The case was one of cancer of the uterus which had spread to all the pelvic viscera; and in addition to this, the patient’s general condition was such that any operation was out of the question.  Yet the patient had never thought of the possibility of any uterine trouble sufficiently serious to make a local examination necessary.  It was only the loss of control over the bladder that drove her to seek a physician’s advice.

Case II.—­ Woman aged fifty-three years came to consult me because of pain, hemorrhage, and loss of weight.  There had never been any cessation of the menstrual period.  She said that she began to have irregular hemorrhages three years previously, and that they were constantly becoming more frequent and more alarming, and that, in addition to this, there was a constant discharge of blood, which necessitated her wearing a napkin all the time.  She also stated that for the preceding six months the pain had been so severe that she had not had one solid night’s sleep, and that in that time she had lost forty pounds in weight.

This patient was in the very last stages of cancer of the uterus, and all that could be done for her was to make her comfortable.  She had given birth to one child which caused a deep tear of the neck of the womb; and it is probable that this neglected tear was the primary cause of the cancer, which began in the neck of the womb.

Case III.—­ Woman aged forty-five years; married, but had never had any children.  She said that the periods were normal as to duration and amount, but that for the past two years they had two days ahead of time, and that for the past four months she had been having just enough irregular bleeding between the periods to keep her clothing stained.

On examination a diagnosis of cancer of the uterus was made.  The pathological examination proved this to be a most malignant type of cancer of the neck of the womb.  The entire uterus and appendages were at once removed.  And although the patient made an excellent recovery from the operation, she succumbed to the disease one year after the operation was performed.

These cases have been cited at length because they are all typical and because of the variety of symptoms and the great difference of age.  Only in one of the cases was there any very severe pain, and it was really the pain, which had become unendurable, which caused the patient to seek relief.

It is the concensus of opinion of the medical profession that cancer of the uterus is one of the common causes of death among women; that the cancer rate of mortality has increased during the last four decades; that it is most common near the time of the menopause; and that there is a direct causal relation between cancer of the neck of the womb and the traumatisms which occur during childbirth.