of the great organs in the abdomen. It is estimated that dilatation, and letting down of the stomach, will be found in sixty per cent, of all adult persons. Oftentimes there are no symptoms indicating this, but when present they point toward a series of disturbances resulting from loss of muscular quality in the stomach itself. In those whose abdominal walls are feeble the organs have a tendency to sag and droop. This produces a series of alterations in the relationships of the organs and particularly of the blood vessels and structures concerned in their function. In the case of the kidneys, whose support is largely through the vessels which enter and leave them, and whose shape is so nearly spherical that they move readily, the suspensory tissues are not seldom twisted, thus shutting off the passage of waste material and interfering with the action of the nerves to the extent sometimes of causing pain and suppression of the function. In females this tendency to ptosis falls seriously upon the genito-urinary cycle, hence the uterus and ovaries are thrown out of their normal adjustments. In women who have borne children the abdominal parietes have all suffered more or less overstretching, and the slackening of these supporting tissues works mischief and discomfort. In some men, too, this is experienced. It becomes especially conspicuous where faulty attitudes are added to the structural defect. I have elsewhere expressed my opinions more fully on this and offered suggestions for relief (Phila. Medical Journal, January 10, 1903). These visceral ptoses are recognized as of large significance and their remedy is a matter of increasing importance. It can be seen at a glance that misadjustments of the abdominal organs require attention, sometimes to a very pronounced degree. The first means of relief sought by women is by the use of various forms of the corset. This garment is so universally used that we are compelled to accept it as a necessity, although I am of the opinion that we could get along very well without it if it were possible to bring women to believe so. However, the main thing is to induce women to use those corsets which will do the least harm. A certain amount of harm inevitably must follow the use of a needless artificial support. The walls of the abdomen should be competent to support the contained viscera. Where these walls are notably defective they should be supported artificially only until they can be trained to do the work adequately for which they were constructed. It is an axiom that all artificial support is merely for the purpose of conserving function until the tissues can be brought back to the normal. The first thing to be acquired in getting rid of these defects is to teach the person to stand correctly and continue to maintain proper attitudes under all circumstances. Wherever there is a stooping position maintained without effort at holding the abdominal organs in place voluntarily, there is a tendency for the abdominal viscera to pour out over the brim of the pelvis, which is thus necessarily in a slanting position.
