 
26 remained permanently in its normal 
position. I removed the stem one 
year after its introduction. I exam- 
ined the patient a few days ago. The 
uterus has its normal conformation 
and position. The patient is well. 
But this paper has already grown 
too long, and the report of other 
cases that have come under my treat- 
ment would he a mere repetition of 
the preceding. Suffice it to say that 
during the last two or three years 
I have treated thirty-two cases of flex- 
ion without a single failure. 
But please understand that I do not 
claim that this stem is applicable to 
all cases. I do claim, however, that 
it is applicable to all cases in which 
there exists no serious pelvic disease 
outside the uterus; that it will in 
many cases obviate the necessity of 
Alexander’s operation for shortening 
the round ligaments, and the opening 
of the abdomen to suture the fundus 
uteri to the abdominal wall, and all 
other operations for straightening the 
flexed uterus. And finally that it will 
cure almost every case of painful 
menstruation where the cause lies 
within the uterus. 139 North Meridian St. 
27