We have hitherto been considering inflammation as affecting the whole substance of the womb, but cases every now and then occur, where the upper parts are perfectly healthy, the disease being confined to the mouth and neck of the organ. The general symptoms very nearly resemble those of hysteritis, described in the former part of the lecture, but they occur in a slighter degree : patients complain, for example, of the same kind of uneasiness in the back and loins, great irritability of the bladder, with derange- ment of stomach, A dull heavy pain, at the upper part of the vagina, is also complained of, with an uncomfortable bearing-down sensation, this latter feeling often extending to the rectum. A white, opaque, slimy mucous discharge from the vagina is always present, the peculiarity of which will always assist the practitioner in his diagnosis, as it is present in no other variety of uterine disease. I will read to you a very accurate definition of its cha- racter, from the work of Sir Charles Clarke, " On the Diseases of Females," a book which ought to be in the library of every medi- cal man, anxious to obtain information upon those subjects on which it treats, for it is clearly the product of experience and ob- servation, not the act of a compiler. " This discharge," he observes, "is opaque, of a perfectly white colour, and it resembles, in con- sistence, a mixture of starch and water made without heat, or thin cream ; it is easily washed from the fingers after an examination, and is capable of being diffused through water, rendering it turbid. A morbid state of the glands of the cervix of the uterus, probably gives rise to this discharge ; at least the cases, in which it comes away, are those in which the symptoms are referred to that part ; and when pressure is made upon it, the woman experiences con- siderable pain." In order to judge accurately, it is necessary, as Sir Char es Clarke rightly observes, to make the examination after the female has been for some time perfectly quiet, as the common air becoming entangled with it. drawn by Sir C. C. : — " Such a mixture of mucus and air will not render the water turbid with which it may be combined, and this forms a distinguishing mark between hand the white mucous dis- charge." The great difference in the quantity will also assist in the diagnosis between this and the leucorrhceal discharge, the latter often flowing in large, whilst the former always occurs in small quantities. After the disease has existed for a lengthened space of time, this white discharge is no longer observable, the secretion becomes decidedly purulent, and sometimes streaked with blood, so that, in ordinary cases, we do not perceive the diagnostic dis- charge, for the female at the beginning of the affection feels no inconvenience, with the exception of trifling pain ; this, probably, too little to excite apprehension, or even attention, much less does she think it necessary to send for medical advice. Still, however, on inquiring into the early symptoms, you will be told that this appearance has been observed. A very careful vaginal examination is necessary before giving an opinion respecting the nature of the complaint. You will feel the os uteri to be tumid, the lips of which communicate to the finger the feeling of ^edematous effusion. Pressure, I have already told you, gives a certain degree of pain, though, in many cases, this is not a very urgent symptom. The finger when withdrawn, is sometimes mixed with purulent matter, mingled with blood. The freedom of every part but the os uteri from disease, and the total absence of fcetor, will prevent you from confounding the disease with carcinoma of the uterus. From what has been already said, with regard to the few unpleasant symptoms pro- duced, it is reasonable to believe that many of the cases get well without the medical man being referred to at all ; at the same time it must be acknowledged, that the consequences of the disease are occasionally most painful, and, therefore, when the opportunity is afforded, means for arresting the progress of the inflammation, or for removing its effects, ought to be promptly had recourse to. The functions of the uterus are not necessarily interfered with, at any rate until the disease has existed for several months ; menstrua- tion and conception appear to take place just as readily as at other times.