SUPER-INVOLUTION.
This condition is the opposite of sub-involution. In the one there is incomplete retrograde metamorphosis, in the other there is excessive. The uterus is smaller than normal instead of larger; amenorrhea, instead of metrorrhagia, is an accompaniment. The amenorrhea need not be absolute, however; there may be a slight periodic discharge of a few hours duration although the uterus is lessened in size, and this is a point which materially modifies the prognosis in regard to the result from the insti tuted treatment. As long as there is evidence of ovarian activity we may hope for success from persistent treatment. In the absence, therefore, of external manifestation of ovulation, the presence of molimina is a favorable prognostic factor. Obviously the treatment called for is stimu lation. This may be secured in a variety of ways, such as by applications to the endometrium, the insertion of stem pessaries, the use of sponge tents, but unquestionably the most direct and powerful stimulant is the faradic current, applied by preference to the interior of the uterus by means of a double internal electrode, or else one electrode externally over the uterus and the other within the cavity. The applications of faradism
are called for in particular just before and during the presence of moli mina. In the intervals, frequent utero-abdominal galvanization should be resorted to, the negative pole being placed within the cavity to secure the local hemorrhagic effects. Constant treatment of this nature may result in enlargement of the uterus and in restoration of the menstrual periods, for we thus not only stimulate the uterus to growth but the ovaries as well to function. Where the super-involution has existed for some time and there is complete absence of molimiva, it is questionable if even persistent electrization will be of benefit, although it should always be given a faithful trial.