INTRODUCTORY.

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cost of subsistence, ancl properly enters into the sum total of the possible burden in­volved by the loss to effective industry of the working female. There is no lack of evidence going to establish the special tend­ency of uterine and functional disturbance to produce insanity, and of the predisposition of certain lines of female work to cause these disturbances. It is found that “ laborers ” hold the second place in numbers among the patients of the Massachusetts insane asylums, and that a large preponderance of these are females. Of these, it is believed that fully five per cent have found the direct or aggravating cause of their insanity * in

* “ It is certain, however, that disease of them (the gen­erative organs) may act as a powerful co-operating cause in the production of insanity, without giving rise, so far as we know, to a special group of symptoms. Thus, for example, melancholia distinguishable by no feature from melancholia otherwise caused may he the effect of dis­ease of the uterus. Schröder van der Kolk mentions the case of a woman profoundly melancholic who suffered from prolapsus uteri, and in whom the melancholia disap­peared when the uterus was returned to the proper place. I have met with one case in which profound melancholia